I find that Botox is very helpful in patients with TMJ in whom conservative measures have been unsuccessful. As with any other treatment site, the muscle mass of the site being treated determines the dose to be delivered. I usually start with 15 units per side, distributed in the areas of maximal hypertrophy/tenderness.
I inject 25 units per side and it usually lasts 3-4 months. This is a very large muscle and in order to obtain a good result sufficient amount of the toxin is necessary.
The dose for masseter muscle hypertrophy varies with the magnitude of the muscle, varies with male or female, and varies if TMJ symptoms are present. In general I start with 5 to 15 units per side and I see the patient in 6 weeks. We then see the effect and decide if additional is necessary. I find each patient is very different and the dose varies both in number of units and in frequency. My Best, Dr C
I usually start with 6 to 8 units per side and gradually increase based on patient feedback. The starting dosage will depend a little on the magnitude of your hypertrophy. The injections are very effective and very simple to perform
in experienced hands.
The effective dose does vary a little from person to person. 6 units per side, is not enough for some of my patients, so I usually recommend 12 units per side, 24 units total, which is the same dose recommended for crow's feet.
For the first treatment, 6 units each side, in 3 separate injections is effective in most women.
The location of Botox injection must be carefully selected. Injected too high and your smile becomes unnatural because of weakening the zygomaticus muscles.