If you got Botox and developed the Botox “boba” phenomenon, what is the fastest solution and how much does it cost?

Hello.

This is YeKum Dental Clinic, located right across from Samsung Main Building, Exit 7 of City Hall Station in Seoul.

Our clinic is one that many foreign patients visit. Among foreign patients, many receive Botox procedures at other dermatology clinics in Korea as well, and among those, many get jaw Botox. So when side effects occur, foreign patients, able to speak English, often look for our clinic because we perform Botox frequently.

Jaw Botox is a very safe procedure, but among all patients who receive it, there are very few who experience side effects. This is a side effect known in papers and academic sources as the “boba” phenomenon, which only about 0.5% to at most 1% of patients experience. Foreign tourists who experience this side effect at another clinic often search around and come to us.

In cases like this, people seem to think that rather than aesthetics, the side effect should be removed quickly through treatment. That may be why they come to a dental clinic like ours rather than the aesthetic clinic where they received Botox.

(In the case of our clinic, since opening in 2018, for 7 years we have performed more jaw Botox than other dental clinics for TMJ Botox and bruxism Botox, but only one patient has experienced the boba phenomenon. Many dental clinics also perform jaw Botox to prevent teeth from being damaged by excessive chewing force.)

[We only disclose cases with the patient’s consent.]

▲This is a patient who received jaw Botox for cosmetic reasons at another dermatology clinic and experienced the Botox boba phenomenon.

A phenomenon called paradoxical masseteric bulging

The compensatory Botox boba phenomenon is a side effect that sometimes appears rarely. After receiving Botox in the jaw, it can appear as early as about a day later, 2 to 3 days later, or around a week later, and so on.

Rather, every time they chew, it pops out noticeably, so if it happens on only one side, it can look even more asymmetrical, and when eating, it can be noticeable enough to the person sitting across from them. In severe cases, it can even feel like it bulges every time they chew.

Is it Frog Boy Tutu (?)?

One patient even said, “It looks like a frog cheek.” I think they probably said that because it looked like Tutu’s cheeks from Frog Boy.

In general, it is not that the muscle is large and the jaw or temporalis muscle bulges every time you chew, but rather it protrudes conspicuously like holding a boba candy in the cheek, as in the patient in the video below.

Botox is injected into a deep layer, and if the ligament tissue is tough, it may not spread well from the deep layer to the superficial layer, causing this symptom. There are also various theories, such as when the Botox does not spread evenly enough to weaken the activity of the muscle injected in multiple branches, causing nearby muscles other than the weakened muscle to become more active; when the split portions of the masseter do not receive Botox evenly, resulting in both relaxed and contracted areas at the same time; and when the muscle is larger, it tends to occur more often.

Usually, if you wait about a week after symptoms appear, they often disappear, so you can wait. Or, if the symptoms are severe or need to disappear quickly (for example, if a wedding or a photo shoot is coming up), a method is used to make them disappear faster.

What is the method to make the boba phenomenon disappear quickly?

You got jaw Botox to look prettier and slimmer, but if it bulges every time you chew, that would be very difficult. Especially if you have important events coming up, such as a wedding, a blind date, a family meeting, or a broadcast, and you got Botox to make the square-jaw area slimmer, but the wedding or photo shoot is right around the corner, it can be extremely discouraging if the hospital tells you to wait a week. Also, staff members who are not medical professionals and do not know better may misunderstand it as swelling after the injection and say, “You may have swelling after Botox. Wait longer.”

Then it would be truly awful.

And sometimes the symptoms continue for more than a week. (There was actually a patient who received it at a skin clinic and came to us because it had lasted more than a week.) Of course, it would be good to wait a week, but for those who cannot, what is the method to make it disappear quickly?

You can inject a little more Botox into the bulging area. If more is injected, it disappears quickly, around the same day or the next day. Because it is being injected for a side effect, even if you get Botox at a factory-style dermatology clinic, we recommend getting the post-side-effect touch-up from a medical professional with a lot of experience.

Treatment cost for the boba side effect

If you wait a week, there is no cost, but if you need to get rid of this side effect quickly because it is urgent (wedding, broadcast, wedding photos, etc.), you will need to pay for treatment. If you receive the touch-up at the same place, it may be free or only a small fee may be charged, but if you receive treatment for the side effect at a completely different place, there will naturally be a cost. In our clinic, the Botox cost for this boba side effect is 110,000 KRW, which is 100,000 KRW plus 10% VAT.

(For domestic products. For imported Allergan, the cost is double.)

(This is the same as the cost of square-jaw Botox.)

Therefore, whether you wait a week, or get a touch-up again at the same place, or pay extra and receive touch-up treatment somewhere new, you can decide according to your own situation. However, when receiving a touch-up, please be treated by a medical professional who has a lot of experience and knows well how much dosage should be injected.

Jaw Botox is not a permanent treatment, so whatever side effect occurs, it is a treatment that allows the side effect to disappear well. Even if you develop the boba side effect, please do not worry too much, and depending on your situation, either keep observing it a little longer or get a touch-up!

This was Yeonsei YeKum Dental Clinic, located at Exit 7 of City Hall Station in the center of Seoul.

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Yeonsei YeKum Dental Clinic, which foreign visitors from overseas intentionally come to visit