Masseter Botox - is 5 Units Per Side Enough? (photo)

I would be surprised if you could detect much of a difference with 5 units per side.  Perhaps he meant 5 units per site?  5 units per site distributed over 5 sites (for a total of 25 units per side) is a very effective initial dosage for most patients.  For the initial treatment, some additional units may be necessary on follow-up 1-2 weeks later to achieve full relaxation of your masseter.  

I reserve 10 units per side for people with thin faces that want to address clenching problems.  For facial slimming, you may see modest results with 10 units, but, based on your picture, I suspect that you may need at least 15 units per side, depending on the bulk of the muscle and your goals.  

Thank you for your question. Botox in the masseter region usually takes longer than in the standard areas to take effect. I tend to use anywhere from 15 units (conservative treatment) to 50 units (for someone with really strong masseters) on each side to get the desired result. It may start within the first week but I tell my patients to wait three weeks before doing a more thorough evaluation. The treatment typically lasts longer than the forehead/crows feet/frown regions. It is also a gradual onset of the return of masseter function. I have tried the masseter injections myself and space the treatments around 4 months apart, but use smaller doses to maintain the effect. I normally know the effects are wearing down when I start to clench my teeth more heavily at night when asleep.