Botox didn’t wear off after 8 months. Will it laser forever? (Photo)

Question

I had my masseter Botox in 21.8.23. It slimmed my face very much. I got 27.5 units per side. But it didn’t pass. My muscles feel strong as before but look VERY slim STILL! doctor said it wears off after 3-4 months and I’m stuck, I want my old square face shape!! Will it last forever?? I can’t stop having panic attacks about it. If it’s relevant I wear a retainer at night (got my braces off a year ago)

Anna Chacon, MD, FAAD · Answer

Hi, thank you for sharing your concerns and the photo—it really helps to understand what you’re experiencing.

It’s completely understandable to feel anxious about this, especially when your face shape hasn’t returned as expected. Here’s what’s going on:

Duration of Botox: Typically, masseter Botox lasts about 3–6 months. It works by temporarily relaxing the muscle, which can slim the jawline. Most people see the effect gradually wear off, but occasionally, some patients notice a slower return to muscle fullness or a lingering change in shape.

Why your face still looks slim: Even though the Botox effect on muscle strength may be fading (you notice your muscles feel strong again), the jawline can still appear slimmer for several reasons:

Muscle atrophy: Prolonged relaxation of the masseter can reduce muscle bulk. This slimming effect can persist for months, sometimes longer, especially if the muscle had been treated multiple times over the years.

Bone and fat changes: The face can subtly adjust when muscles shrink—fat pads may redistribute slightly, or bone remodeling may play a small role, which doesn’t revert immediately.

Retainer use: Wearing a retainer is generally unrelated, but constant jaw pressure from clenching or grinding could slightly influence muscle shape.

Will it last forever? No, it won’t last forever. The muscle will eventually regain size and tone, but it may take longer than you expect—sometimes several more months. The process is gradual, and your original “square” jaw may slowly come back as the masseter fully regains its bulk.

Managing anxiety: It’s completely normal to feel panicked, especially when changes are visible. Taking photos over time to track gradual change and reminding yourself the effect is reversible can help reduce stress.

Next steps: Most importantly, patience is key. There isn’t a permanent “lock” from a single Botox session, even if the visual effect seems prolonged. If it continues to be distressing, gentle massage or targeted exercises may help the muscles regain tone faster—but they should be done carefully.

You are not stuck forever—your face will continue to return to its natural shape. The timeline just varies from person to person.

Donald B. Yoo, MD, FACS · Answer

Botox will relax the target muscle for ~3-4 months, after which time the masseter will begin to regain its function. During the 3-4 months it was relaxed, it was not able to contract or "work out" so it began shrinking in size. This atrophy will not reverse immediately once it regains its activity but will happen gradually over months. If you are still concerned about the slim appearance of your masseters, chewing gum and eating chewing intensive food will help accelerate the masseter gaining mass once again.

Charbel Medawar, MD · Answer

usually Botox's effect is completely gone after 6 months, especially if its a brand like Allergan or dysport.However sometimes brands imported from other countries have more preservatives and can last up to 8-9 months. Nevertheless, the effect will resolve and you will have more movement. muscle hypertrophy will come back if you clinch your teeth again just like when you exercise any other muscle in the body.

Jo Herzog, MD · Answer

The Botox will have worn off and will not last forever. Your muscles will take time to get back to where they were as they are muscles and increase in size with use. They do not pop back when the Botox wears off. Keep chewing and you will be fine.

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