Lip Fillers

Botox

Are you planning to get your Botox injected by someone other than your rhinoplasty surgeon? Getting Botox won't necessarily preclude you from getting rhinoplasty done safely; however, you want to make sure that your surgeon has evaluated you before any Botox treatment and you also want to make sure to relay your concerns about the smiling deformity associated with the depressor nasi septi. Your rhinoplasty surgeon may include resection of the muscle as part of the surgery, which can be a more definitive treatment for your concerns. This is why it's very important for your surgeon to be fully aware of your concerns as well as any treatment you may be planning. Talk to your surgeon.

So I am planning on getting botox injected into my depressor septi muscle to see if it does anything for my drooping tip. However within 3 months, I plan on getting a rhinoplasty. I know botox lasts anywhere from 3 to 5 months. Would this have any effect on my rhinoplasty? Can I get the surgery done even if the effects of botox are still present?

Would Botox in the depressor septi muscle interfere with Rhinoplasty?

There are various techniques for lip injection and lumpiness is unfortunately an inherent risk of all techniques, but possibly more visible with this "tenting" technique. I can see the course of the needle where you were injected. Massaging immediately after injection can sometimes help to even out the filler. I personally don't do this tenting technique and prefer going transversely, parallel to the lip. I'm not sure that you as a patient can never get tenting (maybe it's an effective approach in some providers' hands) but I personally don't prefer this technique due to the risk of these findings.

I've been getting lip filler for years and for the first time I went to someone new. We dissolved old migrated juvederm and she refilled using Restalyne Kysse. She used the "tenting technique" to give me the height I asked for, and now I'm lumpy. I went back after two months to see what was going on, and she added more filler. Now I'm more lumpy. She suggested I'm not a good candidate for that technique. My question is, is that true? Or is this an issue with the injector? Please help.

Lumps and ridges after tenting technique - am I not a good candidate for Lip Fillers or is it the injector? (photos)

You actually have a very nicely shaped upper lip, but it looks very prominent compared to your lower lip and I think it's the mismatch that may be concerning you. I would suggest augmenting your lower lip using dermal fillers. It would be safest to do this in a stepwise approach and not do too much at once. I would recommend getting a conservative amount of filler in the lower lip and then reassessing how it looks (once swelling comes down) and then buildling up the lip with more filler as needed.

I have always had my top lip hang over my bottom and it’s been something I’ve been insecure about for a long time. I’m curious what the best way to fix this issue is? I’m interested in a lip flip but would that work?

What’s the best attack plan for my lip shape? (photo)

Nance Yuan, MD

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