How Effective is Botox for Changing the Shape and Size of a Nose? (photo)

Question

I spoke with a surgeon today who suggested that surgery wasn't necessary and that if I really wanted botox could be an option to reduce the size/flaring of my nostrils. I feel however after researching rhinoplasty, that alar-plasty could be helpful. Any help would be greatly appreciated.

Jonathan Kulbersh, MD · Answer

In general, Botox is used to treat the following cosmetic issues:

	1) Crow's feet
	2) Glabella (the "11" between the brows)
	3) Forehead wrinkles
	4) Smoker's lines

	 

	Botox will not help reduce the size of the nostrils.  This can be achieved with an alar base reduction.  I would recommend seeking the advice of a qualified surgeon who has experience performing alar base reduction surgery. Thank you and I hope this helps.

Ron Shelton, MD · Answer

There have been off-label uses to change the shape of the nose in some individuals with Botox. As an example, some people when smiling have a downturn of the tip of the nose and a couple of units of Botox, off-label, in the columella (strut) of the nose can soften this downturn. Injecting the outer nostril muscles can minimize the flare that you may get with smiling but it can negatively affect your smile and you may be unhappy with the appearance for three to four months while awaiting for the result to go away. Surgical reduction of the nostrils, if creating the appearance you desire, with minimal evidence of scarring could provide you a permanent good result unlike botox that would have to be repeated frequently and the effects not consistent.

Christopher R. Hove, MD · Answer

While Botox (or Dysport) is useful in weakening or paralyzing muscles, it is not often recommended for nasal injections. True, many muscles act on the sidewalls, ala, and base of the nose, but immediately surrounding muscles also influence the smile, so weakening those may also affect your smile. The good part is, the results are temporary. The bad part is, the results are temporary. So if you like the Botox results, repeat injections are necessary. I cannot recommend any nasal base/alar surgery without seeing the remainder of the face, particularly the inner corners of the eyes (aka medial canthus). The alar margins ideally should be aligned with a vertical line dropped from the inner corners of the eyes. If they extend beyond that landmark, Weir incisions will likely give you the best long term results.

Kenneth D. Steinsapir, MD · Answer

It is critical that you understand that essentially only two specialties provide reliable rhinoplasty: Plastic surgeons and facial plastic surgeons. Facial plastic surgeon receive the most systemic training in rhinoplasty techniques. Plastic surgeons who have completed an aesthetic fellowship may also have extensive training in rhinoplasty. fellowship training is not the only way to learn this procedure. Many very solid rhinoplasty surgeons developed and refined there skills while in practice. Just be aware being a board certified plastic surgeon or a fellowship trained facial plastic surgeon does not guarantee that one can perform your rhinoplasty to your liking. It was once the case (and it is still true today) that in larger markets, there would be the guy in that market that dominated rhinoplasty in that town. Often what you got was the same basic rhinoplasty for everyone. Now the best rhinoplasty surgeons offer very individual and customized surgeries that much more closely approach what is requested by the patient. For this reason, it is essential that you carefully do your homework in finding a rhinoplasty surgeon who is right for you. BOTOX will have minimal effects. Alar reduction can cause visible scaring and should only be undertake after careful consideration of your overall concerns.

Misbah Khan MD, FAAD, FACMS · Answer

sometimes alar flaring can be a result of overactive muscles in the area that can be softened with the use of Botox. it is a temporary effect. the good thing is, its non-invasive, no downtime, much affordable and if u dont like it u dont have to do it again as it is reversible. if u much rather prefer a permanent route its best to have a rhinoplasty done that will correct alar flaring.

Michael Bowman, MD · Answer

Botox can be used to prevent dynamic changes in the shape of the nose.  Most commonly, Botox can keep the nostrils from flaring during facial expressions or keep the nasal tip from drooping when you smile (as it does for some people). 

	
	Although my assessment is limited by the lack of other nasal views, it appears that the base of your nose is somewhat wide.  Therefore, a "Weir Excision," or alarplasty is probably the best option to narrow the base of the nose. 

	
	Although the Botox injections are indeed safe and reversible, I think you are likely to throwing away your money.

	
	I would make sure that you are being evaluated by an experienced rhinoplasty surgeon.  He/she will be able to advise you on the best method to achieve the results you desire, as well as discuss the risks and benefits associated with the recommended procedures.

Darryl J. Blinski, MD · Answer

Posted photo only shows ONE view. But are you sure you where with a boarded surgeon? Because I believe ONLY an alar - plasty could help.

Steven Wallach, MD · Answer

Botox can perhaps temporarily improve the flaring by paralyzing the local muscles so that when you small it does not flare as much. It may affect your smile. A more permanent method is alar base surgery.

Tal T. Roudner, MD, FACS · Answer

Alarplasty is part of rhinoplasty procedure to treat alar flaring and is permenant the drawback to those procedures is possible scaring. Rarely hear of Botox injections to correct the flar it is a temporary treatment as well.

	 

	Best wishes!

Richard W. Fleming, MD (retired) · Answer

Botox injections can change the dynamics of your smile but it will not change the size and shape of your nose. The nose should be evaluated with the face at rest. Please send a picture of your nose and eyes when you're not smiling. Narrowing the base of your nose (an alarplasty) may be helpful.

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