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hours; light activity the same day."},"final_result_months":{"min":1,"max":2,"unit":"months","qualifier":"Slimming of the lower face becomes visible from 2-4 weeks and peaks around 4-8 weeks as the muscle thins."},"fly_home_after_days":{"min":0,"max":1,"unit":"days","qualifier":"Flying is allowed the same or next day; no pressure-related restrictions."},"follow_up_visits":[{"purpose":"result_review","after":{"min":14,"max":30,"unit":"days","qualifier":"Optional review or touch-up assessment; often done remotely for international patients."},"requirement":"conditional"}],"indications":["Masseter hypertrophy causing a square or wide lower face","Teeth grinding (bruxism) with jaw muscle overactivity","Jaw clenching or tension-type jaw pain"],"main_risks":["Bruising, swelling or tenderness at injection sites","Temporary weaker chewing, especially with hard food","Uneven or asymmetric smile or contour","Paradoxical bulge of the masseter","Headache","Rare: diffusion to nearby muscles causing smile changes","Rare: dry mouth or reduced saliva","Possible facial gauntness or loss of fullness with overdosing","Rare: antibody formation with repeated high doses"],"pain":"Mild; brief pinprick sensations from fine needles, usually tolerated without anesthesia. Cooling or numbing cream is optional.","preparation":["Stop blood thinners, NSAIDs or fish oil beforehand, if approved","Avoid alcohol for 24 hours before","Arrive without makeup on the lower face","Tell the doctor about prior toxin treatments and neuromuscular conditions"],"recovery_timeline":[{"phase":"Day 0-1","description":"Small injection marks and mild tenderness may appear. Normal activities continue.","restrictions":["No massaging the jaw area","Avoid intense exercise for 24 hours"]},{"phase":"Weeks 1-2","description":"The masseter begins to weaken. Clenching and jaw tension ease.","restrictions":["Avoid very hard or chewy food if chewing feels tired"]},{"phase":"Weeks 4-8","description":"The muscle visibly thins and the lower face looks slimmer. This is the peak result.","restrictions":[]}],"rehabilitation_days":{"min":0,"max":1,"unit":"days","qualifier":"No formal rehabilitation; normal activity resumes the same day."},"result_longevity":"Typically 4-6 months. Repeat sessions are often needed 2-3 times a year, and the effect can last longer with repeated treatment.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Touch-up injection for asymmetry or insufficient effect within 1-2 months; excludes planned repeat treatments."},"scars":"No scars; tiny needle marks fade within hours to a day.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One injection session; repeat treatment is needed only after the effect wears off."},"stages":[{"code":"injection","label":"Botulinum toxin injection into both masseter muscles","after":{"min":0,"max":0,"unit":"days","qualifier":"Same visit."}}],"qualifier":"Single-visit treatment."},"success":{"metric":"Visible lower-face slimming or reduced masseter thickness","value":80,"unit":"percent of patients","horizon":"4-8 weeks after injection","population":"Adults with masseter hypertrophy receiving standard botulinum toxin injections","evidence_status":"limited"},"techniques":[{"name":"Standard masseter injection (3-5 points per side)","suits_whom":"Most patients with masseter hypertrophy, bruxism or a wish for jaw slimming","recovery":"No downtime; the effect appears in 2-4 weeks."},{"name":"Ultrasound- or EMG-guided injection","suits_whom":"Patients with asymmetry, a thin muscle or previous uneven results","recovery":"No downtime; slightly more precise placement."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.25,"max":0.5,"unit":"hours","qualifier":"Includes assessment, marking and bilateral injections; the injections themselves take about 10 minutes."},"initial_assessment_documents":["Front and side photos of the face","Photo of the jaw while clenching teeth","Previous botulinum toxin treatment dates and products","List of blood thinners","Note on pregnancy or neuromuscular conditions"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single injection session; can fly home the same or next day. Results develop over 2-8 weeks."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask who will give the injections, as this may differ from the prescriber","scope":"procedure","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"The person giving the injections does not have to be the same person who gave you the prescription.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C2","text":"Confirm the person giving the injections is trained and safe to do so","scope":"procedure","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"But the prescriber must ensure that the person giving you the injections is trained and safe to do so.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C3","text":"Check that a consultation with a doctor or nurse happens before the botulinum prescription","scope":"procedure","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"They can only be prescribed after a consultation between you and a healthcare professional, such as a doctor or nurse.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C4","text":"Ask the practitioner what could go wrong, and which products they will use","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/before-you-have-a-cosmetic-procedure/","host":"nhs.uk","quote":"Ask them about the procedure, the products they'll use and what could go wrong.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C5","text":"Check the practitioner has the right insurance to correct anything that goes 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with no time to think after the consultation","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"Your practitioner should give you time after your consultation to decide whether you want to go ahead with the procedure.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F2","text":"The offer is promoted by a social media influencer, who is usually paid","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/before-you-have-a-cosmetic-procedure/","host":"nhs.uk","quote":"Social media influencers are usually paid to advertise the service.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F3","text":"The practitioner cannot say what could go wrong with the procedure","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/before-you-have-a-cosmetic-procedure/","host":"nhs.uk","quote":"Ask them about the procedure, the products they'll use and what could go wrong.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F4","text":"No consultation with the person who will do the procedure before the final decision","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"Always book a consultation with the person who will do the procedure before making your final decision.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F5","text":"The offer does not identify who prescribed the botulinum toxin or who will inject it","scope":"procedure","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"who the prescriber is; who'll be giving the actual treatment","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Trouble breathing","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/drugs/18160-onabotulinumtoxina-injection-cosmetic-use","host":"my.clevelandclinic.org","quote":"Get medical help right away if you have problems with breathing, swallowing, or talking.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W2","text":"Trouble swallowing","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/drugs/18160-onabotulinumtoxina-injection-cosmetic-use","host":"my.clevelandclinic.org","quote":"Spread of botulinum toxin effects—unusual weakness or fatigue, blurry or double vision, trouble swallowing, hoarseness or trouble speaking, trouble breathing, loss of bladder control","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W3","text":"Trouble talking","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/drugs/18160-onabotulinumtoxina-injection-cosmetic-use","host":"my.clevelandclinic.org","quote":"Get medical help right away if you have problems with breathing, swallowing, or talking.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W4","text":"Unusual weakness in other muscles","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/drugs/18160-onabotulinumtoxina-injection-cosmetic-use","host":"my.clevelandclinic.org","quote":"Tell your care team if you feel unusually weak in other muscles.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W5","text":"Facial, lip, tongue, or throat swelling","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/drugs/18160-onabotulinumtoxina-injection-cosmetic-use","host":"my.clevelandclinic.org","quote":"Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge 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