Botox in the masseter muscle – my face doesn’t move normally!

Dear Dr. Irwan, I have done almost 3 weeks ago botox in the masseter muscle, like 30 units each. And after 2,5 I began to see that my smile is changing, I can't laugh normal anymore, it seems like frozen, my nasolabial is different and I had laugh dimples in my cheeks before and they are gone now. When I laugh my cheeks look very puffy and even the left corner of my mouth is pulling down. When will this effect started to go away, like i mean: when is the official breaking down proces of the botox started? And the most scared of all I am of the results when the botox is not workin anymore, i am so scared my face won't be the old face again. Like how is it possible to get the dimple back en the nasolabial turning back into normal after positionering almost 4 months like this? I really hope you can answer my questions, thanks so much.

For those who are wondering what and where the masseter muscle is …….it’s the large muscle at the angle of the jaw that’s under the earlobe and forward just a bit.  Clench your teeth and you should be able to feel it.   It’s part of the problem (usually) in TMJ and clenching issues and sometimes Botox is used in these muscles by doctors who treat TMJ.

Botox/Dysport is used aesthetically most in Korea where a large masseter muscle is considered unattractive, especally for females.   It is also used sometimes in the U.S. and other parts of the world to slim the lower face. 

In my opinion, it is best to start with this process, if it’s indicated, conservatively!  Meaning in a female somewhere between 10-15 units on each side.  A smaller female on the lower side.  If more slimming is needed later, another treatment can always be done.   Also, placement is key.  It is possible that the doctor who injected you, injected into  different muscle groups as well.

Please, please ………..go back to your doctor and find out exactly where the Botox was placed and have a respectful but honest conversation so the doctor can see the results.

To reassure you, your face will go back to normal but it may take 2-6 months, depending on exactly where the Botox/dysport was placed.   It may help to find a good aesthetician who does electrostimulation facials and have her/him stimulate the muscles that are currently slack in the interim.    I’m very sad this happened to you and I know it’s frustrating.

Hope this helps,  Dr. I


Dr. Brandith Irwin, MD

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