How Is Botox Injections Done To The Masseter Muscles?

Q: Dr. Eppley, how many injections and where do you give it and what dose of Botox in treating muscle hypertrophy of the jaw? How many visits and what is the cost?

A: Botox injections can be very beneficial in the treatment of bruxism, masseteric muscle pain and large masseter muscle size. The injections take but a few minutes and are done in the office. A good starting dose is 25 to 35 units per side or each masseter muscle. The injections are placed in the bulk of the muscle near the jaw angle. It is not a good idea to place the injections above a line drawn from the corner of the mouth to the top of the earlobe. Injecting above this line runs the risk of paralyzing one or more of the buccal branches of the facial nerve, resulting in upper lip paralysis for the duration of the Botox effect. Masseter muscle size starts to shrink down even after the first injection session. How many injection sessions it takes to cause a permanent reduction in muscle size, if that can really be achieved, is controversial. Some report three Botox injection sessions spaced four to six months apart as the protocol. Dramatic reduction in masseter muscle size can certainly be achieved with three sessions. Whether that creates a permanent result varies in each patient.

Dr. Barry Eppley

Indianapolis, Indiana