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

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,

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.

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.

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

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.