Botox 3 times in masseter, is it going to be permanent?

I had mildly hypertrophied jaw muscles. I got botox injection,25 units each side last yr. I felt it over slimmed them and looked very odd .So got only 10 units next time ,3mnths bk, and 5 units each side very lately. Issue is post latest injection of just 5 units, it again seemed to have over slimmed massters. I am afraid there might be a chance of it being permanent. Can you please suggest? How long can it take for muscles to be back? What should be the dose next time? Many thanks in advance!!

Doctor Answers 4

Botox injection to reduce hypertrophic Masseter muscles

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Although 25 uints of Boxtox injected into each muscle is the common starting point in the treatment of hypertrophic masseter muscles,  some patients may require lower or higher doses to achieve the desired effect.  In your case, from your history, it appear that you will require a very low dose of Botox, going forward, to achieve the effect you are seeking.  Don't worry if you feel the effect was greater than what you desired, the muscles should regain their size and strength over the next six to twelve months.  I would suggest you space out the injections from three months to four to six months and decrease the dosage 25% to 50%.  If you don't see the results you would like in three to four weeks your doctor can add additional Botox at that time.  Best wishes.  

San Jose Plastic Surgeon
4.8 out of 5 stars 59 reviews

Masseter Muscle Atrophy after Botox

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Botox is an injection of a neurotropic agent, which paralyzes a muscle. Within 4-6 months, the muscle should return to relatively normal strength. However, there are reports of permanent atrophy after Botox injections.
Everyone has a different response and recovery.

Consult a Board Certified Plastic Surgeon.

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 24 reviews

Botox in jaw

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Botox in the masseter will soften it over time after repeated treatment.  If one stops using botox the muscle will more than likely hypertrophy again.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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Botox result not likely permenant

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Botox generally lasts 3-4 months. True atrophy of muscle will take repeated injections of significant dose over a few years and even then, generally the muscle begins to regain density and bulk once its reinnervation has resumed upon complete degradation of the Botox protein. I would recommend that you stop the injection for a period of 6 months at which time the muscle bulk and density should return to pre-injection state.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon

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.