Filler For Line Going Across Horizontal Top Part of My Nose?

Question

I can not receive botox bc it gave me acne cysts. My question is can I receive a filler for the line going horizontal over the top of my nose? I thought I read this was dangerous to that specific area. I dont have the option of botox and this line makes me look very old for my age. If a filler and botox is not an option is a brow lift the only solution or can a laser help me?

Kenneth Hughes, MD · Answer

For the glabella, the injector should inject an HA filler only and preferably with a blunt cannula.  For the top of the nose, it is safe to inject one of the HA fillers.    Kenneth Hughes, Los Angeles

Sam Naficy, MD, FACS · Answer

The primary muscle that creates the horizontal line across the top of the nose is your procerus muscle. Botox is the prefered treatment and typically does not trigger acne. However some Hyaluronic Acid fillers can be used to help with this line If done carefully by an experienced injector. Radiesse is not a good choice for this area because it cannot be dissolved if needed. The issue is that you have important blood vessels near that area and if you accidentally inject product into a vessel you can occlude it. This could lead to a compromise in circulation, tissue necrosis or blindness. For safety, I would recommend trying Botox again before fillers

Nelson Lee Novick, MD · Answer

Although I, too, have not personally seen a case of acne resulting from treating acne (or even read about in the medical literature) in the twenty-one years I have been using Botox for aesthetic treatment of dynamic wrinkles,  I suppose anything is possible, and there is always a first time for anything.

	With that in mind, I have a few suggestions. Although the ideal approach for treating wrinkles in this area is to address the dynamic ones (those created by our expression muscles) with neruomodulators, like Botox and Dysport, in this case, I would suggest beginning with the treatment of any static component (i.e a wrinkle at rest created via years of dynamic muscular movement). I prefer to use Juvederm UltraXC or Belotero for this region, both hyaluronic acid products.

	In the event that the results are sufficiently gratifying, nothing further need be done. If there is still a need to control the dynamic component, I would suggest a trial of Xeomin (which is essentially Botox stripped of any additional proteins that might elicit an inflammatory reaction). The combination approach also leads to longer-lasting results.

	I would suggest that you seek the consultation of injector experienced with a wide variety of injectables.

David Shafer, MD, FACS · Answer

For fine lines and wrinkles there are several treatments that you list (Botox, Filler, Laser, etc) and all are good when used in the appropriate candidate.  Without a picture or seeing you in person, it is impossible to give you advice.  In general, dynamic lines of the upper face are nicely treated with Botox.  Static lines with filler and fine lines with peels, laser and topical medications such as Renin-A.

	 

	Good Luck.

Cameron Rokhsar, MD, FAAD · Answer

Radiesse works very well in the nose because it resembles the feeling of bone. However, I'm unsure what you're referring to? Bunny lines? Please give us more of an idea about this line, with a picture if possible. Then we can give you a better answer.

Jeffrey Epstein, MD, FACS · Answer

I have never heard of Botox causing acne, so I'd likely recommend trying it again.  For fillers in this area, Restylane is usually the best product for this in my experience, due to its high safety profile and good results.

Stephen Weber MD, FACS · Answer

I agree with my colleagues that cystic acne after Botox would be very unusual. The go to treatment for that area is Botox to soften the repetitive muscle contraction that creates the crease. Hyaluronic acid based fillers such as Juvederm are effective in the area between the areas but must be performed carefully. Issues related to injection into or compression of blood vessels in that area have caused problems. To minimize the risk, seek an experienced Facial Plastic Surgeon of Dermatologist for treatment of this area. I hope this information is helpful.Stephen Weber MD, FACS

Robert L. Kraft, MD, FACS · Answer

Without a photo, it is difficult to know what would be suitable.  I have never heard of botox producing acne or cysts.  It is not dangerous in this area, either so I don't know where you are getting this misinformation.  Filler may be beneficial and you should see a board certified plastic surgeon or dermatologist for evaluation an recommendations.

Cheryl A. Hull, MD · Answer

First, I must say I have never seen or heard of Botox causing acne cysts. Have you tried Botox more than once and did you determine Botox was the cause of the acne cysts or did a health care professional tell you this? While anything is possible in medicine, I find it highly unlikely that the Botox caused acne cysts. With that being said, I would like to answer your question about treatment. While Botox is my first recommendation to treat the condition you are describing, your second best option would be to consider filler. I often use Belotero Balance to treat a more superficial line and would consider a product like Juvederm if the line is much deeper. Belotero is injected superficially and does not have the increased risk of complications as a deeper injection to treat a deeper fold. Your primary risk with a deeper injection is occulsion of a vessel if the product is inadvertantly injected into vessel. Be sure to consult with an experienced injector if you consider treating this area with fillers. Good Luck!

Filler For Line Going Across Horizontal Top Part of My Nose?

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