25 units of Botox injected in each masseter muscle but see no difference. Do I need more?

Question

I had 25 units of botox injected to each masseter muscle last year, but never saw any significant difference. It did shrink slightly, but not by enough. Do I need to get more injected this time?

John Mesa, MD · Answer

Botox can be used to decrease the bulk of the masseter muscle and therefore narrow the lower face around the corner of the mandible . In order to do that the muscle hast to shrink (become atrophic)  dude to decrease activity secondary to Botox treatment. This doesn't happen overnight. Therefore, in order to see the effect of Botox in masseter: 1) time has to pass and 2) very likely several serial treatments of Botox might be necessary

Goretti Ho Taghva, MD, FACS · Answer

Hello, thank you for your question. Botox to the masseters can reduce the size of the muscle, which in turn can slim down the posterior part of your face/jaw.  It really all depends on what is causing the facial fullness in the first place.  If you have strong masseter muscles and they make your face look wide posteriorly, then you should have a pretty good result with the Botox.  The dosage needed ultimately depends on the physical examination as well as your past experience with Botox injections.  However, if the cause of facial fullness is due to skin thickness/ fat/ the fullness is more on your anterior cheeks, then Botox to the masseters will most likely not create a significant difference.  Hope that helps.

Jerome Edelstein, MD · Answer

Hello, 
Thank you
for your question. 
It
appears that you may require a larger dose. I'd recommend speaking with your
qualified injector to discuss your concerns and to determine your options. 
All the
best.

Kyle Coleman, MD · Answer

Botox can be a great option for decreasing the size of the masseter muscle and in patients who grind their teeth.  Generally, dosages range from 20-40 units per side.  It is important to know that the best results from treatment of this muscle will take time unlike treating movement lines.   Over time, due to muscle inactivity, the muscle will shrink with a peak at 4-6 months; repeated treatments are usually necessary to further improvement.

Robert M. Tornambe, MD · Answer

It is not unusual to need a second treatment of Botox approximately 2 weeks after the first treatment to optimize the result for Botox reduction. Be sure to consult with a board certified plastic surgeon or dermatologist. Good Luck!

Nelson Castillo, MD · Answer

Thank you for your question.  There are two possibilities for your results, the dosing was appropriate but a single dosing alone is unlikely to lead to significant atrophy, and more regular masseter injections are needed, while the other option is that 25 units was not a sufficient amount of Botox for the masseter and a higher amount would be needed to have effect. Voice your concerns with your injector they should be able to help you attain the goals you want.

Donald B. Yoo, MD, FACS · Answer

Botox for masseter reduction is very effective at reducing the bulk of the masseter muscle and thereby slimming the jawline.  25 units per side is a very typical dose to relax an average sized masseter muscle.  If your muscle did not move and remained soft even with clenching, then it was an adequate dose.  If there was still significant muscle movement, then a slightly higher dosage of Botox would be more effective at creating slimming.In addition, serial treatments - every 4-6 months, will accentuate the slimming effect by continuing to shrink the muscle.

Marla M. Klein, MD · Answer

I typically start with 25 units per side for the masseter muscle.  On the followup visit, the patient says whether it was adequate and if it wasn't I will typically go up.  I've gone to 40 units per side for an occasional patient.

Sheryl D. Clark, MD, FAAD · Answer

Dear Likelotus:An intelligent answer to your question would require a more extensive history and an examination. I would want to know if you grind your teeth, have TMJ problems with headaches,  or are they looking to make a squarish face more oval. After the treatment, I would want to discover if you are still able to clinch your masseter muscles, and if there are any areas of the muscles where you don't have a full affect.With this treatment, the size of the masseter muscles reduces more with each treatment that you have, especially if you do not let full function return before the next treatment. It's like having a cast on your arm – – if you have ever had this you may recall that the muscle get smaller when it's not used. Similarly, the masseter muscle needs to remain at rest, or at least not clench as much as it did before for a period of months before it will reduce in size.So depending upon your history and examination, you may not need a larger dose you may just need to have it done more frequently.All the best,Dr. Clark

Steven Wallach, MD · Answer

Patients seem to think that after a single treatment with botox in the masseter that it will shrink in size.  It requires multiple consistent treatment every 4 months or so. It does not occur after just one treatment.

25 units of Botox injected in each masseter muscle but see no difference. Do I need more?

Answers (18)

More Botox Questions

Sick for a week after Botox?

Can you get red eyes from Botox?

How many units of Botox for my forehead?

I received my first Botox yesterday. I was given 15 units in my forehead. Any suggestions?

Botox left dent in forehead - adding a filler left dent and bump what to do? (photos)

Unusual submental lymph node after Botox and Restylane injection

WE SEND PRETTY
EMAILS