Jawline Botox Affected my Smile, Will Facial Muscle Exercise Help Get my Smile Back? (photo)

Botox can be injected into the masseter muscles to lengthen the face, slim the jawline, and decrease the "squareness" of the jawline. It is a place for experienced injectors only - so that is good that you went to someone with experience. Botox, xeomin, and dysport (the neuromodulators on the market in the US), do diffuse away from where they are injected. The amount of diffusion depends on how much saline the botox is made up in. As long as the doctor is using the same concentration everytime, they should have a good idea of diffusion.

The botox can diffuse slightly into the muscles that control smiling when you are treating the lower face. Luckily, your smile should return back to completely normal. I know it can be frustrating, and make you feel self conscious. Hang in there. It usually takes a lot less than the 4 months. I have seen smiles go back to normal after even a few weeks. It can't hurt to do smile exercises.

Finally, if I was your doctor, I would definitely want to see you back - as would all good docs - so I would counsel you to call your doctor and see him/her back.

The injection affected the muscle that pulls back on the corner of the mouth.  In my opinion, a good starting dose for seomeone like yourself would be 15-20 units per side.  In any event, this effect will wear away, but will take time.

You do have to becareful with masseter injections since the product can diffuse into the neighboring smile muscles if placed too superficially and too anteriorly.  I use a very small amount of saline to dilute the neuromodulator (Botox, Dysport or Xeomin), and place product deep and into the belly of the muscle.  Unfortunately, you may have to wait until the Xeomin wears off to regain the smile.

Yes, Botox may last for four months, but often, in active muscle mass, such as the masseter muscle used for chewing it does appear to wear off more quickly, rather than taking longer.  There have been some question if cold temperature can negate the effects of Botulinum toxin. There needs to be formal medical studies about this as a treatment to help reverse unwanted Botox results. An ice test can be used by neurologists to reverse the lowering of the eyelid in myasthenia gravis, a neurological condition in which the eyelid is affected. Exactly how the cold temperature improves this neurologic condition is unknown, and how it can be used to improve an unwanted Botox result is not yet worked out.

40 units per side is quite a bit. It does sound like your doctor planned on injecting most of the masseter muscle (instead of concentrating on the lower portion only), and if he or she injected high enough, may have effected the smiling muscles as well. Given that they tried to place most of the Xeomin into the masseter, it is likely that very little actually went into the smiling muscles, meaning that it will likely improve much sooner- maybe even 2 months. Unfortunately, there really is nothing (including exercise) that will help this come back sooner. Best of luck.