Smile is not the same after masseter muscle botox? (Photos)

Last Tuesday I had some follow up Botox in my jaw after having some the week before that Everything was fine before the follow up. I didn't scrimp on my Doc & she was highly recommended. I can't lift my cheeks any more & look like a granny(it is funny) Doc said allow up to 2 weeks & should resolve itself. I have read it take 3-4 months, and some have even said weeks,but I am just looking for reassurence I will get it back-and any personal stories of where anyone has seen it faster than that?

Doctor Answers 12

Botox side effects

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Thank you for your question LFA.SMCN. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. In the lower face Botox can be placed in the master muscle to address TMJ or to contour the face. With any Botox injection there is a risk that the Botox can spread to nearby muscles. In this case the nearby zygomaticus muscles serve to elevate the corners of the mouth when one smiles. If Botox spreads to these muscles it can lead to a temporary asymmetric smile. Usually this resolves within a couple of weeks but it could last longer. The good news is that it is not permanent.

Please consult with a doctor for specific recommendations. Good luck!

Smile is not the same after masseter muscle Botox?

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I am sorry this has happened to you. This is from the injection affecting the risorius muscle. There is nothing you can do to improve this. It takes 3-4 months for Botox to wear off. This is a specialized area and needs an expert injector. 

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 47 reviews

Results after Botox injection to the masseters

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Sorry to hear about your Botox experience. It appears the Botox diffused into an adjacent muscle responsible for your ability to smile. The muscle was either the risorius or the zygomaticus major. Either way, the Botox will wear off over the next 3-4 months and your smile will return to normal. I'm not sure what exactly your injector did wrong, but the injections were either placed too anterior (forward) or superior (high) along the masseter and/or overly dilute Botox was used resulting in easier spread to adjacent muscles. Hang in there, your smile will return to normal.

Smile is not the same after masseter muscle botox? (Photos)

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I have been doing this since the 1990's I  inject on the bone, and have never seen this happen. It's because the injection is deep in the muscle.  I suspect that  your dr didn't get the needle all the way into the muscle. In any event it will go away within a few months, Less if the leak wasn't so bad.    


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It takes 2-3 months to see improvement.

My best,

Sheila Nazarian, MD, MMM

Beverly Hills, Board Certified Plastic Surgeon

Smile is not the same after masseter muscle botox? (Photos

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.  Yes it will come back. It may take 3-6 months but it will come back to normal. Unfortunately this is a very common side effect following botox injection to muscles around the mouth or involved with moving the mouth/jaw like the masseter muscle. Just remain patient knowing it is only temporary which is the positive and negative of botulinum toxin. Good Luck! 

Jordan P. Farkas, MD
Paramus Plastic Surgeon

Smiling Asymmetry After Botox

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It can take 3-4 months for Botox to dissolve and it sounds like there was some diffuse spreading to nearby muscles which are affecting your smile. You can try Venus Legacy treatments to improve. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Smile is not the same after master muscle botox

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Hello, thank you for posting your question and I'm sorry you did not receive your desired results. Botox takes 7--10 days to take effect, with full results setting at ~day 14. Botox usually lasts ~3 months, with no medication that will counter-act it's effects. I would suggest seeing your provider and discuss the results you have obtained. Best of luck, Justin Harper, MD. 

Botox for masseter muscle

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Have done Botox for masseter and fullness for years and have not seen this.  Best to go back to your injector and see what next.   It will definitely wear off but timing is impossible to guess.    Should definitely be gone by 4 months.  My Best,   Dr Commons

Smile affected by Botox in masseters

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This is caused by the risorius muscle being affected by the injection. This will take about 2-3 months to improve. These is nothing that can be done to improve this. I'm sorry this has happened. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.8 out of 5 stars 53 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.