If you look at a photo of Bethenny Frankel from 2008 and compare it to a clip of her from last week, you’ll notice something immediately. It isn’t just the "aging" thing people like to snark about on Twitter. Her actual face shape changed. For a long time, the internet was convinced she’d gone under the knife for a full jaw reconstruction. People love a good "secret surgery" narrative, don’t they?
But the truth is actually much weirder and, honestly, more relatable for anyone who wakes up with a headache from clenching their teeth all night.
Bethenny Frankel before and after isn't a story of a secret facelift. It's largely the story of a very specific, non-surgical injectable that did more for her jawline than any scalpel ever could.
That "Square" Jawline Wasn't Just Bone
Back in the early days of The Real Housewives of New York City, Bethenny had a very distinct, square jawline. It gave her that sharp, intense look that matched her "tell it like it is" personality. Fans assumed that was just her skeletal structure.
It wasn't.
Years of severe bruxism—that’s the medical term for grinding your teeth and clenching your jaw—had basically given her jaw a gym workout every single night while she slept. When you clench that hard, your masseter muscles (the ones you use to chew) get bulky. It’s called hypertrophy.
Basically, her jaw muscles were "swole."
By 2016, the change was so dramatic that she had to address it. Her face looked narrower. The sharp, heavy angles at the back of her jaw had softened into a more heart-shaped silhouette. Naturally, the plastic surgery rumors went nuclear.
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The Masseter Botox Revelation
She eventually set the record straight: it was Botox. But not for wrinkles.
She started getting Botox injections into her masseter muscles to stop the tension and the grinding. "You can see that my jaw has completely changed," she told The Daily Mail. "It's like a muscle, it's like working out with weights. My jaw from grinding so many years was like [a closed fist]."
When those muscles finally relaxed, they shrank. The "after" effect was a total transformation of her lower face. It’s one of the few times a celebrity "transformation" is actually backed by a functional medical treatment rather than just vanity.
More Than Just Injectables
Of course, it's not all just jaw Botox. Bethenny is 55 now, and she’s been refreshingly blunt about what’s real and what’s "assisted."
She’s admitted to a breast lift and, at one point, having implants that she later removed because they didn't feel right on her frame. She’s also been open about using filler and Botox in other areas, though she’s famously wary of "filler face."
There was a moment in 2023 where she posted a TikTok pointing at her face, saying, "This is not all natural." She’s even called out the "scary" side of fillers, preferring to look like herself rather than a filtered version of a human being.
The POTS Factor
Lately, the Bethenny Frankel before and after conversation has shifted from "Did she get work done?" to "Is she okay?"
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In early 2023, she went public with her diagnosis of POTS (Postural Orthostatic Tachycardia Syndrome). It’s an autoimmune-adjacent condition that affects blood flow and can cause massive swelling or a "deformed" look in the face depending on hydration and salt levels.
She’s had days where her face looks significantly different due to this health battle.
"I've experienced some health issues and my face was super deformed and people were saying 'Your face looks totally f—ed up. What did you do?'" - Bethenny Frankel on TikTok.
It's a reminder that what we see on a red carpet or a curated Instagram post is often a snapshot of someone managing a complex health reality.
Staying "Skinnygirl" at 55
You can't talk about her transformation without talking about her body. For decades, she’s been the subject of "too skinny" debates.
Honestly? She seems over it.
She recently walked the Sports Illustrated Swimsuit runway in 2025 and looked incredibly fit. Her secret isn't some crazy 3-hour gym grind. She actually hates the gym. She told Women’s Health that she focuses on:
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- 10,000 steps a day (mostly walking on the beach).
- Militant sleep (7 to 9 hours is her non-negotiable).
- Hydration stations (using electrolyte packets to manage her POTS symptoms).
She calls it "balance." She doesn't do weights. She doesn't crash diet. She just moves and sleeps.
The 2026 Reality
Just this month, in January 2026, she gave fans another "before and after" moment—this time a scary one. While vacationing in St. Barts, she picked up a bacterial infection that left her face covered in a severe rash.
She posted the "raw" look on TikTok, leaning into the Devil Wears Prada audio to poke fun at the situation. It cleared up with topical meds, but it was another example of her refusing to hide behind filters when things get messy.
What We Can Learn From Her Journey
If you’re looking at your own "before and after" and considering cosmetic help, Bethenny’s trajectory offers some pretty solid takeaways:
- Fix the function first. If you have a heavy jaw or "jowls" from clenching, masseter Botox might do more for your face shape than a thread lift ever could.
- Transparency is easier than lying. She’s 55. She knows she’s aging. By admitting to the Botox and the lift, she takes the power away from the "haters."
- Health impacts aesthetics. Swelling, "deformity," or sudden changes are often signs of internal health issues (like POTS) rather than a bad surgeon.
Bethenny Frankel's look will probably keep changing. That’s sort of the point of being a human being. But whether she's rocking a blonde bob for her birthday or showing off a bacterial infection from a tropical island, she’s stayed remarkably consistent about one thing: she’s going to tell you exactly what’s going on, whether you asked or not.
Practical Next Steps:
If you're noticing changes in your own jawline or face shape, start by tracking your symptoms. If you wake up with jaw pain or notice your face becoming more "square," consult a dermatologist about masseter Botox for TMJ rather than jumping straight to fillers. Always prioritize sleep and hydration—as Bethenny shows, they are the cheapest and most effective "procedures" available.