What causes creping at nose after botox?

Question

The first time I had botox on lower/upper forehead and crows feet I developed scrunching/creping wrinkles at side of nose which disapated when botox wore off. Since then I only have lower forehead done and results are good, but a few years on I really want to address my whole forehead now as I but worried this will happen again? What could of caused it, the upper forehead or crow's feet injection?

Martin Jugenburg, MD · Answer

Thank you for your question. Without a photo it is hard to provide an accurate answer. That being said those muscles could be compensating for the lack of movement to the crows feet. Speak to your injector and discuss an injection to your bunny lines. All the best,

Adam Scheiner, MD · Answer

It may be that when botox was affecting the crows feet and forehead muscles that the only muscle left to move normally was the Nasalis muscle which causes "bunny lines".These can be treated at the same time as the forehead and crows feet and result in a smoother outcome.Hope this was helpful.

Anne Taylor, MD · Answer

hello! I hear this question a lot-- it is funny because we don't usually notice the wrinkles until the other ones are not there!So the muscles that are not moving do not have wrinkles but the rest of your face still does! hope that helps explain it!Good luck!

Mark T. Boschert, MD · Answer

There is a little muscle that was recruited when the others were treated.  Next time have them treat the small superficial muscle called procerus and it should be fine.good luck!

Steven Wallach, MD · Answer

Botox paralyzes the local muscle.  If you try to scrunch you nose other muscle not he side of the nose try to react. These can be treated as well to reduce what are called "bunny lines."

Richard Ort, MD · Answer

It's not possible to say for sure without seeing a picture, but you may have bunny lines forming at the sides of your nose.  This lines run diagonally from the inner corner of the eye toward the nose.  Sometimes people will recruit the muscles that cause these lines after a Botox treatment and will see lines in this area.  It is a straightforward treatment to inject a little bit of Botox into the upper sides of the nose to reduce the bunny lines.  I would suggest that you return to see your injector 1-2 weeks after your next Botox treatment so that they can check your results and make sure that you don't need any extra Botox to any areas that still bother you.

Deborah Kessler Hudak, MD, MHA · Answer

I have seen people get wrinkles and boggy skin in areas of the bridge of the nose when too much botox (or Xeomin or Dysport) was injected too low and too deep in the midline between their brows.  Injecting the crow's feet will not do that.  Injecting the upper forehead generally does not do that, either.  I believe the subsequent injections of the lower forehead were done properly.I have more than 20 years experience injecting Botox, and have seen a lot of "accidents" caused by other injectors.  In nearly all cases, the undesired effects were from too much Botox being injected and/or the Botox was not injected in "just the right place."  The most common undesired effect I see from other injectors is inattention to the strength of the lateral parts of the frontalis muscle, resulting in "Spock eyebrows" after treatment of the glabellar complex ("1's" or "11's" between the brows).

Stephen Weber MD, FACS · Answer

It sounds like you've develop "bunny lines" that appear on the sidewall of the nose. These will often develop when Botox is used in the upper face. In my experience, very expressive people will recruit these muscles hwen they are unable to use the muscles treated with Botox. They can be treated with a small amount of Botox placed on the sidewalls of the nose. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

What causes creping at nose after botox?

Answers (8)

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