Cosmetic Question: What is the best neurotoxin for TMJ and masseter hypertrophy?
Cosmetic Answer:
It varies, and here’s why-
There are several neurotoxins available. The most commonly used are Botox, Xeomin and Dysport. Dysport is the most expensive, Botox next and Xeomin least. Only Botox is made in the USA. The others come from Germany and Ireland, respectively.
Depending on the research, some studies show one neurotoxin is best, some show another one is. Since Botox is made in the USA and always available, I start with a moderate dose of Botox.
Often a person gets a response to Botox the first time with TMJ pain relief and the return of their facial shape in a week. Then the second time, they may see less response, because our muscles are so adaptable. So I will increase the dose until we get the look and the pain relief we want. You may need treatment every six weeks at first, because the masseter is a big muscle.
However, Botox contains a tiny bit of protein, so if you need frequent high doses, your body may begin to inactivate the Botox. Then it’s time to go to Xeomin – it has no protein at all, so no interaction.
But Botox and Xeomin are very concentrated – sometimes a muscle is so big we want the neurotoxin to spread widely. Then we go to Dysport. Because it spreads, Dysport may be more likely to affect nearby muscles and give you a funny smile, so it has to be given expertly.
It sounds like a lot to know, and it is, and of course there is much more. The fact is, all the neurotoxins work on cosmetic masseter hypertrophy. How to get the best result requires the knowledge and experience of an expert. Usually these experts are Board Certified Plastic Surgeons like myself, we have the most cosmetic training, so it’s no surprise we’re likely to get the best cosmetic results for you.