Services - Seattle Jaw Surgery

Botox is not only used for cosmetic purposes. At Seattle Jaw Surgery, we offer Botox as a clinical treatment for patients experiencing jaw pain, chronic muscle tension, and TMJ-related discomfort. It is sometimes referred to as “Botox for TMJ” because of how commonly it is used to address TMJ-related symptoms.

How it works

The masseter muscle, located on either side of the jaw, is responsible for chewing and clenching. In patients who grind their teeth, clench habitually, or have chronic jaw tension, this muscle can become overactive and enlarged. Over time, the sustained pressure it generates contributes to jaw pain, headaches, and accelerated tooth wear.

Botox injected into the masseter temporarily reduces the activity of the muscle. As it relaxes, patients typically experience a noticeable reduction in jaw tension, pain, and clenching force. For patients with tension headaches originating from the jaw, treatment of the temporalis muscle may also be recommended.

Who performs the treatment

All Botox consultations and treatments at Seattle Jaw Surgery are performed by Andrea Burgess, PA-C. Andrea’s background in oral and maxillofacial surgical care means she approaches this treatment with a detailed understanding of jaw anatomy, muscle function, and the relationship between the masseter and the broader TMJ complex.

Is it right for you?

A consultation is the appropriate first step. At that visit, Andrea will complete a full assessment of your jaw, muscles, and joint function. If Botox is the right fit, treatment can typically be completed the same day. If a different approach would be more effective, you will leave with a clear understanding of your options.

Masseter Botox may be appropriate if you experience:

Chronic jaw pain or tightness
Teeth grinding or clenching (bruxism)
TMJ discomfort that has not resolved with conservative treatment
Tension headaches related to jaw muscle activity
Facial width you would like to reduce

Benefits

Patients who respond well to masseter Botox typically experience:

Reduction in jaw muscle tension and chronic pain
Decreased force of clenching and grinding
Relief from tension headaches with a jaw muscle component
Progressive reduction in masseter hypertrophy with repeat treatment cycles
Softening of lower facial width

Risks

As with any injectable procedure, there are risks to be aware of prior to treatment:

Insufficient relief from muscle tension or pain
Temporary nerve weakness affecting smile movement or eyebrow elevation
Bruising at injection sites
Infection (rare)

Schedule a consultation

To schedule a TMJ consultation with Andrea Burgess, PA-C, contact our office by phone or email.

[(206) 207-1525] | [info@seattlejawsurgery.com]

For a full walkthrough of the appointment process, visit: What to Expect at Your Masseter Botox Appointment.

Coming Soon.

Upper Jaw

Upper jaw surgery is most commonly a Le Fort Osteotomy. This is a surgical technique that moves the upper jaw in three dimensional space. The surgery either moves the upper jaw to the lower teeth position (single jaw surgery) or into a three dimensional position to optimize form and function of the face.

Surgery on the upper jaw may be performed to correct:

Significantly receded or protruding upper jaw
Crossbite
Too much or too little teeth showing
Open bite
Reduced facial growth of the middle of the face (midfacial hypoplasia)

Your surgeon cuts the bone above your teeth so that the entire top jaw – including the roof of your mouth and your upper teeth – can move as one unit. The jaw and upper teeth are moved forward until they fit properly with the lower teeth. This can be planned on a computer to determine if additional work, such as orthodontics, will be needed to help correct any remaining fit difference.

An open bite occurs when excess bone grows above the molars, causing what’s normally a flat, even surface, to become angles. To fix this, excess bone is removed or shaved away. Once the jaw is realigned, plates and screws hold the bone in its new position.

Lower Jaw

A mandibular osteotomy (lower jaw surgery) can correct:

Receding lower jaw
Protruding lower jaw

The surgeon makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. The jaw can then be moved to its new position either forward or backward. Plates and screws hold the jawbone together as it heals.

Coming soon.

A genioplasty can correct a small chin (deficient chin). A small chin often accompanies a severely receded lower jaw. Typically, surgeons can alter the jaw and restructure the chin during the same surgery. The surgeon cuts a piece of the chin bone on the front of the jaw, moves it forward, and secures it in a new position with plates and screws.

Customization of hardware has always been a part of jaw surgery. We bend each plate and adapt each screw to your individualized anatomy. For TMJ surgery, replacement devices are fabricated by hand to fit your individual anatomy. These are all invaluable and have been a mainstay of contemporary orthognathic surgery

Over the last 5-10 years, hardware companies have been promoting 3d printed hardware. This type of hardware can be a very useful tool in complicated surgical situations such as cancer or trauma reconstruction. Dr. Bobek uses this type of hardware during jaw surgery with some inverted L osteotomies, some revision surgeries, and with some inferior positioning of the maxilla surgeries.

The trouble with the 3d printed hardware is cost. Jaw surgery can be very expensive and increasing the absolute cost of hardware by 5, 10, or even 15 thousand dollars seems wasteful for routine surgeries. American healthcare is plagued with cost overruns and it is our belief that the large hardware companies are marketing these devices to make more money. We value transparency in cost and being good stewards with all of our resources.

There has been no evidence that 3d printed hardware improves surgical outcomes or decreases surgical time for routine orthognathic surgery. Again, it is very useful in complicated scenarios, but we just cannot justify the cost for the vast majority of jaw surgeries. At Seattle Jaw Surgery, we will consider your situation from all aspects – quality, cost, risk and benefit. Come see us to see which kind of hardware is best for you!

Coming Soon

At Seattle Jaw Surgery, we uniquely involve patients in the process of their surgical planning. Each person now sits down with Dr. Bobek to “fly through” and adjust the surgical plan. He involves you in your preferences for surgery, customizing the amounts of movement, location of bony cuts and accounting for the particular risks in your anatomy. We find that patients learn much more from seeing and interacting with the actual 3 dimensional planned movements. Unfortunately, most centers give you pdf images of what they think is right. We want you involved!

Here is an example of how planning was used to correct the way the teeth fit while also narrowing the lower jaw. This improved the jawline esthetic while improving the function of the teeth.

At Seattle Jaw Surgery, we are on the cutting edge of planning. We use the latest technology for digital impressions of teeth, low dose, three dimensional CBCT imaging of the face and versatile surgical planning software. This allows for a comfortable patient experience while understanding what will be happening in surgery. Our all digital workflow allows for easy coordination with orthodontists and coordination of care for patients living far away from Seattle.

Jaw surgery planning has not always been this way! Traditional surgical planning involved dental impressions, clinical examination, 2 dimensional xrays and face bows. It is amazing that the surgeons at the time did such an excellent job with such limited data. Dr. Bobek has the unique experience of training in the traditional surgical planning while also being involved in the advancement of virtual surgical planning.

Virtual surgical planning shines in complex situations. Since jaw surgery is performed through very small incisions, the ability to visualize complex movements and trouble shoot difficult situations makes the surgical teams work much easier.

Here, more than 4cm chin advancement is planned with TMJ replacement devices, a segmental upper jaw surgery, and a subapical osteotomy.

Unfortunately, virtual planning isn’t perfectly accurate. Errors commonly are noticed in midlines of the upper and lower teeth, TMJ position, the way the teeth fit, and asymmetry. Our team has planned thousands of cases and we are always on the lookout for better ways to do things!

A good example of how virtual planning can be inaccurate is in head position. Here is an example of how much head position alters the final plan.