How long until my smile becomes normal again after Botox? (Photos)

Botox is a temporary fix and usually lasts 3-4 months.  The Botox injections relieve jaw tension by making muscles unable to engage in the powerful, often unconscious movement of the jaw.  Your smile should return to normal soon.

Botox only lasts for 3-4 months in most patients and areas, but in the masseter muscle, patients may see results for about 6 months.  In general, there should not be any changes to the smile with masseter Botox when injected properly, but small asymmetries are possible.  There is no way to speed up the process of eliminating Botox from your body.  I always advise speaking with the doctor that did the injection if you have any questions or concerns.All the best,

Despite excellent technique there could be involvement of other muscles when trying to relax the clenching muscle responsible for bulging cheeks and a fatter appearance of the lower face. A trained Botox expert palpates the masseter muscle and injects it with Botox as this off-label procedure is intended to slim the lower face. However, if Botox by unknown reasons affects neighboring muscles or if injected into them as opposed to the masseter chewing muscle, then the lip muscles that control opening and closing could be affected. Fortunately this undesired effect is not permanent and usually resolves itself by 14 - 16 weeks.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

Hello and thank you for your question. Most patients see a decrease in the effect of botox in about 3 to 4 months. However, it can take up to 6 months or so for the FULL effect to diminish. Best of luck!

Hey there - unfortunately the botox has migrated forward to the risorius muscle, it might take another 4 months for the muscle to begin working again I'm afraid but it shouldn't be something your friends will notice.

Botox lock the release of a chemical called acetylcholine, which triggers the muscle contractions that create wrinkles. Botox essentially paralyze the muscles and stops them from contracting. Results from these treatments are visible within 3-7 days with results that can last anywhere from 3-4 months. Hope this helps. 

Hi Tam,Thanks for sharing your query with us. Botox tends to last between 3-4 months depending on the patient. If your smile seems to be effected more so on one particular side, then we would suggest seeing your practitioner again to see if they can re-inject to create symmetry. Otherwise, you will be best off to wait until the botox wears off.All the best.

thank you for your question. Most patients see a decrease in the effect of botox in about 3 to 4 months. However, it can take up to 6 months or so for the FULL effect to diminish. Best of luck!

Thank you for your question and for sharing your photographs tam.b. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.

To determine if someone is a good candidate for this treatment it is necessary to look at a person’s lower face when biting and comparing it to when the person is not biting. If a bulge is seen on the outer portion of the jawline, then the person is likely a candidate. It can also be felt with the fingers when biting.
In the mid face, the risorius muscle and zygomaticus muscles sit near the masseter muscle which is treated for TMJ pain or to contour the lower face. When smiling, the risorius muscle pulls the corners of the mouth outward towards the ears and the zygomaticus muscles pull the corners of the mouth upward. The masseter muscle is used to bite down when eating. If Botox spreads from the masseter muscle forward toward the risorius muscle or upward toward the zygomaticus muscles, these muscles can also become relaxed, leading to the appearance of an asymmetric smile. This side effect resolves on its own in 2 weeks to 4 months, depending on the severity. Some find that laser skin tightening treatments using infrared light or radiofrequency may speed up the resolution process.
If I had a patient with the concern described here I would reassure her that the results are not permanent and possible recommend a skin tightening treatment with infrared light or radiofrequency as described above to try to expedite the resolution.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

Hi Tam,
I can see what you mean by having an uneven smile, thats so unfortunate especially when injecting Masseters is a relatively simple procedure.
The use of Botulinium Toxin (BoTA) to reduce the muscle activity in patient with Bruxism (tooth clenching and grinding) is normally a straight forward routine procedure that I as a dentist perform on a daily basis, however it is important to assess each individual patient's presentation and needs in order to determine the exact dosage required and the best position to inject within the muscle. What is also crucial is the 'post operative instructions' that are given to a patients for the 4 - 5 hours following the administration of the BoTA in order to prevent the undesirable complication that you seem to have experienced.
I think you smile will start to return to normal very soon if the BoTA was delivered 7 weeks ago. I would suggest the BoTA in your case has drifted forwards on the Right hand side into the 'risorius' muscle which attaches close by the corner of mouth..... hence the right corner of your mouth doesn't respond when smiling.
I hope this has been of some help.