When will face tighten up and look the way it did before masseter Botox?

Question

I had masseter botox in april 2023 and it deflated my 40 year old face like a balloon. I had deeper nasolabial folds and worsening of jowls, especially since i have a recessed chin. Fast forward 7 months later this past november my face was still narrow but nasolabial folds got slightly better and so did jowling but only a little. I went to get a nefertiti lift(neck botox) and the new injector hit my masseters again! So now ive had it twice in 9 months. Will my face ever be what it used to?

Camille Cash, MD · Answer

The effects of Botox are temporary and as time goes on your face should gradually return to your previous look.  You can consider fillers to help contour your face.  You can also consider treatments like Morpheus8 to improve overall skin tone and texture.

Ryan Welter, MD · Answer

The effects of Botox, while temporary, can feel lasting when it comes to facial changes, particularly if administered more than once in a relatively short timeframe. When Botox is injected into the masseter muscles, it can indeed lead to a narrowing of the lower face and exacerbate concerns such as nasolabial folds, jowling, or overall sagging—especially for individuals with existing facial volume loss or structural concerns like a recessed chin.

Over time, as the Botox effect wears off—typically three to six months after injection—your masseter muscles should gradually regain their strength and volume. However, this process can vary depending on individual muscle mass and metabolic factors, and since you've had two rounds of injections within nine months, it may take longer for your facial contours to normalize. While waiting for this natural recovery, there are non-invasive options to help address the concerns you're currently experiencing.

At Regeneris, we focus on restoring balance and supporting collagen regeneration for patients experiencing changes in facial volume and structure. Treatments like PRP (Platelet-Rich Plasma) or PRF (Platelet-Rich Fibrin) are excellent options for rejuvenating the skin and improving elasticity, which may help reduce the appearance of nasolabial folds and jowls. For tightening and lifting, Accent Prime—a combination of ultrasound and radiofrequency—is a powerful non-invasive option that stimulates collagen production and improves skin laxity. These treatments provide support and structure to the skin without adding unnatural volume or masking your natural features.

If your concerns stem from volume loss in the midface or jawline, dermal fillers can be strategically placed to restore harmony and lift to the area. It's crucial, however, to work with a practitioner who understands your facial anatomy and aesthetic goals, particularly since fillers can enhance or exaggerate existing features when not done thoughtfully.

Finally, addressing the root cause of your dissatisfaction—perhaps the recessed chin—could lead to the most comprehensive solution. Options such as chin augmentation using dermal fillers or even longer-term approaches like implant consultations might be worth exploring as part of your overall plan. However, we’d emphasize that non-invasive tightening and rejuvenation are often sufficient for younger patients in their 40s seeking a natural look without surgery.

It’s essential to have a personalized consultation with a skilled practitioner to develop a tailored approach that aligns with your goals. Over time, with proper care and carefully selected treatments, your face can regain its harmony and balance while embracing natural, graceful aging.

Lisa Vuich, MD · Answer

Collagen loss begins in our late 20's at a rate of just over 1% per year. The rate escalates after menopause- we may lose as much as 30% of our collagen in the first 5 years post menopause. Your 40's is thus a great time to get ahead of this game and get onto a collagen restoration program. Waiting for your masseters to enlarge enough to pick up the slack so to speak is not a great approach. There are a number of excellent collagen regenerating procedures to choose from. We have been particularly successful with both Sofwave (micro focused ultrasound)- a no downtime procedure, and with Morpheus8 (RF microneedling) which does produce a few days of redness. Expect to do a couple of sessions of either one initially, then yearly maintenance.

When will face tighten up and look the way it did before masseter Botox?

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When will face tighten up and look the way it did before masseter Botox?

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Recommended reading

Everything you need to know about Nonsurgical Neck Lift

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