Horizontal crease above my lips and vertical crease on my chin when I smile, what can I do to fix it? (Photo)

Question

I have been getting Botox injections to fix a gummy smile and I have noticed that I have developed a horizontal crease above my upper lip whenever I smile. This wasn't there prior to me getting the Botox. My doctor injected botox in 3 areas under my nose to get the line to relax but it doesn't seem to be working. Do I have any other options? I also have a vertical crease in my chin when I smile. It extends from the corners of my mouth down to my chin. Can anything be done about this?

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  This appearance can result with Botox placement into the upper lip and is best treated by either avoiding botox injections into the upper lip, or placing them more along the outer corners of the nose.  Fillers can be placed now to try and improve upon this current crease appearance.  Hope this helps.

Aldo Guerra, MD · Answer

Thanks for this question. The relaxation of the muscles there are likely contributing to the formation of the creases. Perhaps, next time lowering the dose might prevent this. At this point, you can consider filling the creases with a fine HA filler like Restylane Silk. Speak with your injector, Best. Dr. ALDO

Monika Soni, MD · Answer

Thank you for your question. I do not think Botox has caused the wrinkles. I recommend waiting 3-4 for the Botox to wear off to see if the wrinkles improve. If the wrinkles do not improve after the Botox wear off, then I recommend having them filled with a filler such as Volbella. You can also have them treated with Volbella now if you do not want to wait. Best of Luck!

Hardik Soni, MD · Answer

Thank you for your question. I do not think Botox has caused the wrinkles. I recommend waiting 3-4 for the Botox to wear off to see if the wrinkles improve. If the wrinkles do not improve after the Botox wear off, then I recommend having them filled with a filler such as Volbella. You can also have them treated with Volbella now if you do not want to wait. Best of Luck!

David Owers, MD · Answer

The gummy smile is more common than you realize. Injecting the oval-shaped muscle that circumscribes the mouth, in the portion that lays above the upper lip, is only successful in mild cases of the gummy smile. There is an important muscle that runs on each side of the nose called the Levator Labii Superioris Alaeque Nasi that often needs to be addressed. I give you this complicated name so that you may address this with your injector with specifics. I hope this helps.

As to your other question related to the other lines in your lower face, I am sorry, but there is not enough information in the picture to properly address your concerns. For a more accurate comment, dynamic expression in real time is needed.

As to your other question related to the other lines in your lower face, I am sorry, but there is not enough information in the picture to properly address your concerns.  For a more accurate comment, dynamic expression in real time is needed.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question knavarro01. I am sorry to hear about your situation. Botox is
a purified protein used to address wrinkles associated with facial expression. In the lower face Botox can be placed on the sides of the nose to address the gummy smile. Sometimes when one muscle is relaxed with Botox (in this case the LLSAN) another muscle (in this case DSN) is recruited to compensate. This is most commonly seen as the appearance of bunny lines when frown lines are addressed with Botox. Botox can be placed in the recruited muscle to address the further wrinkles. Fillers such as Volbella can also be used for wrinkles around the lips. Please consult with
a doctor for specific recommendations. Good luck!

Shaun Patel, MD · Answer

I'm not sure that the Botox injections caused this crease to form although the timeline suggest it did. That being said, you could wait for the Botox to wear off and see if the line improves. If the line doesn't improve after the Botox wears off, then I would treat it with a filler such as Volbella. If you do not want to wait for the Botox to wear off, you could also have the filler injected sooner. Hope this helps.

Michele S. Green, MD · Answer

It sounds from your description that Botox caused this wrinkle.  I would expect the lines to disappear once the Botox has dissolved.  In the meanwhile Volbella should help treat this area very well.  Please consult an expert.  Best, Dr. Green

Steven F. Weiner, MD · Answer

My guess is that the line is going to be there even if the Botox wears out. I would do just that. If still there, inject with filler. The marionette lines can be help with filler too.

Horizontal crease above my lips and vertical crease on my chin when I smile, what can I do to fix it? (Photo)

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