Am I stuck with this smile for three months post masseter Botox? (Photo)

Thank you for your question and pictures.  Well the good news is that over the next couple of months this will resolve.  I am not sure why you were having Botox injected into you masseters.  You have a beautiful natural smile so I hope it wasn't for cosmetic reasons.  If for medical reasons, be sure to seek a Board certified doctor who has experience in this.

Botox will resolve in 2-4 months. I suggest you see an expert in cosmetic dermatology for future treatments. Best, Dr. Emer

This is a strange result for isolated masseter injections. I see patients for second opinion with all sorts of issues following jawline slimming and this typically results from injections outside the masseter muscle that weaken muscles other than the masseter. This should resolve by three months but hopefully sooner. Rest assured, however, that this is temporary. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Since the masseter is a muscle of mastication and is posterior to and somewhat anatomically isolated from muscles associate with smiling, I am not sure what the root cause of your problem is. Were other areas injected around the mouth injected simultaneously? Secondly, the photos are insufficient to really determine the measure of change that you may see in the mirror.  I encourage you to discuss this with your Doctor

Thank you for your question and for sharing your photographs.  I see your area of concern for your smile but I would allow a couple of more days to pass to allow the Botox to fully mature.  There can be subtle changes in the 10-14 day range after treatment.  If there is little improvement in appearance one of the muscles responsible for fully elevating your upper lip was partially affected and will need time to return to normal.  This may take several weeks.

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!

Dear finallySophia: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,Dr. Clark

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

This could be from an injection of Botox away from the master affecting another set of muscles that aid in smiling. If this is the case, it will resolve in 3-4 months.

Sorry to hear about your issue with Botox injection. It appears that the physician who injected your masseter may have injected a little to anteriorly and so the Botox spread into the risorious muscle. That is almost certainly why you have an altered smile. Nonetheless, the Botox effect will wear off with time (approximately 3 months). Some physicians might consider injecting your other risorious to balance out the smile but I would probably wait for the Botox effect to just wear off. This is a rare complication of Botox injection into the masseters. I would hope you continue to get the injections because it really does help with the clenching/grinding. -Dr. Patel