Masseter Botox - is 5 Units Per Side Enough? (photo)

I would be surprised if you could detect much of a difference with 5 units per side.  Perhaps he meant 5 units per site?  5 units per site distributed over 5 sites (for a total of 25 units per side) is a very effective initial dosage for most patients.  For the initial treatment, some additional units may be necessary on follow-up 1-2 weeks later to achieve full relaxation of your masseter.  

I reserve 10 units per side for people with thin faces that want to address clenching problems.  For facial slimming, you may see modest results with 10 units, but, based on your picture, I suspect that you may need at least 15 units per side, depending on the bulk of the muscle and your goals.  

Thank you for your question. Botox in the masseter region usually takes longer than in the standard areas to take effect. I tend to use anywhere from 15 units (conservative treatment) to 50 units (for someone with really strong masseters) on each side to get the desired result. It may start within the first week but I tell my patients to wait three weeks before doing a more thorough evaluation. The treatment typically lasts longer than the forehead/crows feet/frown regions. It is also a gradual onset of the return of masseter function. I have tried the masseter injections myself and space the treatments around 4 months apart, but use smaller doses to maintain the effect. I normally know the effects are wearing down when I start to clench my teeth more heavily at night when asleep.

For masseter treatment, 5 units is small and certainly not likely to harm you.  Generally, I start with 15 units per side.  In looking at your photo, I wonder if you might do well with other approaches.  Before prescribing yourself a treatment which is essentially what you are doing, you might consider having an actual consultation to see what a cosmetic surgeon recommends to help you achieve your goals.

If you really have masseter hypertrophy, and are hoping that reducing it with Botox will make your jaw look less wide, then 5 units is insufficient.  25 units per side works well depending on the size of the muscle, but would be appropriate for most women.

 

In my experience 5 units for of Botox in the masseter for jawline slimming is NOT enough, especially for the initial treatment. The injector's own website states that the injector, who is an anesthesiologist BTW, has performed "hundreds of injections" during their career. Most plastic surgery offices perform hundreds of Botox treatments per month. You might consider seeking a more experienced second opinion. I hope this information is helpful.

Stephen Weber MD, FACS

Lone Tree Facial Plastic Surgeon

Hi Anne.  We use 25 units per side and we usually repeat treatments every 4-6 months.  5 units would seem to be way too little to accomplish much.  Good luck.

Five units of Botox per side will do very little, if anything to reduce the size and/or strength of your masseter muscles. Without doing an assessment in person, it's difficult to say what the exact dose would be for you, however, injecting 30 to 50 Units per side to see some significant changes is more common.

Botox in the masseters can be very helpful for reducing the strength and size of this muscle which can soften the jawline and achieve a beautful contour in that area. Typically 5 units is a small dose for this area but more can be added, usually 20 to up to 50 units per side depending on how large the muscle is and how much of an effect you're looking for. 

In general, 5 units of Botox is not enough. More like 20-30 units per side.  In fact, you might not see a change until you have used it regularly for several treatments.