I have been thinking about a nonsurgical nose job. As you can see from the profile where I am not smiling, my bridge is a bit crooked. When I smile, my nose kind of goes to the right a tad and down. I have heard of using botox in the muscle below the tip, above the lip but I think just more anchorage in the bridge might keep it from drooping. Please let me know what you think. Everyone was so helpful with the last question. Thanks!
Would Some Filler in my Bridge Give my Nose More Support when I Smile?
Doctor Answers (5)
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Fillers in your nose for a non surgical nose job will not improve the look of your nose or support your nose when you smile. Smiling is dynamic and the entire face changes when you smile, not just your nose. But your nose is dipping down due to lack of tip support most likely and the action of the muscles. A good nose job can support your tip and make it cuter and make the whole nose fit your face better. A bad nose job will make you regret ever even thinking about a nose job so be careful and do lots of research.
Use of fillers to correct bridge
Most patients have a hump in the middle bridge region. Filler can be beneficial in "flattening" the dorsal hump. It can also correct small irregularities in the tip and dorsal area. If the tip is deviating right or left the use of fillers is not going to be of much help. BOTOX has the effect of raising the tip, and filler at the base can help support the tip as well. The beauty of these options is that they are not permanent but can help the patient for several months.
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Non-surgical Techniques Will Not Cure the Problems
Fillers are OK for some situations but I do not think they are the best choice for you.
First, the nose is pulled down by the action of the Depressor Septi muscle, the one that would be neutralized by the Botox you mentioned ( injection site below the tip).
Further, the filler cannot negate the action of the facial muscles and their effect on the nose.
From the photo, you would seem to be an excellent candidate for the real thing, a rhinoplasty. You have great facial features. If your tip is bit bulbous, as it appears, surgery and only surgery can handle that. Plus, surgery will permanently remove the bump or hump in the mid-portion of the nose.
Seems as though you could have a great nose in less than two hours so why not do it once and be done with it? Otherwise, you will tire from the lifetime of " temporary" fillers and Botox. Guaranteed.
Robert Kotler, MD, FACS
Beverly Hills, CA
Non-surgical nose job may not give you the support you are looking for
Adding filler to the bridge of the nose often works well to provide definition. In general we use it more for thicker skinned individuals on the upper portion of the nose not necessarily the tip. One area that might help improve tip projection would be augmenting the columella by placing some filler in the columellar labial junction. This with the Botox can sometimes diminish the tip plunging with smiling. In some cases rhinoplasty surgery to release these muscle and provide the tip with a little more support may provide a more predictable result. Best wishes.
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