How do I reduce nostril flaring without decreasing upper teeth exposure? (Photo)

I would highly recommend getting a formal evaluation with and treatment from a board-certified cosmetic dermatologist and expert in facial sculpting. An experienced physician will be able to determine which technique will give you the result you're looking for. See an expert. Best, Dr. Emer

You can decrease nasal flare with Botox by injecting it into the nasal ala. This placement should not change your smile in any way. The placement that can change your smile is typically lateral to the ala.

Thank you for your question and photos. It appears you might benefit from a bit of a well-placed neuromodulator like Botox to target the nostril flare without affecting the upper lip. While Botox is not surgery, it does require a significant amount of precision and skill to produce an optimal outcome. Make sure you work with an experienced, qualified injector to ensure the best possible result.

Although I am limited by the photos, it appears that your ala do widen with smile excursion which is normal to some degree. The nose is nicely balanced at rest, but with smile I recognize your concerns. The muscles which cause you to smile act to pull the alar (notril) soft tissues laterally and superiorly. This effect cannot be fully diminished with botox as it would cause some degree of facial paralysis to inject the main smiling muscles (zygomaticus major/minor/risorius). It can be worth a trial of a small amount of botox at the depressor septi muscle which appears to be pulling your tip down when you smile and enhancing the effect. You physician can also place a judicious amount of botox at the levator labii superioris alque nasi muscle as well. This is always a balance because weakening the dilating muscle can cause unwanted nasal obstruction. Filler would not be a good option for your concerns.

Given your age and helpful photos, it seems your main issue is nostril positioning or widening with animation. At rest, the nostrils sit in better proportion. I would suggest a non surgical approach as you lip length ratios are in good proportion. The nasalis muscle is a sphincteric like muscle that can cause nostril flaring in certain individuals. An experienced injector can place their toxin of choice in the targeted muscle to relax the flaring during expressive movements. It is hard to tell given the photos are static images but some toxin placed in the depressor septi nasai may help with tip depression during smiling.

Hello cc212:

Easy-Peasy: an expert injector (this truly does require someone with many many years of experience) can place a small amount of Botox in the muscles that flare the nostrils, while avoiding the levator labialis (LLSAN). One would need to use a highly concentrated form of Botox or Jeuveau, which is not commonly used.

I hope this is helpful to you!

All the best from New York City,
Sheryl Clark MD, FAAD