How many units of Botox will I need for jaw reduction? It's my first ever Botox so I want to go slowly (Photo)

Without examining you it is difficult to be certain but generally 30 units per side is a good starting dose. In terms of the other symptoms, if they are related to grinding or clenching of the jaw then masseter reduction may help. Gcp

Hello, Thank you for your question. For women, a softer, less prominent jawline is usually considered to be more feminine, and therefore, more attractive. The Botox, injected in both sides of the jaw, will selectively relax the masseter in the days following your injection, gradually making it less prominent and square. The width of your jawline will slowly narrow, transforming your facial shape into more of an oval or heart. Typically patients receive 50-70 units for masseters, based on the strength of these muscles. Upon your assessment, your skilled and qualified injector will be able to provide you with a quote and will determine if you're a good candidate for this treatment. Take care. 

I start with 25-30 units per side and reevaluate 2-4 weeks later.  Often up to 50 units of botox per side is needed.  In korea they often do even more.  Best, Dr. Emer.

Botox is a great option for shaping and contouring the face.  Injection of the masseter muscles should help relieve grinding of the teeth at night but may or may not have effects on tension that extends down to you shoulder.  As is always the case, there is a range of dosages that may be required.  Starting conservatively and working your way up may be helpful.  Too large a dose can lead to a sunken-in look. 

Generally, we use 20-40 units of Botox for each side of the masseter depending on the size and strength of the muscle.

Many of my patients have gotten excellent results with 25 units per side into the masseter muscles. The effect is longer lasting than that of botox injected for wrinkles and usually also improves muscle tension and TMJ symptoms.

 Thank you for your question and for sharing your photos. I commonly used 25 units in each masseter to help with jawline reduction. For patients who want to be more conservative, I'll start off with 15 units on each side, and then build up by five units every few weeks to achieve the desired goal. 

Thank you for your question and for sharing your photographs soopertrooper. 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.If I had a patient with the concern described here I would say she is a good candidate for this treatment with the dose recommended above assuming she has no contraindications. This treatment does help with pain associated with TMJ such as headaches and may help with pain in the neck and shoulder area as well.The safety record of Botox is well established. The product has been used for over 20 years for a variety of treatments with minimal side effects. Botox is amongst the safest treatments for treating facial wrinkles.While Botox is one of the safest treatments offered, there are some situations where it is not appropriate. These include anyone who has an allergy to any of the inactive ingredients or who has had an allergic reaction to any botulinum product including Botox, Dysport, Xeomin, or Myobloc. The safety and efficacy of Botox has not been established in women who are pregnant, trying to become pregnant, or breast feeding. Therefore, women in these categories are advised to wait until breast feeding is completed prior to having a Botox treatment. Botox should not be placed in the skin on the site of an infection. Those who are taking an aminoglycoside antibiotic, an anesthetic, D-penicillamine, antimalarials, or immunosuppressants should not be treated, nor should those who have undergone chemotherapy within the previous six months. It is important to avoid blood thinners before and after a treatment. These include both prescription and non-prescription medications such as warfarin (coumadin), aspirin, ibuprofen, alcohol, fish oil, vitamin E, and ginko biloba. Those with conditions that affect muscles and nerves such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome should not undergo Botox treatments.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!

40 Units per side works.You can start 20 per side and escalate up to 40All the best

The masseter muscles can be atrophied (in other words, shrink) with Botox injections of about 20 to 25 units per muscle.  For most patients, two or three treatments are needed.  Risk of complication or undesirable results, such as the "sunken-in" look you mention, would be very low in the hands of an experienced Dermatologist.  Keep in mind, treatment of the masseter muscles is a more advanced application of Botox therapy, so be sure that your Dermatologist has plenty of experience using Botox in this manner.