Can I get more Botox in the jaw/masseter for reduction? (photo)

I find that after the first treatment of Botox to the masseter, the second is usually required slightly sooner than with subsequent treatments.  This relates to the mechanism of action with muscle atrophy, where the muscle needs to atrophy the most that very first time. With treatments to follow, the muscle is already smaller and atrophied, so it doesn't tend to take as much product or have to be done as frequently. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.Cameron Chesnut #realself500 Physician

Hi and thanks for your question. Getting another treatment at 9 weeks is perfectly reasonable. Your injector should assess you and determine the dose based on the strength of you masseter muscles. After a few sessions of treatment every 3 to 4 months, it is OK to start spreading the interval of treatment out to 6 months or more. The purpose of the treatment is to cancel out the reflex that connects stress and teeth grinding or clenching. I have many patients who, after a few treatments of Botox, stop clenching and grinding altogether. Make sure that you are seeing a very experienced injector because this is a somewhat advanced Botox technique. Board certification is not mandatory and I have met plenty of nurses and nurse practitioners who are outstanding injectors. Hope that helps!

The masseter muscle is large and strong and can receive upwards to 50 units of Botox on each side. An additional amount injected at this time is safe. If you are interested in a more permanent solution, you might consider an in-office surgery to slim the angles of the jaw itself. The incision is hidden within the mouth and recovery is about a week. 

Receiving your next Botox dose early should not cause any harm.  You may not need as many units as it usually takes to achieve the desired effect. 
Not everyone is a good candidate for this treatment so please see a Board Certified or Board Eligible Plastic Surgeon to evaluate if you may benefit. Good luck!
This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional.  You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. 

Hello,As the panel members suggested, it is not uncommon to require more units with your treatments to reach optimal results.  Optimal results refers to tension relief, aesthetic outcome, and duration.  25 units on each side is a good starting point for most patients with titration upwards as needed.  If you are not reaching a minimum duration of 3-4 months, investing in higher units as a touch up and then at your next regular treatment will be a better investment for your time and money.  It would appear that your left side may benefit from more units than your right and taking this into consideration for a tailored treatment plan is recommended.

Yes, normally these services last 4 to 6 months.  However, there is some loss of effect after about 2 months.  In dealing with the masseter, generally it takes about 6 months before it is clear that retreatment is needed. But those statistics don't work for everyone.  I use to argue with patients who returned at 2 months for retreatment but I no longer do that.  I get that you don't want to see this issue return.

Hello and thank you for your question. You have a very nice aesthetic result. As long as you still have some movement to your masseter muscle, I don't see a problem with adding more Botox to prolong and enhance your result. In some patients we treat much higher Botox dosing for the masseter muscle. 

Thank you for your question.  I would need to see you in person and make sure that you have good motion of the masseter muscles on both sides.  But as long as that looked okay, I think it would be safe to have a booster treatment of Botox at this point.  Typically Botox will begin to lose its efficacy at the 3 month mark and have completely dissipated by 4 months.  Of course, every patient is different.Be sure that you are being treated by a board certified and experienced injector, specifically someone who injects the masseter muscles.I hope that this helps!–David Gilpin

I think it would be fine to have a Botox booster treatment to the masseter muscles 9 weeks after they were last treated.  The particular physician treating you may feel different however.  

In general Botox results last for about 3 months. If you experienced less than the desired outcome with 25 units on each side which in my opinion is the minimum, I would opt for a higher dosage (may be 30 or 35 units on each side) next time around.