Skin sagging from masseter muscle. Will my face return to the previous face before I had Botox? (Photo)

Question

Please help! I had 50 units Botox for my upper face and 20 units each for masseter both side. After 2 weeks I experienced uneven smile and skin sagging on both side of my face. (As pictures attached) Will my face return to the previous face before I had Botox? What can speed up the process? Would chew gummy help? Will it be possible that this effect will be permanent? Will I have my smile back? I am really sad and would appreciate your answers. Many thanks

Camille Cash, MD · Answer

I'm sorry to hear of the issues you've experienced since your Botox treatment.  The effects of Botox are temporary, generally lasting three to four months for many patients and wearing off gradually.  There is no reversal agent for Botox.  I've included a video that I hope you find helpful.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Nadja Haub, MD · Answer

Hi there,
Thank you for your question about facial sagging after Masseter Botox. 
In the photo, I can see that you appear to have more prominent lines between the nose and the corners of your mouth. I agree that this is more than expected for someone your age. The Masseter muscle is a strong muscle on both sides of the lower jaw that helps lift the lower face. 
Botox relaxes this muscle and makes it slimmer. As a result, when the muscle is too slim or over-relaxed, it can lead to facial sagging. 
In your case, you had 20 units of Botox injected into each masseter muscle. The dose of Botox depends on the size of your muscle and how active it is. An experienced injector will palpate your masseter muscle to check how big and robust it is. Depending on that, the injector will choose the correct dose. 
Twenty units into each side can be quite a large dose if the muscle is rather smaller. I wonder if this has relaxed the muscle too much and caused facial sagging. 
I am confident that your facial sagging will improve over time, as Botox only lasts for three to four months. Sometimes, Botox can last up to 6 months. As it is very early stages in your case, I would recommend you wait for now. In the unlikely event that it does to get better, I would suggest you see an experienced cosmetic doctor or plastic surgeon.

Skin sagging from masseter muscle. Will my face return to the previous face before I had Botox? (Photo)

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Skin sagging from masseter muscle. Will my face return to the previous face before I had Botox? (Photo)

Answers (3)

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Everything you need to know about Botox

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