Where to Get Botox Injected for Horizontal Lip Line?

Question

Have tried botox injections on inside of cupid's peak and on outside. Have heard mixed reviews on best place (and amount) of botox to inject. Suggestions? I am considering having surgery to permanently take care of line (ie. cutting of depressor nasi septi muscle), recommendations for doctors in Canada who do this?

Otto Joseph Placik, MD · Answer

The depressor nasi septi muscle which is responsible for plunging of hte nasal tip with smiling can be injected with botox at the base of the columella.

Ron Shelton, MD · Answer

Please make sure that you evaluate any response from a physician who is not examining you in person, my response as well, with caution. You are discussing a horizontal line, not vertical line. Some people get this when they smile. It may not be the depressor nasi muscle. Injecting Botox to minimize contraction of the risorius or zygomatic muscles could create several months of disturbing facial appearance and difficulty with eating and speech. The off-label use of Botox in this area should be done by an expert and sometimes the one unit injected in the mid cutaneous upper lip in 2 to four areas may be enough to minimize the crease...but if you are unhappy with the result, you will have to deal with it for three to four months possibly.

William Groff, DO · Answer

If surgery is not an option (you need to see a plastic surgeon to determine this), laser resurfacing could be an excellent option. Laser resurfacing can soften eliminate lines in this area. (see examples of this in my photos that I have posted on RealSelf). Seek out a dermatologist in your area with lots of laser experience, particularly in the use of CO2/Erbium lasers. Take care, Dr. Groff

Jason Lichtenberger, MD · Answer

If the line or lines that are bothering you are prominent on smiling, they may be very difficult to treat without changing your smile.  Botox may help soften fine lines, but a more prominent line may need to be addressed with a combination of filler and Botox.

	Surgery should be a last resort for this problem.  Hope this helps...

Kenneth D. Steinsapir, MD · Answer

BOTOX is really not so great for the lip.  Artfully placed fillers, particularly Restylane is the way to go.  You will likely be disappointed with the result of the surgery you are contemplating.

David Shafer, MD, FACS · Answer

A word of caution... Botox should not be injected in the lip except in very small quantities. Botox works by temporarily paralyzing the underlying muscles which could be disastrous in the lip if not injected properly. Your best bet may be surgical and or deep laser resurfacing instead of Botox. Good luck.

Steven Wallach, MD · Answer

I use Botox sparingly for lip lines because if too much is used it may cause the patient to smile funny.  I sometimes combine this with facial fillers as well.

Steven Hacker, MD · Answer

This is a very tricky area and I generally discourage most people from Botox in the lip. Risks include asymmetry of the lip including the inability to enunciate "p" and "b" - "Peanut Butter".

Darryl J. Blinski, MD · Answer

Droplets along the vertical ridge on each side, no more than 5 units. But why not wait til after the surgery heals to see if you really need it? From MIAMI Dr. Darryl j. Blinski

Peter A. Aldea, MD · Answer

Regarding: "Where to Get Botox Injected for Horizontal Lip Line?
	Have tried botox injections on inside of cupid's peak and on outside. Have heard mixed reviews on best place (and amount) of botox to inject. Suggestions? I am considering having surgery to permanently take care of line (ie. cutting of depressor nasi septi muscle), recommendations for doctors in Canada who do this?"

	You obviously have done your homework. The Depressor nasi Septi muscle bellies cause a pulling down of the nose tip and a horizontal groove across the upper lip on smiling. The only relatively easy location to hit the muscle is near its attachment to the lower anterior septum, everywhere else it runs close to other structures of the lip and it would be hard to weaken it without weakening the rest of the lip. If a few units of Botox near the septum did not work, you may be best treated with a procedure to disrupt the attachments o the muscle through a high upper lip incision.

	Dr. Peter Aldea

Where to Get Botox Injected for Horizontal Lip Line?

Answers (13)

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