Botox for over 10 years for masseter reduction, now resistant to Botox, Dysport and Xeomin?

I'm not sure what doses of Botox that you have been receiving but this area generally requires more neurotoxin to see significant effects. As we age, gravity is contributing to a downward direction of our facial tissues and perhaps a small incision "facelift" with some neck tightening of the platysma muscle along the jawline would give you the results that you are looking for. Be sure to explore all your options. Good luck.

Myobloc is a botulinum toxin B product.  It is sufficiently different that neutralizing antibodies to BTA, which are very rare for cosmetic botulinum toxin, do not block BTB.  The bad news is that the effect of myobloc is just a couple of months and it much more likely to cause systemic side effects.  Generally for this reason, it is not much of an option if you actually have neutralizing antibodies which is honestly unlikely.

I would add ultherapy and consider double dosing of one of the toxins.  Myobock will work for shorter time period and isn't a good solution.  Best, Dr. Emer.

I would expect that after 10 years of consistent Botox use to the masseters that the muscle would shrink down considerably. Did you change injectors recently? If so, it may be the technique or dosage. If it is true resistance then you may need to explore other options.

I have been botoxing the jaw muscle for over 18 years and have seen the long term effects of jawline botox. What you are most likely experiencing is not resistance to botox but rather reduced effects from a semi - or permanent muscle shrinkage from long term botox. What this means is that the muscle is already shrunk down as much as it can with botox or other neuromodulators. If you desire more shrinkage, unfortunately you would have to do a more invasive procedure - surgery, usually to reduce the bone, but in some cases, to remove a portion of the muscle.

Thank you for your question. Most likely what you are experiencing is not resistance to Botox, but reduce effects from a semi or permanent muscle shrinkage from long time use of Botox. This means the muscle is already shrunk down as much as it can be with Botox. If you are looking for more shrinkage of the masseter muscle than you would have to do a more invasive procedure such as, surgery. I recommend having a consultation with an expert to determine the best treatment plan for you. Best of Luck!