Botox to reduce my masseter muscle. Should I be concerned that this won't give me what I'm trying to achieve?

Hi royal1987,I usually inject at 3 spots per side, to try to distribute the botox more evenly across the lower edge of the jaw.  Injecting in the center of the muscle without the front or back injection will also work.  My only concern is whether there may be some muscle contraction towards the front edge and back edge of the muscle.Proper dosage depending on the size of the muscle may have more of an effect than the number of injections.  For example, if the doctor injected only 5 or 10 units using 3 injection spots per side, versus your doctor injecting 25 units in a single spot per side, I would bet that using the higher dose regardless of the number of injections would work better.On the other hand, sometimes even giving between 20 to 45 units per side depending on the size of the masseter hypertrophy, I have had some patients notice that the majority of the muscle was not contracting with a full clench, but they noticed a small roll of muscle towards the front of the masseter which still contracted.  If this were to happen, I would simply touch up that area with a little more botox to paralyze that area.For that last reason, I still prefer to inject at 3 locations per side, since I already do 3 injections for such a small muscle such as the corrugator muscles (glabellar frown lines AKA 11's).  I like to use about half of the dose in the middle injection and about 1/4 for the front and back.  I imagine that when the muscle contracts (think bicep) the bulk of the muscle is in the middle then it tapers off to the sides (the reason for the smaller doses on the sides).  I hope that makes sense.  Since Botox is a repeat procedure, I'm sure your injector will make adjustments for future injections if the botox result was not ideal the first time.Best,Dr. YangP.S. If you find my answers or other doctors answers to questions are helpful, please +1 those answers to push up the better answers to the top, which helps others who read the same post, get to the more helpful answers first.P.P.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

I suggest you wait for a two to four weeks to see if an improvement occurs. If there isn't, then please return to your injector to discuss your concerns. Injection techniques vary depending on the injector and the patient, therefore it's better no to speculate about the effectiveness of your treatment.

Botox is very effective at relaxing the masseter muscle. Being a larger muscle, I inject it several times. I sometimes also inject the temporalis muscle. Consult a board-certified facial plastic surgeon or a general plastic surgeon in your community for this matter.

The technique for Botox injection will vary depending on the injector. More important is that the Botox is accurately placed into the muscle which is being treated. Since the masseter muscle is a big muscle, it can take up to 3-4 weeks for it to become sufficiently weakened. Also, often it may be needed to give additional units to reach the desired results. Make sure you follow up with your injector for an in-person evaluation.

The most important part of having Botox injections in any site is to have them given by an extremely skilled provider, and we mean at an office of a board-certified dermatologist or plastic surgeon. The masseter injection technique varies by injector but most will inject two or three sites in each of the enlarged masseter muscles. Your injector used one injection – is this wrong? No. Everyone, as noted, does things a little different. We ask that our toxin patients return to our office two weeks after we do the injections to see how things are going. By then, you will know whether the one injection technique worked – or you should have a little more placed to assure that the end result is what you want. Good luck.

Everyone's injection technique is a little different.  I usually injected small aliquots in several locations on each side.  Best of luck.

Botox works well to reduce masseter muscle hypertrohpy (protuberance of the muscle). I tend to inject at multiple points on the muscle as in my experience that yields optimal results, however, if you saw a well trained dermatologist or plastic surgeon they may have their own method that works well in their hands. Give it some time to kick in before you make a conclusion. Good luck.