Could Botox help with skin bunching at the nose when I smile? (Photos)

Question

Hi, as you can see on the pictures, my nose looks totally normal on repose, but when I smile, there is this bump/fold (skin or muscle?) that pops out on both sides of my nose, and it looks white and unsightly. Is there any way to make this go away, e.g. with botox? And if so, exactly where should it be administered - and are there any risks? Thank you!

Justin Buro, MD · Answer

Hello and thank you for your question. This is something we commonly see in our injectables practice, and it’s actually an under appreciated use for Botulinum Toxin (Botox). What you’re noticing when you smile are often called “bunny lines” - small folds or bunching of skin on the sides of the nose. These are caused by overactive muscles, most commonly the levator labii superioris alaeque nasi, which contracts when you smile or scrunch your nose. In some patients, the nasalis muscle higher up on the nose is also involved, which is why the skin may bunch across the nasal bridge as well. 
Botox is a very effective treatment for this concern. A few tiny injections (usually 2–4 units per side) can relax the muscle and smooth the area while still keeping your smile natural. Results typically last 3–4 months, and many patients maintain improvements with routine touch-ups. 
The main risk is over-treatment, which could subtly change your smile if too much product is used or if it spreads into nearby muscles. This is why it’s important to see an injector experienced with treating bunny lines and nasal wrinkles. If the folds are also due to skin texture changes or volume loss, your provider may recommend combining Botox with other treatments such as dermal filler or laser resurfacing for optimal results. 
So to answer your question: Yes, Botox can safely and effectively improve the skin bunching on your nose when you smile. With precise placement by an experienced injector, it’s a quick procedure with minimal downtime and natural-looking results. I hope that helps. 
Best wishes,Justin Buro, M.D.

Could Botox help with skin bunching at the nose when I smile? (Photos)

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Could Botox help with skin bunching at the nose when I smile? (Photos)

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Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.