Face Semi-paralyzed After Botox to Masseter Muscles? (photo)

Question

I had 30 units of botox injected in the masseter muscles on the right side of my face; I leave the left side alone because the muscles aren't as active. I had had 25 units put in about 4 months ago, so this was not new. However, now the right side of my face is semi-paralyzed. My smile looks terrible because the corner of my mouth does not lift. I know there is no antidote to botox, but is there anything I can do to speed up the metabolization, help my smile, or strengthen the muscles? Thank you

Melissa Chiang, MD, FAAD · Answer

I am sorry that you have a suboptimal result.  You are absolutely right that the Botox will wear off, with time.  There is nothing to speed up the process, unfortunately.  The injection to the masseter probably affected the risorius.  This muscle pulls back on the corner of the mouth when you smile.  In general, I stay more posterior and inferior on the masseter muscle in order to avoid the risorius, as well as the zygomaticus.

Ron Shelton, MD · Answer

There may have been more of a superficial treatment to the levator muscles of the mouth rather than a deeper treatment to the masseter muscle.  It will resolve spontaneously with an expected full recovery.  There is nothing that can be done to hasten this recovery as far as I'm aware.

Brent Moelleken, MD · Answer

Off label use of Botox is increasing.  The use in the masseter muscle is one example.  If  Botox is not precisely placed, it will do exactly what it was designed to do and paralyze muscles, only not in the right area.

	The importance of knowing the anatomy is very great, especially when dealing with patients whose faces are in the public eye (i.e. newscasters).

	The muscles that lift the lip are not far from the masseter muscle.

	Hopefully in your case only a small amount of Botox percolated into the lip lifting muscles and the undesirable effects will be short lived.

Mabrie Facial Institute | San Francisco · Answer

I'm sorry that you had a bad experience with Botox. When done properly, treatment to the masseter muscles can be wonderful. It can help relieve symptoms of TMJ and also aesthetically improve facial shape by slimming the face. It seems that your Botox was placed, or spread, anteriorly into a nearby muscle involved in smiling. Unfortunately, there is nothing that can be done to speed up the effects of Botox. It is important to select an injector with extensive knowledge of facial anatomy to ensure accurate injection sites, and also important not to massage the area post treatment to decrease chance of spreading the Botox.
I've created a video that reviews Botox treatment to the masseter muscles, I hope you find it helpful in your research!

Mark Kearns, MBChB, BSc, FRACGP · Answer

Hey Tammy - Unfortunately as you say there's no antidote, and after the botox wears off it will also take a little while for the muscle to regain its original strength - but that should be starting to happen very soon.
Some patients have advised me that when they train more with cardio exercise, their botox wears off quicker - but I cant guarantee this would be the case in everyone.
Good luck

Face Semi-paralyzed After Botox to Masseter Muscles? (photo)

Answers (10)

Answer: Masseter treatment

Answer: Masseter treatment

Answer: Asymetric Smile

Answer: Asymetric Smile

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Face Semi-paralyzed After Botox to Masseter Muscles? (photo)

Answers (10)

Answer: Masseter treatment

Answer: Masseter treatment

Answer: Asymetric Smile

Answer: Asymetric Smile

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.