How much Botox for my nose and how long will it last? (photo)

Hi Lily,A common procedure for Asian patients is to raise the bridge of the nose.  This gives Asian faces which are rounder and relatively flatter than our Caucasian counterparts more definition.Raising the bridge of the nose is called Augmentation Rhinoplasty when it is performed as a surgery, and Injectable Rhinoplasty or Non-surgical Rhinoplasty when performed using injections to add volume to the bridge of the nose.There are two types of injectable procedures.  The most popular injectable is called Botox, which you referred to in your question.  This first type of injectable is a toxin or poison which is used in very tiny doses to temporarily paralyze muscles which are "overused."  You do not have any wrinkles on your face to warrant any Botox, which is why I suspect you were referring to injectables in general as opposed to Botox specifically.  Botox is used for people who are frowning, raising their eyebrows or have fine lines at the corners of their eyes called "crow's feet," all of which you do not have as a young woman.The second type of injectables are called fillers.  These fillers are a type of gel or paste which is injected under the skin.  This filler will add volume to an area under the skin.  We use injectable fillers for smile lines, adding volume to the cheeks, as well as injecting it on the bridge of the nose to add definition by raising the bridge of the nose.  On the profile view it can give a person who has a very flat bridge a higher bridge.  The limitation for the injectable fillers is that it cannot raise the tip of the nose.  Adding filler to the tip of the nose will not make it pointier, instead it will make it a little bit puffy, and if a lot of filler is added to the tip, it will make the tip wider.In general, Asian patients who have the best improvement with a Injectable Rhinoplasty have a low bridge which starts lower than their upper eyelash line.  If the bridge appears to start at the middle of the eye or pupil line, the filler can be added to the bridge of the nose to make the bridge start a little bit higher.  Based on the only photo which you posted, it already appears that your bridge starts at your upper eyelash line.  It is my personal opinion that Asian noses which start at the eyebrow line appear "fake" to me as a fellow Asian person.  Even most Caucasian noses do not start that high, unless they have a prominent brow and deep set eyes.  On a profile view, the bridge of the nose should appear to begin at the upper eyelash line for an Asian or for that matter most Ethnic noses which tend to be rounder or flatter with less definition to the tip.  A bridge that is too high in Ethnic noses, screams nose job in my mind.  I don't know how other surgeons feel about it, but I would rather not perform the procedure if it looks fake in my opinion.If the tip cannot be raised or projected further out, then an already straight Asian nose which starts at the upper eyelash line and goes straight to the tip will not be able to be improved.  If the upper part of the bridge is scooped and lower than the upper eyelash line, then there is room for improvement with the injectable rhinoplasty technique.To raise the tip of the nose then add definition to the bridge with an implant or cartilage to narrow the width of the bridge would require a surgical rhinoplasty, which is not achievable with injections.In general, injectable fillers like Restylane and Juvederm last around 4-9 months before the patients ask for a Touch up.  Longer lasting fillers like Radiesse, may last up to a year or sometimes longer, but there are risks with these type of fillers.  Lastly, there are permanent fillers like Artefill or Silicone, which can cause permanent damage to the skin (Google: "Dean Toriumi and Nasal Injectable Fillers Causing Damage" to learn more about the potential risks.)The safest fillers if you were to choose to have this done would be hyaluronic acid type of fillers such as Restylane or Juvederm.  These can be completely dissolved, where Radiesse or Artefill cannot be dissolved.  If you like the results of raising the bridge of the nose, but additionally want a narrower tip and more definition, it may be a good way to "test out" how you feel about changing the appearance of your nose.  If you really like it, you can first dissolve away the Restylane or Juvederm, then have a consultation for a rhinoplasty without the filler in anymore.  If you have Radiesse, and it cannot be dissolved, a rhinoplasty can be performed, but later as the filler goes away, the bridge may not be high enough as some of the result was temporary.   As you can see, choosing injectable rhinoplasty should not be taken lightly, especially if you choose something which is not dissolvable.  In the 1980's, injectable rhinoplasty was a common procedure in Asia, and they were using silicone.  Although many patients looked great initially, the permanent silicone gel did not stay on the middle of the nose, and began to shift or slide to the sides of the bridge which make the nose not only flat but even wider than before the silicone injections.  Some doctors claim to have invented injectable rhinoplasty, but they may not be aware of the past history of injectable rhinoplasty, and these same doctors are recommending longer lasting and permanent fillers which seems to be the case of, "those who don't know history are doomed to repeat it."Most likely I would not recommend any injectable filler to your bridge, but if your side profile were somehow below the upper eyelash line, or you wanted it slightly higher than the upper eyelash line, but below the eyebrow/forehead, you would most likely use a 0.5 cc syringe or half of a syringe, and potentially not even use the whole amount.  I typically inject smaller amounts and let the patient look in the mirror, before deciding to inject more and make the bridge even higher.  This way it is hard to over inject or make the patient look plastic or ridiculous.I hope that you find this answer helpful.  Good luck on your cosmetic journey.Best,Dr. YangP.S. 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Thank you for your question, You did not mention the reason you were looking for Botox to the nose. Schedule a consultation with an expert injector to discuss possible treatment options. Best,

From the photo provided it is not clear exactly what problem requires treatment. In general terms, however, Botox (as well as the other neuromodulators, Dysport and Xeomin) have been used to treat, alone or in conjunction with fillers, a variety of differing nasal problems related to muscular movement (dynamic wrinkles). These include horizontal lines across the nasal bridge;  the so called "bunny lines"--a radial set of lines seen in certain individuals on the sides of the when smiling; a droopy nasal tip; flaring nostrils; and a hanging columella. Treating each of these problems typically requires small amounts of Botox--only a couple of units on each side. Results tend to last about three to six months. Neuromodulators used in this fashion are not within the purview of most injectors and only an experienced, board certified core aesthetic physician with specific expertise in these techniques should be consulted for treating the nose. 

What area of the nose are you trying to treat with botox?  Typically the frown lines or "11" lines 15-25 units are used in women.  If you are talking about the lines that form when you smile or express on the dorsum of the nose, they are referred to as "bunny lines," only a 2-6 units are needed.  But if you are talking about nasal reshaping, which I do frequently on the nasal dorsum and supratip, you would need a filler and I suggest using an hyaluronic acid (HA) typic filler that can be reversed if you are unhappy or if a complication were to occur.  Good luck, Dr. Emer.

Thanks for your questions.  It is unclear what you are looking to treat.  If you are thinking about treating the "bunny lines" which occur when you scrunch your nose, generally 5-10 units of Botox on each side of your nose is usually sufficient for a natural result.Good Luck