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

What you’re describing is often called a “bunny line” or nasalis fold. These lines or bunching appear when smiling or scrunching the nose because the nasalis muscle contracts and pulls the skin upward and inward. At rest, the area is smooth — but with expression, the folds show.
Botox (or another neuromodulator such as Xeomin, Dysport, or Daxxify) can help. A few precisely placed units on each side of the upper nose weaken the nasalis muscle just enough to reduce the bunching when you smile.
Risks to know:
Over-treating this area can cause unnatural stiffness when smiling.
If placed incorrectly or too high, Botox could affect muscles around the upper lip or under the eyes, altering your smile.
Results last ~3–4 months, so touch-ups are needed.
Key takeaway:Yes — properly dosed Botox from an experienced injector can smooth these smile-related nose folds. The placement is very specific (tiny injections along the upper sides of the nose), so you’ll want to see a provider highly familiar with facial anatomy.

Hi! Dr Peterson here! Thank you for sharing your concerns and photos. Based on your description, the bump or fold that appears only when you smile is likely related to muscle activity of the nasalis or other perinasal muscles, rather than a structural issue with the nose itself. The whiteness you see is likely transient skin compression or minor blanching.
Botulinum toxin (Botox or other neuromodulators) can sometimes help: • It works by relaxing the overactive muscles that cause the bump or fold. • Treatment must be precise, targeting only the specific muscle fibers involved, to avoid affecting nasal tip movement or smile dynamics. • Typically, very small units are injected just lateral to the nasal sidewalls or along the nasalis fibers.
Risks include: • Mild bruising or swelling at the injection site • Temporary asymmetry if one side is over- or under-treated • Rarely, changes in nasal tip movement, flaring, or drooping
Because of the delicate anatomy and functional role of these muscles, it’s important to see a board-certified cosmetic dermatologist or facial plastic surgeon experienced with nasal/upper lip neuromodulator treatments. They can assess exactly which muscle fibers to target and minimize risk while improving the appearance.

Hello! I’m Lauren, the aesthetic injector here at Colorado Plastic Surgery Center. Yes, Botox can help with the skin bunching at the sides of your nose when you smile. This issue is often caused by overactive muscles in that area. A small amount of Botox can relax these muscles, softening the folds or "bunny lines" that appear when you smile.

This could be corrected with injecting Botox into the dilator naris muscles by on each side of the nose. I recommend approximately 2 units of Botox on each side of the nose.

Yes a few units of Botox on each side of the nose can soften the effect of these "bunny lines" when you smile. The treatment is done in the office with final results seen after two weeks. The effect will fade gradually typically over three to four months. See an expert injector near you for treatment.