How Much Units of Masseters Botox to Start With?

My Doctor is compelling me to go for Masseters Botox, he said 2 sittings will be required, at first sitting he would inject 100 units of Botox at each side and after 6 months one more sitting will be required. I think 100units on each side is a high amount to start with, but my Dr says, for effects to show min 75units must be injected , less than that does not work. I have been reading here at realself people getting benefited from even 25units. Please guide me.

Doctor Answers 12

Botox 75 Units Per Masseter?

75 units of Botox per masseter is not necessary.  The doctor is most likely referring to Dysport, which is about 3:1 Botox.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 334 reviews

435 North Roxbury Drive
Beverly Hills, CA 90210

Don't let anyone "compell" you to have botox anywhere you don't want...

if you and the doctor agree your masseter muscles are too large and you want to improve your look, then of course botox is the perfect solution to the the old days, massive amounts of botox were used, but today we know the same benefits accompany much smaller doses...I frequently start with only 15 units per side and if needed add a little more in a month or so...then the results typically last for about a year...most doctors tend to use slightly higher doses...about 25-35 units/side...

Ken Landow, MD
Las Vegas Dermatologist
4.5 out of 5 stars 9 reviews

10080 Alta Drive
Las Vegas, NV 89145

Botox and the masseter muscles

The number of Botox units required depends on the strength of your masseter muscles, your gender and the shape of your face.  Most people benefit from 20 to 40 units per side.  100 Botox units per side is excessive.  Did he mean Dysport units?  If you are interested in treating your masseter muscles, either discuss the product and amount with your doctor or seek another opinion.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 20 reviews

1849 Yonge Street
Toronto, ON M4S 1Y2

Depends on the patient

You are correct that 100 U on each side sounding excessive. Generally at a minimum we start treating at 20u/side, and increase all the way up to 50u/side depending on the size of the muscle. Perhaps they were referring to Dysport units, which would make more sense of 50-80 units per side. Have your physician clarify with you which toxin is recommended and the difference in conversion of units.

David W. Kim, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

55 Francisco Street
San Francisco, CA 94133

Appropriate dosage for Botox and Dysport for masseter reduction, "V-line" procedure

100 units for each side is excessive.  You should notice a marked improvement with an initial treatment of 25 units per side.  With serial treatments, even with 20 units per side it should be possible to virtually eliminate the activity of the masseter muscle causing the bulky appearance along your jawline.  

Even for Dysport, 100 units is excessive.  50-70 units per side with Dysport produces excellent results.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

120 South Spalding Drive
Beverly Hills, CA 90212

Botox for masseter muscle reduction

I recommend 40-50 units and that seems to be effective in my practice - it is very important to have someone inject masseter muscles who has exerience doing it. You can always add more ... and good follow-up is a must.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
5.0 out of 5 stars 27 reviews

5225 Sheridan Drive
Williamsville, NY 14221

Botox for jaw reduction

Dear pari1987,

  • I like starting with 30 units on each side and bumping up the dosage as needed
  • If you can still clench your jaw after 2 weeks, then we add more
  • Some people do start with 100units so everyone is a little different

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews

201 South Lasky Drive
Beverly Hills, CA 90212

Masseter requires much smaller dose

The masseter is a thick, somewhat quadrilateral muscle, consisting of two parts, superficial and deep. The fibers of the two portions are continuous at their insertion. The masseter muscle is sometimes the target of plastic jaw reduction surgery.The superficial portion, the larger, arises by a thick, tendinous aponeurosis from the zygomatic process of the maxilla, and from the anterior two-thirds of the lower border of the zygomatic arch. Its fibers pass downward and backward, to be inserted into the angle and lower half of the lateral surface of the ramus of the mandible.
Deep.  The deep portion is much smaller, and more muscular in texture. It arises from the posterior 3rd of the lower border and from the whole of the medial surface of the zygomatic arch. Its fibers pass downward and forward, to be inserted into the upper half of the ramus and the lateral surface of the coronoid process of the mandible.

The deep portion of the muscle is partly concealed, in front, by the superficial portion; behind, it is covered by the parotid gland.


I use 5 units of Botox with a 90% response rate for grinding and for reduction 15-20 units per side



Arnold W. Klein, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

9615 Brighton Way
Beverly Hills, CA 90210

Masseter botox

I think that it is important to be conservative when injecting botulinum toxin in muscles that have important serve important functional or aesthetic purposes.  This is particularly true when injecting around the mouth.  The massester muscles serve important masticator (chewing) function.  For this reason, it is important to not overinject these muscles.  I start with 20-25 units per side.  This leaves enough motion of the muscle to allow adequate function.  

Jonathan Sykes, MD
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

2521 Stockton Blvd
Sacramento, CA 95817

How Many Units of Botox for Jaw Reduction

Hi Pari.  We agree that the dose being suggested is high.  We use 50 units total, 25 units each side and set the expectation that the patient should return several times in a year.  You may get longer duration with this higher dose, but it seems like overkill to us. 

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

23211 Hawthorne Blvd.
Torrance, CA 90505

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.