Would 15 units of Botox slim my face? (photos)

Question

How many units of botox do i need? Is 15units of botox is enough to see the effect? I have done masseteer botox before but do ou think 15u is ok?

Brock Ridenour, MD · Answer

To slim the face, Botox is injected into the masseter muscles. Appropriate patients for treatment have significant volume of muscle, rather than a strong bony prominence at the angle of the jaw (mandible). Injecting the masseter muscle with Botox decreases the prominence of the muscle and tapers the lower face. Dosage depends on the patient's muscle volume, together with regional and cultural variations in the amount of taper than is considered desirable and attractive.  In patients with small faces and modest muscle volume, tapering can be achieved with as little as 9-12 units per side. In patients with a large muscle volume the dosage required can be as high as 20-40 units per side. I hope this helps.

Alicia Sigler, MD · Answer

Hello and thank you for your question. As far as how many units of Botox you should have injected, it is bes to consult in person with a doctor who injects Botox often. They will have to examine the muscles in your jaw to gauge how much Botox will have the desired effect. Hope you get the results you are after.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Most patients require between 20-25 units per masseter muscle to see an effect.  I hope this helps.

Mariusz Gajewski, MBBS · Answer

Here at Star Cosmetic Medicine, we use an average of 50 units total (25 each side) when treating the Masseters. Of course this will vary depending on the patient, the muscles and what the desired end result.

Monika Soni, MD · Answer

Thank you for your question and for sharing your photographs twentyseven. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.

Deborah Kessler Hudak, MD, MHA · Answer

In most faces, 15 units to the masseter muscles to slim the face is a "spit in the wind."  It would make nearly imperceptible improvement.

Joseph Franklin, MD · Answer

Thank you for the question.  The traditional dose of Botox for masseter hypertrophy is 20 - 40 units PER side.   15 units will not result in a significant “slimming” effect.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photographs twentyseven. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.
To determine if someone is a good candidate for this treatment it is necessary to look at a person’s lower face when biting and comparing it to when the person is not biting. If a bulge is seen on the outer portion of the jawline, then the person is likely a candidate. It can also be felt with the fingers when biting.
In the mid face, the risorius muscle and zygomaticus muscles sit near the masseter muscle which is treated for TMJ pain or to contour the lower face. When smiling, the risorius muscle pulls the corners of the mouth outward towards the ears and the zygomaticus muscles pull the corners of the mouth upward. The masseter muscle is used to bite down when eating. If Botox spreads from the masseter muscle forward toward the risorius muscle or upward toward the zygomaticus muscles, these muscles can also become relaxed, leading to the appearance of an asymmetric smile. This side effect resolves on its own in 2 weeks to 4 months, depending on the severity.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Aric Aghayan, MD · Answer

Thank you for your question and for submitting photos. 15 units is likely to be inadequate to achieve visible results. The typical dose for the masseter muscle (which is the muscle injected to thin the face) is 25-30 units per side. Make sure to consult with an experienced plastic surgeon. Good luck.

James Wokes, BSc(Hons), MBBS, FRCS · Answer

In my experience masseteric muscle Botox to reduce the cheek bulk requires much more than 15 units each side.
I regularly use 50 units per side and it often needs a little more.
Hope that helps!
James

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