Kimberly Eickhorst, MD

It is not uncommon after Botox Cosmetic to have small little "welts."  I tell my patients to expect "bug bite" like bumps immediately after the procedure.  For some patients, they have no reaction at all to the injections, and for others their bumps can persist for some time but usually have resolved with a 24 hour period.  It also is not uncommon to bleed after receiving Botox, but again the bleeding is usually pinpoint and should cease fairly quickly after the procedure; if however, you are on blood thinners (aspririn/ Advil/ or have even drank alcohol recently) bleeding can be more pronounced.  It's most likely that if your "lumps" are persisting you simply have either a bruise or  little collection of blood (hematoma); these will both resolve over the next week or so and you do not need to worry .

An in-person consultation is going to best serve you, to allow a physician to feel and see your lips in movement, real time.  There are many choices available to you: surgical alteration, lips implants, and filler.
Hopefully these options can be further addressed at the time of your visit. All the best.

On the face, Botox can last anywhere between 3-6 months.  Generally, with good maintenance and regular, consistent Botox follow, the length of time that Botox will last for you as an individual will improve.  For example, if you start using Botox to treat forehead wrinkles, and the effects only last 3 months after your first treatment, you will find that if you follow up regularly with treatments, the effects of the Botox will start to last 4 to 5 months. 

Performing cosmetic procedures is often more an art than a science.  Results can not always be guaranteed but if you are unsatisfied with your result see a follow up check with the individual who delivered the treatment, and express your concerns/disappointment.  From there, there may be many options (more Botox, drops, other procedures, etc) that may help you to achieve "the look" you desired.  The unwanted side effects of Botox will resolve.  The rate of improvement will depend on the amount of Botox used, and the location in which it was placed.   

I think one of the most telling ways to tell if a therapy is "the best" is to survey what "doctors do" when they need a treatment.  I will tell you that whenever physicians have a basal cell or squamous cell carcinoma on their nose, Mohs seems to be their first choice of treatment.  This hopefully adds some insight.  But more importantly are the long-standing, successful cure rates of Mohs Surgery.  As stated in prior responses, Mohs Surgery provides a 99% cure for basal cell cancers, and a 97% cure for squamous cell skin cancers. However, there are many alternatives to treating skin cancers on the nose that should also be considered; those treatments range from traditional excision, to topical chemotherapy creams, radiation, scraping and burning, lasers, photodynamic therapy, and newer immunologic oral drugs. Having a dermatologic professional at your side should help you tease apart what the pros and cons are to each option for treatment.