Alar Botox after Rhinoplasty

I completely understand your concerns, especially since you’ve already gone through rhinoplasty and are cautious about further procedures. Botox in the alar region is sometimes used to reduce nostril flare when smiling. Unlike fillers, Botox does not add volume or carry the same risk of blocking a blood vessel, so the risk of vascular complications, necrosis or blindness) is not present with Botox.

That said, Botox in this area requires very precise placement and conservative dosing, because over-relaxing muscles that control the nostrils could affect how you breathe through your nose or alter the way your smile looks. The white spots and scabbing you mention are likely related to how thin your skin is over the cartilage and not something Botox will directly treat. Botox won’t strengthen the skin or stop friction at those pressure points, but it may slightly reduce how much the nostrils flare when you smile, which could lessen some of the stress on that thin skin.

Botox in the alar region is generally safe and does not carry the same risks as filler injections, but it does need careful technique to avoid functional or aesthetic issues. It may help with nostril flare but won’t correct the thin skin or cartilage prominence you’ve described.

Hello and thank you for your question. Generally speaking a Revision Rhinoplasty would be a much better result than having Botox at the alar base. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

All treatments come with some risk, but in the hands of an experienced injector these risks are kept to a minimum. An evaluation of your concerns is needed to determine if Botox is the right treatment to help you or if an alternate application would be recommended.