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Is There a Way to Reserve the Effect of Botox on Jawline?

Hi I got a Botox (Dysport) injection on my jaw line 2 weeks ago and I'm starting to notice my jaw line slimming down. I'm satisfied with the result, but I'm concerned because my friend told me that repeated process of Botox injection make your body tolerant to Botox and will not give me the same result as it did in the first place? Is this true?

Doctor Answers 7

Botox and Dysport for jaw slimming

Thank you for your question. Botox or Dysport can be a very effective way to contour the jaw line by reducing the masseter shadow through the outer jaw skin. In addition, it can reduce symptoms of jaw clenching or grinding of teeth at night time. This is an advanced technique that requires a strong understanding of the underlying anatomy. Some side effects can results in some very unintented effects. This can include affecting the smile due to diffusion of the Botox into neighboring smile muscles. Over treatment can also overweaken your jaw muscles making it harder to chew food and causes your jaw muscles to relax too much when you sleep.
The injection technique does vary by physical exam and the goals of the treatment. Facial contouring goals may change the injection sites themselves to affect different portions of the masseter as well as the dose. The strength of the masseters can be felt by palpation and also helps me to determine dosing. In general, I start with 15- 25 units of Botox (OR 50-75 units of Dysport) per side for most patients. If they have very strong masseters, then I may increase the dose, but more commonly ask them to return in three weeks for a touch up. Once you get the desired result, I let patients know that future treatments may require less to maintain the look or the jaw clenching symptoms, especially if they get treated as soon as they notice the symptoms return. This can be as soon as three to four months, but in some cases, patients report that it lasts six months or more. I find it depends on the dose we use and how many times we have done the procedure as the duration may lengthen for patients that repeat it regularly.

Tolerance or resistance to botox is extremely rare

It is very very rare for providers of cosmetic botox to see an immunity or tolerance develop to botox. The numbers of patients that physicians see who need to come in much more frequently that they did years ago when first having botox is very low.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 34 reviews

Botox resistance


If you like the results you have achieved from Botox in the masseter muscle, you shouldn't let a fear or worry about resistance disuade you from future treatment...quite the contrary actually.  If you keep up with a regular series of injections in that area the muscle will weaken with time and you may require less Botox less often.  If you go long periods between treatments the muscles will only have more time to strengthen in between and you'll be back to square one.  Resistance is rare in cosmetic patients.  If resistance is a concern for you, you can also try Xeomin, the newest Botulinum Toxin Type A.  It has less of a protein coat which should theoretically make it likely to cause resistance.

Good luck~

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 96 reviews

Is Botox resistance a concern?

Although not common, Botox resistance does occur as evidenced by one of our staff members experience.  This potential should not be a concern if patients are avoiding a routine of frequent treatments that are not spaced at least three months apart.  

With regards to your specific question, it is important to follow the treatment plan that your injector outlined to maintain and receive optimal results for the Masseter muscle.  In our practice, the recommendation is another treatment close to four months after the initial one.  Once optimal results are achieved within the first year with 2 to 3 treatments, outcomes may be sustained for approximately 2-3 years.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Is There a Way to Reserve the Effect of Botox on Jawline?

 No, true resistance to neurotoxins is exrtremely rare.  You will get repeated results from the Botox injections.  Be sure the MD performing the Botox treatments understands and follows the proper aesthetics of facial beauty when slimming down the Masseter muscle.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 14 reviews

Your friend is wrong

you can use Botox or Dysport repeatedly for many years. It is extremely rare to develop resistance to the drug. It should work the same for many many years.

Jeffrey Schiller, MD
Staten Island Oculoplastic Surgeon
5.0 out of 5 stars 10 reviews

Botox / Dysport for wide jaw line.

I guess you could build up antibodies but I haven't seen this clinically. It's important to stick with intervals of 3 or more months between injections so that this isn't an issue. With the jaw line, I have had excellent results with Dysport as well as Botox. I prefer Dysport because it seems to last longer. Muscles undergo atrophy with not used. This is the case with the toxins and their effect. Therefore the treated muscle shrinks and this usually means less toxin needed at subsequent injections.  Plus I find that I can spread out the intervals more and more as time goes by. Stick with it, and feel your jaw muscles regularly so that you know if they are starting to increase voluntary contractions.  It's at that point you probably need another injection or at least a follow-up with your doctor. 

Justin Yovino, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.