Can Botox Injections For Temporal Muscle Reduction Cause Poisoning?

Q: Dr. Eppley, Ok with Botox, in some instances it can cause poisoning and permanent nerve damage. I think if we use a high dose the risk is higher of botox spreading to other parts in the face. If you remove part of the muscle, what % of the muscle are you removing. Is it 10%, 50%? Has any of your patients(younger and older), experienced any chewing problems. Can chewing issues develop?

A:In answer to your questions:

1) Every drug has a known LED. (lethal effective dose) For Botox that has been shown in laboratory animals to be around 35,000units of extrapolated to humans by weight. So a few hundred units injected into a human is not going to cause any of the symptoms to which you describe. (poisoning or permanent nerve damage)

2) I assume you are referring to the posterior temporal region which is the only temporal region where muscle can be technically and aesthetically safely removed. Typically 100% of the muscle is removed to get the maximal effect which is what many male patients need/desire. But there is a technique for subtotal reduction where about 50% of the muscle mass is left.

3) No patient will complete temporal muscle reduction ever experienced any masticatory (chewing) dysfunction….nor would I expect them to.

Dr. Barry Eppley

Indianapolis, Indiana