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

I just contacted a botox doctor about masseter botox and he said he would do it and suggested 5 units per side, but we'd do a consultation first to make sure. After my research, people suggest 20-40 units per side. This makes me wonder if he's ever done masseter botox before? The doctor is from sdbotox(dot)com. My jaw is square, but my cheekbones are very high and prominent, so the masseter makes my cheeks appear chubby when I have very little fat on them. Looking to slim it up a bit.

Doctor Answers 14

Botox for Jaw narrowing

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First off you have to determine if your jaw width is mostly bone or soft tissue or if the thickness of the Masseter muscle is contributing to its width.  If your Masseter muscle is an issue then you need at least 10u of botox per side but 20 to 40 units would work better.  I do have many patients who get only 10u per side and do notice an improvement.  But 5 units is just too low.  

Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 119 reviews

How much Botox is used for the jaw muscle

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I don't know if this doctor has done this type of injection before, but you should certainly ask that question! 5 units per side is a very low amount, and I would have a hard time believing it would do much of anything because the jaw muscle is very strong and that's why we tend to recommend 20 units minimum, on average. With that being said, the doctor did say he wanted to see you in person to confirm that amount, so it's hard to say if you really will receive 5 units per side, or more, when you get there. There are many qualified injectors in the San Diego area so if this isn't the doctor for you, you can find another one, I'm sure of it.

Botox and masseter size

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Five units of Botox per side will do very little, if anything to reduce the size and/or strength of your masseter muscles. Without doing an assessment in person, it's difficult to say what the exact dose would be for you, however, injecting 30 to 50 Units per side to see some significant changes is more common.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Masseters - minimal dosing is 10 units per side

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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.  

Botox dosage for masseter

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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.

Botox dosage for masseter reduction

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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.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

This doctor is an anesthesiologist not part of the aesthetic core.

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For masseter treatment, 5 units is small and certainly not likely to harm you.  Generally, I start with 15 units per side.  In looking at your photo, I wonder if you might do well with other approaches.  Before prescribing yourself a treatment which is essentially what you are doing, you might consider having an actual consultation to see what a cosmetic surgeon recommends to help you achieve your goals.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Masseter Botox. Is 5 Units per Side Enough?

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If you really have masseter hypertrophy, and are hoping that reducing it with Botox will make your jaw look less wide, then 5 units is insufficient.  25 units per side works well depending on the size of the muscle, but would be appropriate for most women.


Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 54 reviews

Botox can be very effective in re-contouring the jawline as an off-label use

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Botox in the masseters can be very helpful for reducing the strength and size of this muscle which can soften the jawline and achieve a beautful contour in that area. Typically 5 units is a small dose for this area but more can be added, usually 20 to up to 50 units per side depending on how large the muscle is and how much of an effect you're looking for. 

Doris Day, MD
New York Dermatologic Surgeon

Masseter and Botox

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In general, 5 units of Botox is not enough. More like 20-30 units per side.  In fact, you might not see a change until you have used it regularly for several treatments.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.