Is 65+ units Botox each side of the masseters "too much"? (Photos)

Question

Is 65+ units to EACH SIDE OF THE MASSETERS considered "too much"? I'm needing an increase in Botox (resistance built up after 4 years) and I'm concerned that I'll need more than 65+ units on each side now. Is this abnormal and are there any risks? I have severe TMJ and have very large masseters that cause me a lot of pain. I also need touch ups within 1 month- which seems very odd since doctors advised that it should be spaced 3 months apart.

Kenneth D. Steinsapir, MD · Answer

You also indicated that you tested positive for botox antibodies.  Right now you are seeing someone who is making a lot of money selling you botox.  The question is with neutralizing antibodies, are you really getting anywhere with this treatment.  You are spending a fortune for these treatments but are they really making a difference.  Perhaps it is time to see a TMJ specialist for a night guard or other approach to helping your with your grinding. Your current approach is not working.

Milan Doshi, MS, MCh · Answer

Hi,thanks for the question.I personally feel injecting about 65+ units of botox in masseter area in a single session is excessive.We normally give about 25-30 units each side in a single session.We call the patient for a follow up visit after 2-3 weeks and decide for the touch up if required.Touch up in intervals of every  one month is not advisable.

Shaun Patel, MD · Answer

I typically start with 20-25 units of Botox per side in my patients. 65 + units per side is a high dose. You may want to try Dysport or Xeomin to see if you get a better response using a lower dose.

B. Edward O`Dell, MD · Answer

65+ plus units per side is pretty excessive.  There is likely antibody resistence to the Botox so I would ask your injector about trying Xeomin for one or two treatments.  It's possible that could help.  Thanks for your question.
Dr ODell

William Marshall Guy, MD · Answer

Hello mystlilith,65 units into each masseter muscle is a large dose of Botox.  If you are only having results for a month then that is also not to be expected.  At doses that high (130 units) it is possible you have developed antibodies.  You could try other neuromodulators like Dysport.  Another option is to use a neuromodulator based on a different molecule called Myobloc.  It is more expensive than the others, not usually used in cosmetic practices, but can be used in place of therapeutic Botox for medically indicated reasons.I hope this helps and good luck.

Is 65+ units Botox each side of the masseters "too much"? (Photos)

Answers (7)

Answer: Increased Botox to the masseter muscles

Answer: Increased Botox to the masseter muscles

Answer: Is 65+ units Botox each side of the masseters "too much"?

Answer: Is 65+ units Botox each side of the masseters "too much"?

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Is 65+ units Botox each side of the masseters "too much"? (Photos)

Answers (7)

Answer: Increased Botox to the masseter muscles

Answer: Increased Botox to the masseter muscles

Answer: Is 65+ units Botox each side of the masseters "too much"?

Answer: Is 65+ units Botox each side of the masseters "too much"?

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Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.