Zygomaticus hit with Botox - Help! (photos)

Question

My zygomaticus muscles were injected with Botox instead of the masseter. 3 weeks post injections and my smile remains paralyzed and the masseter hypertrophic. 30 units were injected on each side. My questions are: Will 30 units into the zygomaticus dissipate in 3 months, or is it likely to take longer? Is 3 months of paralysis likely to cause nasolabial folds, increased buccal fat, jowls and cheekbone drop? If so, how long for my face to resume its normal shape? Thanks for your responses!

Jason Emer, MD · Answer

It can take a few months for Botox to wear off, but your smile and facial shape will return to normal. It may take a series of treatments to contour the jawline. See an expert. Best, Dr. Emer

Michael A. Zadeh, MD, FACS · Answer

Sorry to hear about your experience with Botox to the masseters. It does look like either the zygomaticus or risorius muscles were affected by your injections. Hopefully not all 30 units were injected into these muscles by mistake. Unfortunately, there is nothing you can do except wait for the Botox to wear off which may take 3-4 months. However, you may notice some function return around 2 months or so. There will be no long lasting complications from this and things should return completely back to normal. Best wishes.

Philip K. Robb Jr., MD, FACS · Answer

Thanks for your question! This is a tough one. It's hard to really tell what your full smile looks like from this snap shot but it does appear that your zygomatic complex was involved in the treatment. From the jaw picture it does appear that your left side is slimmer than the right. That said, botox to the masseter can take a bit longer to work than in other areas.

Returning to your injector would be a good place to start and see if they can offer any more information- often results can be palpated or felt prior to seen.

As far as how long- was it 30units per side or total? I will often start with 15U per side and titrate up as needed. This too will last between 2.5mo a 3.5mo.

Hope this helps!

Dr. Robb

Hardik Soni, MD · Answer

Botox works by blocking signals from the nerves to the muscles. The injected muscles can no longer contract, which then causes the wrinkles to relax and soften. Botox injected into the masseter can create a slimming affect to the face. If Botox is injected into the zygomaticus muscle it can affect your smile. It will take 3-4 months for Botox to wear off. Unfortunately there is no way to speed this up. I suggest having an in person evaluation to by an expert injector.

Ram Chandra, MD · Answer

Masseter injection site is not close to Zygomaticus major or Zygomaticus minor. Jaw shaping takes a series of regular injections. Good news is all these should revert to normal in 3-4 months.

Zygomaticus hit with Botox - Help! (photos)

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Answer: Zygomaticus hit with Botox - Help!

Answer: Zygomaticus hit with Botox - Help!

Answer: Masseter injection of Botox - problem?

Answer: Masseter injection of Botox - problem?

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Zygomaticus hit with Botox - Help! (photos)

Answers (10)

Answer: Zygomaticus hit with Botox - Help!

Answer: Zygomaticus hit with Botox - Help!

Answer: Masseter injection of Botox - problem?

Answer: Masseter injection of Botox - problem?

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Recommended reading

Everything you need to know about Botox

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