Nose widens when smiling. Can Botox help with this? (photos)

Question

I am East Asian and when I smile my nose widens. I don't think rhinoplasty/an alar reduction would help as I only have an issue with my nose when I smile. I heard that Botox can treat this as it can paralyse the muscle that causes the nose to widen when smiling. Which muscle(s) would be targeted? I have seen the depressor nasalis muscle mentioned for the problem of a droopy/depressed tip but what about a widening nose? Would it affect my smile/the functioning of the nose? Thanks for your help!

Peter N. Butler, MD, FACS · Answer

Hi, thank you for your question. Yes, 2-4 units of Botox can be placed at each alar base to reduce nasal flare when smiling.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist to go over your desired results. Facial fillers (like Voluma, Restylane, Juvederm) can be used to improve the symmetry of the nose, but surgery would be needed to improve nostrils or overall shape. Best to see an expert. - Dr. Emer

Eric M. Joseph, MD · Answer

If you paralyze the muscles that widen your nose, you would lose your ability to smile completely. We do not recommend neurotoxins for changing the shape of someone's nose. Thank you. Dr Joseph

Nelson Lee Novick, MD · Answer

Nasal wing (alar) widening with smiling is not an uncommon problem. You are quite correct that since the problem arises with motion (smiling), logical treatment would be aimed at addressing the dynamic (movement-related) component upon smiling, rather than the static (at-rest) position of the nasal wings. One or two microdroplets placed into the base of both wings can be helpful for reducing this problem. Make sure that you consult an experienced aesthetic physician. Best of luck and Happy New Year.

Johnson C. Lee, MD · Answer

Thank you for your photo. A small amount of botox in the area can help reduce the amount the nose spreads when smiling. You may consider an alar reduction for more permanent narrowing of the base of your nose. Hope this helps!Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Nose widens when smiling. Can Botox help with this? (photos)

Answers (6)