How many units of botox is required to treat masseter hypertrophy where the hypertrophy on the right side jaw is more than left?

hi. I am opting for botox injection treatment for reducing my jaw masseter muscles (left and right). however the hypertrophy on the right side of my jaw is relatively more then my left side, as i had the habit of chewing things ONLY on my right side for years. so the units of botox going to be administered will be more on the right and less on the left? or the amount will be the same on both sides? in either cases what will be amount of units going to be administered? Thanks in advance :)

Doctor Answers 11

Botox for masseters

Hello, and thanks for your question. If your masseters are asymmetric, then one will likely need more units than the other side. It's impossible to say for sure what you'll need without examining you. Men generally require more units than women, and everyone is a little different. I recommend seeing an expert. Best of luck, Dr. Frucht.  


Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Reduction of masseter

Skilled, board-certified injectors commonly treat the masseter area.  Twenty to thirty units is more of a typical treatment dose, whereas five to ten units is generally not very effective.  However, it really depends on both the cosmetic and functional result you are treating.  If is it more cosmetic, and you are really trying to shrink the masseter muscle, the dosage needs to be higher.  It’s better to start conservatively, but in my experience, a minimum of 15 units per side is needed for an aesthetic result.  Other options such as Xeomin or Dysport also work equally well in this area or even preferred depending on the amount of reduction you are seeking.  I hope that is helpful and best of luck.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 64 reviews

Botox for masseter

Best to use good amount to target this large muscle group.  25 units is what the books say, take +/-5 units each side.  Your injector will determine if she or he needs more on a particular side or not. Hope that helps,Yazdani, MD

Botox for masseters - How much required

An in-person evaluation is usually required to determine how much Botox you will need. Generally, I start with 15-30 units of Botox into each masseter muscle. At followup, additional units can be injected as needed. Men usually require higher doses. In your case, the right side may require more than the left.

Botox and Results -- MASSETER

the average dose is 15-30 units per side and this can be tailored to the amount needed per muscle.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Botox for masseter muscles

The amount of Botox required for treating the masseter muscles depends on the size and strength of the muscles.  A cosmetic dermatologist can determine the amount needed by examining you.  Twenty to 40 units per side is the average amount and one side may require more than the other.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 21 reviews

Botox for Massater hypertrophy

I typically use 30 units per side for both Massater Hypertrophy and TMJ treatment.  If one side is smaller or less painful (in TMJ) I use less.  I have found that this dose lasts longer and is more effective.  I recommend a retreatment in 6 months.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 211 reviews

Masseter and Botox

I usually use a about 25 units per side on average. If the one side is a bit smaller I may use a bit les.  Best to be evaluated in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

How many units of Botox is needed to treat masseter hypertrophy?

Thank you for your excellent question.  If there is a distinct size asymmetry between your masseters I would favor adjusting dosing to compensate for this.  I would recommend approximately 15-20 units in the smaller side and 20-25 units in the larger side.  See a board certified plastic surgeon in consultation to maximize your results.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Botox for masseter muscles

I typically start with around 15 units on each side and would recommend that you proceed further in a stepwise matter. If you need more on one side this can be done incrementally to ensure that the desired outcome is achieved.

Pamela Stuart, MD
San Jose Physician
5.0 out of 5 stars 2 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.