Am I stuck with this smile for three months post masseter Botox? (Photo)
Doctor Answers 17
Change in smiling after masseter muscle injection with Botox
The risorius muscle lays anterior and superior to the masseter muscle. If Botox was injected more anterioriorly or superiority than usual, especially if a dilute concentration was used, the risorius muscle can relax as well or instead of the masseter muscle. This muscle inserts into a fascial plexus called the modiolus just to the side of the corner of your mouth, and is responsible for drawing your lips to the side, to create the wide or sardonic smile.
Fortunately, this effect will peak at 2 weeks and then slowly wear off in a few weeks to several months, depending upon the amount of Botox that reached the risorius muscle. You should still be able to create a genuine smile, since the zygomaticus major and minor muscles are responsible for the real smile that also crinkles the eyes.
This effect can be avoided by using Botox in a concentration of 100 units per ml, placing the injections low and posterior, into the mass of the masseter itself (easy to feel by asking the patient to clench their teeth, grasping the muscle that pops out, and injecting into the largest portion of it in a triangular pattern) and not deep to the parotid gland.
I am sorry you have to endure this rare side effect. But it will wear off and should not happen again.
All the best,
Botox and Masseter Muscle
It sounds as if one of the nerves that affects your smile was inadvertently injected with the masseter muscle. It will wear off in 4 months. Please consult an expert for the best cosmetic results. Best, Dr. Green
Complication of Botox injection into masseter.
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Am I stuck with this smile for three months post masseter Botox?
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon
Masseter injection with smiling problems
Masseter Botox Smile Change
It seems that your Botox was injected a bit too high or was too dilute and has spread into the zygomaticus muscle that makes us smile. Unfortunately, you are stuck for the time it takes the Botox to wear off to regain your normal smile. Silver lining, the zygomaticus is strong muscle so it shouldn't take too long to counter the Botox.
Dr M Ganijee
Spread of Botox
Thank you for your question finallysophia. 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 masseter to help shape the face or to address clenching of the teeth. If the Botox spreads to the nearby risorious or zygomaticus major or minor muscles, a temporary asymmetric smile may result. Most people enjoy their results for 3-4 months. At that time the face should be back to baseline. Please follow up with your doctor for specific recommendations. Good luck!