hi my nose is slightly flatter towards the lower 1/3 (tip end). would botox in the bit of skin below the nose/above the lip be the best solution or a non surgical nose job with filler injected into the bottom of the nose to strengthen the support there? I am concerned about necrosis and injecting into an artery but is this risk greatly reduced with the use of a canulla? Any advice on the best route forward would be very much appreciated, thank you. Sarah
Nose drooping. Would Botox help?
Doctor Answers 5
Nose Drooping, not a Botox issue
Botox works by weakening facial muscle function. The only nasal muscles that possibly could impact the tip are those at the base of the nose which can indeed pull the tip down, but mainly when smiling. Fillers may indeed assist in lessoning flattening but would not "strengthen the support". Also, keep in mind that fillers are temporary. Usually, a flat nose is caused by weakening of structural support, so an actual rhinoplasty likely remains your best option.
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Nose Drooping and Botox
The Use of Fillers in Nonsurgical Rhinoplasty
Botox has many off-label applications and the nasal depressor muscle can be targeted to improve a tip that droops with smiling. Although there is no permanent replacement for surgery, injecting facial fillers to increase the projection of the tip and improve the droopiness. To avoid improper injections into an artery, consult a well-trained plastic surgeon that has experience in nonsurgical rhinoplasty.
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Addressing nasal tip ptosis nonsurgically
Botox and fillers can be used in concert to address a ptotic tip, but typically the more dramatic change can be created with fillers during nonsurgical rhinoplasty. The risk of necrosis can be minimized by seeking a doctor with expertise in nonsurgical rhinoplasty. I personally feel Restylane is also the optimal filler to use because it is more firm than the other hyaluronic acids, but since it is a hyaluronic acid, can be easily reversed if any issues arise.
Botox to Nose
I have never used Botox in the nose or the nasal depressor area. However, if a small amount works, you get the benefit without surgery. With that being said, it is worth a try but I don't think you will get the desired result. Your concerns of tissue necrosis are unfounded as there is virtually no chance if performed correctly. I would try Botox before a filler to solve the problem of a droopy nose, although surgery would be the best alternative for a permanent result.
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