Ask a doctor

My nose has changed since I had botox for a gummy smile. What is the cause?

I did a gummy smile botox but i noticed that my nose changed .. Its werid i think when i do a duck face my nose Nostrils are different one of them is lower than the other , maybe thats silly but I think its important to know if it can cause a different or my dr did something wrong . And thank you all

Doctor Answers 9

My nose has changed since I had botox for a gummy smile. What is the cause?

April 11th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. It is difficult to tell without before and after pictures. If you are concerned, I would consult with your injecting physician. 

Regards,

Web reference: http://torontosurgery.com/non-surgical/botox-cosmetic-clinic/

Martin Jugenburg, MD
April 11th, 2016

My nose has changed since I had botox for a gummy smile. What is the cause?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. It is difficult to tell without before and after pictures. If you are concerned, I would consult with your injecting physician. 

Regards,

Learn more: http://torontosurgery.com/non-surgical/botox-cosmetic-clinic/

Martin Jugenburg, MD

Botox for gummy smile

April 10th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for your interesting question.  Without photographs it is difficult to say what exactly is going on.  In general, since botox causes selective weakening of muscle it can effect the position of facial structures when muscles are used strongly (like when you make a duck face).  If you do not care for the effect, it is expected to wear off in 3 - 4 months.
Mark Beaty, MD

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

April 10th, 2016

Botox for gummy smile

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for your interesting question.  Without photographs it is difficult to say what exactly is going on.  In general, since botox causes selective weakening of muscle it can effect the position of facial structures when muscles are used strongly (like when you make a duck face).  If you do not care for the effect, it is expected to wear off in 3 - 4 months.
Mark Beaty, MD

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Botox for Gummy Smile

April 12th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without photos it is impossible to say what is happening but I would definitely return to your treating physican for assessment.  Best, Dr. Green

Web reference: http://www.michelegreenmd.com/botox-cosmetic

Michele S. Green, MD
April 12th, 2016

Botox for Gummy Smile

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without photos it is impossible to say what is happening but I would definitely return to your treating physican for assessment.  Best, Dr. Green

Learn more: http://www.michelegreenmd.com/botox-cosmetic

Michele S. Green, MD

#GummySmile

April 11th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I would like to ask if you could possibly post again, with photos showing you at rest and making the face that elicits the different you are describing.  I have never seen this complication from injecting the levator labii superioris alaeque nasi, and also am not sure what a duck face is.

I am thinking that the Botox spread to either the compressor narus or alar nasalis muscle, which are nearby. I have personally found that using concentrated Botox, just 1 cc for 100 units, prevents complications, as larger volumes spread farther. I would not say your doctor did something wrong, but just that it probably spread farther than intended, so next time, having a smaller and/or more concentrated dose will likely prevent this event.

Web reference: http://www.jcasonline.com/viewimage.asp?img=JCutanAesthetSurg_2012_5_2_115_99447_u1.jpg

Sheryl D. Clark, MD
April 11th, 2016

#GummySmile

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I would like to ask if you could possibly post again, with photos showing you at rest and making the face that elicits the different you are describing.  I have never seen this complication from injecting the levator labii superioris alaeque nasi, and also am not sure what a duck face is.

I am thinking that the Botox spread to either the compressor narus or alar nasalis muscle, which are nearby. I have personally found that using concentrated Botox, just 1 cc for 100 units, prevents complications, as larger volumes spread farther. I would not say your doctor did something wrong, but just that it probably spread farther than intended, so next time, having a smaller and/or more concentrated dose will likely prevent this event.

Learn more: http://www.jcasonline.com/viewimage.asp?img=JCutanAesthetSurg_2012_5_2_115_99447_u1.jpg

Sheryl D. Clark, MD

Change after gummy smile treatment

April 11th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is hard to tell without actually seeing what is going on but it sounds like some of the muscles under the nose were weakened and although this is unusual it will disappear. to make things more even another injection in the area that is not weakened will help
Melvin Elson, MD
April 11th, 2016

Change after gummy smile treatment

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is hard to tell without actually seeing what is going on but it sounds like some of the muscles under the nose were weakened and although this is unusual it will disappear. to make things more even another injection in the area that is not weakened will help
Melvin Elson, MD

Notify your doctor

April 11th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The changes you describe could be from the Botox.
Notify your doctor as possibly some adjustments can be made with the next treatment.
Keith Denkler, MD
April 11th, 2016

Notify your doctor

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The changes you describe could be from the Botox.
Notify your doctor as possibly some adjustments can be made with the next treatment.
Keith Denkler, MD

Botox - did my doctor do something wrong

April 11th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for asking about your Botox.

  • Botox for a gummy smile involves injecting muscles near the nose.
  • It can lead to a mild asymmetry - if one muscle responded differently.
  • Or if it revealed an underlying asymmetry.
  • Point it out to your doctor for her/his information -
  • It does not sound as though anything wrong was done.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.
Elizabeth Morgan, MD, PhD
April 11th, 2016

Botox - did my doctor do something wrong

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for asking about your Botox.

  • Botox for a gummy smile involves injecting muscles near the nose.
  • It can lead to a mild asymmetry - if one muscle responded differently.
  • Or if it revealed an underlying asymmetry.
  • Point it out to your doctor for her/his information -
  • It does not sound as though anything wrong was done.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.
Elizabeth Morgan, MD, PhD

Change in nose

April 11th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The muscles injected to get rid of a gummy smile make the nose move as well. When this muscles are paralyzed, the nose will act differently. It will resolve when the Botox wears off. 
Yaritza Perez-Soto, MD

Yaritza Perez-Soto, MD
Naples General Surgeon

April 11th, 2016

Change in nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The muscles injected to get rid of a gummy smile make the nose move as well. When this muscles are paralyzed, the nose will act differently. It will resolve when the Botox wears off. 

Yaritza Perez-Soto, MD
Naples General Surgeon

Botox

April 15th, 2016
{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello,

Thank you for your question.

It is difficult to determine without a full assessment. I'd recommend booking a follow-up appointment with your skilled and qualified injector to discuss your options.

Take care.

Web reference: https://edelsteincosmetic.com/learning-centre/botox-cosmetic-information/

Jerome Edelstein, MD
April 15th, 2016

Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello,

Thank you for your question.

It is difficult to determine without a full assessment. I'd recommend booking a follow-up appointment with your skilled and qualified injector to discuss your options.

Take care.

Learn more: https://edelsteincosmetic.com/learning-centre/botox-cosmetic-information/

Jerome Edelstein, MD

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.