Botox Into The Depressor Septi Muscle to Help With Stuffy Nose?

Question

I have struggled with post nasal drip and a stuffy nose for years. An article says if the upper lip muscles are weak, it can cause the Depressor Septi to be loose. When the muscle is loose, it relaxes against the mucus membrane of the nose, causing all kinds of problems. The article said to flex the upper lip so that the depressor septi muscle stretches. It's AMAZING, once I stretch the muscle, ALL my problems go away! Could Botox freeze the muscle while it's stretched or should I have it cut?

Ron Shelton, MD · Answer

Botox can not freeze the muscle in a stretched state. The Botox could only relax the muscle which might worsen a condition that improves when the muscle stretches. The treatment also could cause a lengthening of the upper cutaneous lip that might make it unattractive or bothersome when brushing teeth or drinking / eating. I would not recommend the treatment but you should consult a board-certified plastic or ENT facial plastic surgeon who is experienced at both rhinoplasty (nose job) surgery and botox injections.

	The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Michel Siegel, MD · Answer

Placing Botox on the DSM, will cuase the muscle to relax and theoretically give you some increase rotation (increase tip elevation) The degree will depend on other anatomical facotrs related to how your tip is anatomically "put together".

	The real question is whether the increase in tip rotation would give you enough lift to recreate what with your own fingers. In my experience, patients, get about 5 degrees of elevation. Although it may work it may not be enough to alleviate your symptoms, and a rhinoplasty may still need to be performed.

	Best,

Arnold W. Klein, MD (in memoriam) · Answer

An active depressor septi muscle can accentuate a drooping nasal tip and shorten the upper lip on animation. We have found that dissection and transposition of the depressor septi muscle during rhinoplasty can improve the tip-upper lip relationship in appropriately selected patients. Although the anatomy of the depressor septi muscle has been described, the anatomic variations of this muscle have not been previously reported. The goals of this study were two-fold: (1) to define the anatomic variations of the depressor septi muscle using 55 fresh cadaver dissections and (2) to develop a clinically applicable algorithm for modification of this muscle during rhinoplasty in those patients with a short upper lip and/or tip-upper lip imbalance. Fifty-five fresh cadavers were dissected, and the anatomic variations of the depressor septi muscle were recorded. Three variations of the depressor septi muscle were delineated: type I inserted fully into the orbicularis oris (62 percent); type II inserted into the periosteum and incompletely into the orbicularis oris (22 percent); and type III showed no, or rudimentary, depressor septi muscle (16 percent). Sixty-two patients over a 4-year period (from 1995 to 1999) were identified preoperatively with a hyperactive depressor septi diagnosed by a descending nasal tip and shortened upper lip on animation. These patients underwent dissection and transposition (not resection) of the paired depressor septi during rhinoplasty with improvement or correction of the tip-upper lip imbalance in 88 percent of cases. The anatomic study, surgical indications, rationale for the operative technique, and clinical cases are presented. Dissection and transposition of the depressor septi is a valuable adjunct to rhinoplasty. Thus these patients would benefit most from Botox. Where this is enough to rid of a stuffy nose I think not.

Botox Into The Depressor Septi Muscle to Help With Stuffy Nose?

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Botox Into The Depressor Septi Muscle to Help With Stuffy Nose?

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