Botox in depressor Septi for drooping nose, 1 day post, should I be worried about my mouth going weird? (photos)

It is likely that you will not have too much too worry about as it appears to have elevated the tip of your nose. Even if some botox does head to the upper lip region, it is a small quantity and any side effects will be short lived.

I have been using Botox for lifting drooping tips for nearly twenty years. In general it takes only a few units to achieve the lift and most often, as you correctly noted, it is achieved by injection centrally only. That being said, injection in the side locations that you indicated in the photo are not likely to lead to any real untoward reaction, given the relatively small doses you indicated that were used. Over the past fifteen years or so, I have combined the use of centrally injected Botox with the use of a filler with good lift, such as Restylane Lyft (which is my go-to for this in my NY office) and Hyabell Deep, which is my first choice in my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizing fillers are available. Botox combined with filler in my experience tends to yield a synergistic effect that prolongs the four to six month Botox effect and the six to eight month filler effect to a year long effect when the two agents are used. Filler, like Botox is best injected centrally under the columella. Given what you have written, you would do well to be patient and wait two weeks before assessing the effects of your current treatment. Make sure that you are consulting with a board certified aesthetic physician. Best of luck.  

It can take up to 2 weeks for final results with Botox. I would wait a full 2 weeks before assessing results. However, try not to worry, it is unlikely to cause drooping based on your photos. Hope this helps.

It's too soon for final results. Botox results take 1-2 weeks. If you're unhappy with your final results, they can be softened with venus legacy and thermage treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Thank you for sharing your question and photograph.  It is unlikely that anything negative will happen with the injections you posted.  If they were placed out further to the side of your nostrils it may have resulted in some dropping of your upper lip.  Allow your results to mature for 2 weeks and then revisit your results.  Hang in there.

Thank you for your question! It can take up to 2 weeks for final results with Botox. I would wait a full 2 weeks before assessing results. However, try not to worry, it is unlikely to cause drooping based on your photos. Best of luck!

Thank you for your photos and your experience.  The depressor septi muscle is a centrally located muscle that is typically not to that thick or wide.  The 2 lateral injection sites that you depict are likely outside of the depressor muscle.  Is it likely to cause an issue?  Likely not in the doses you have stated.  Other muscles in the area would be orbicularis oris and the elevating muscles of the lip typically are more lateral than you have depicted.  I would not worry about it at this point.  See what happens over the next 2 weeks.Andre Levesque M.D.

Hi Kimmi592,  
Based on your photo and where you marked your injections, it doesn't look like you will have issues when the full effects are in place.  Of course, it is easy for me to say "don't worry"!  It can be so frustrating waiting for botox results.  Hang in there!
Best,

Thank you for your question and for sharing your photograph kimmi592. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.While Botox is most commonly used in the upper face, it can also be used in various areas in the lower face. Botox can be placed in the orbicularis oris muscle around the lips to provide a pout to the lips and reduce the appearance of vertical lines around the lips sometimes called smoker’s lines (although they are seen in people who do not smoke as well). In this area 2-4 units are used above the upper lip and 2 units are used on the lower lip. Botox can be placed in a vestigial muscle (seen in some people) called the depressor septi nasii to prevent the tip of the nose from moving downward when smiling. Here only 1-2 units is required.The pivotal studies demonstrated that the peak results are seen 14 days after the treatment. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important.If I had a patient with the concern described here, I would recommend that she be patient and wait two weeks for full results. Each doctor has his/her own technique and I would not worry about the exact placement of the product.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

How can you worry about something that hasn't even manifested itself yet. Be patient and see what happens next. Good luck from New York City