How many units of Botox do I need for a nasal tip lift (to keep the nasal tip from being pulled down when smiling)?

Question

What would happen if too much Botox was used? Would it affect the smile? Also, where would the injection be done?

Monica Boen, MD · Answer

Hello and thank you for your question. Botox is one option for creating very subtle nasal lift as long as it is used precisely and in small amounts, about 2-6 units. I encourage you to schedule an in-person consultation with a board-certified cosmetic dermatologist who can assess you personally and create a customized treatment option for you.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist to go over your desired results. Facial fillers like Voluma, Restylane, and Juvederm along with Botox can be used to improve the symmetry of the nose and lift the tip; however, it won't make the nose appear smaller. Surgery would be needed to improve the nostrils or overall shape. See an expert. Best, Dr. Emer

Kenneth Yu, MD · Answer

Hello.  Botox in a small quantity like 2-3 units injected into the base of your columella can achieve a very subtle nasal lift.  As long as you understand the small improvement, then it's a reasonable option.  Fillers can add another degree of improvement.  An obvious droopy tip won't improve much with botox, and rhinoplasty remains the best option.   Take care.

Mohammed F. Ahmad, MD · Answer

Hello. Thank you for your question. Botox is injected under the tip of the nose. This requires very few units, approximately 2-4. It should not affect your smile. The injection can be a little uncomfortable, but is very quick.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question lauraelaine. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Although Botox is most commonly used in the upper face, it can also be used in various areas in the lower face. Botox can be placed in a vestigial muscle (seen in some people) called the depressor septi nasii to prevent the tip of the nose from moving downward when smiling. Here only 1-2 units is required. The product is placed above the center of the upper lip, just below the base of the nose. The muscle is small and only a small dose is required. If too high a dose is used in the lower face it can lead to spreading to nearby muscles. If the Botox spreads in this area it can affect the orbicularis oris muscle around the mouth, making it difficult to close the mouth and leading to drooling.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Leonard Grossman, MD · Answer

Botox can be a very effective tool in preventing nasal tip drooping in some of the patients. It doesn't work for everyone. The amount of Botox is typically extremely small, usually between one and three units. I hope this helps and good luck from New York City

Justin Harper, MD - Account Suspended · Answer

Hi lauraelaine,Depending on the how your nose tip descends when you smile, a few units of Botox (2-6 units) are injected using a fine needle to the   Depressor Nasii Septii. Because of the resulting "paralysis", the nose tip is prevented from descending when you smile. This is also an effective technique for older adults whose nose tip have started drooping. There is some redness after but practically no pain or bruising. Expect to see effects after a few days upto 3 weeks. Effects can last longer than Botox injected on the upper third of the face. It shouldn't affect your smile.All the best, Justin Harper, M.D.

How many units of Botox do I need for a nasal tip lift (to keep the nasal tip from being pulled down when smiling)?

Answers (7)

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