Correct dosing for masseter Botox as a very small person?

Question

Awhile back I got masseter tox at a clinic for my TMJ where I got 28U on my right (bigger side), 22U on my left (smaller side). Even though it helped with the TMJ, t gave me bad jowls and I really didn’t like the look. It also seems like the 5U difference was too much, as my right side ended up being way smaller than the left. I’m a lot smaller than the avg person (5ft, 90lbs), so this amount was too much for me, but the consultant kept pushing for 20 minimum. However, when it started to wear off and my masseters regrew (last pic) I REALLY liked the look of it, and my TMJ problems were still fixed! I figured yall would know a lot on dosing, and standard protocol hasn’t rly helped me since I’m not average sized. So any advice on if I were to do it again, how much to do to get the result of the last pic?

Camille Cash, MD · Answer

When dosing for Botox the injector will take into consideration the hypertrophy of the muscle as well as other factors.  Some patients metabolize the Botox quickly, while others it lasts for longer.  Always have your treatment with an experienced injector and discuss your concerns.  You can begin more conservatively and return for a touch up if needed.

Anna Chacon, MD, FAAD · Answer

When determining the appropriate dosing of Botox for masseter reduction, especially in a smaller individual, several factors should be considered to achieve both functional and aesthetic goals. Here are some general guidelines:

Individualized Dosing: Since you are smaller in stature, starting with a lower dose than the standard might be more appropriate. An initial conservative approach could involve starting with 10-15 units per side, with adjustments based on muscle size and desired outcomes.

Incremental Adjustments: Given your previous experience, consider adjusting the dosage incrementally. A smaller difference between sides, such as 2-3 units, may help achieve a more symmetrical appearance.

Follow-Up and Assessment: Schedule a follow-up appointment a few weeks after the initial treatment to assess the effects and make any necessary adjustments. This will help in fine-tuning the dosage for future treatments.

Long-Term Planning: Since you preferred the look when the effects started to wear off, a slightly lower dose than your previous treatment may help maintain some muscle volume while still addressing TMJ issues.

Communicate Preferences: Clearly communicate your aesthetic preferences and previous experiences with your provider. This will enable them to tailor the treatment plan to better suit your needs.

Consideration of Jawline and Facial Structure: Discuss with your provider the potential impact on your jawline and facial structure, as reducing masseter size can affect the appearance of jowls and overall facial contour.

By working closely with your healthcare provider, you can develop a dosing strategy that balances muscle relaxation for TMJ relief with maintaining the facial aesthetics you prefer.

Jeffrey H. Spiegel, MD · Answer

Masseter Botox is intended to quiet down the masseter muscle to reduce clenching and grinding as well as slim the face. Sometimes people will do this procedure for the slimming purposes, but typically to also eliveate headaches and stress caused by clenching and grinding. typically start with 15 units per side.  But, it can be lower and probably a high as 25 units per side.  I hope this is helpful.

Correct dosing for masseter Botox as a very small person?

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Correct dosing for masseter Botox as a very small person?

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Everything you need to know about Botox for TMJ

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