Will Botox help my nose from pointing down when I smile?

Question

My nose points down very far when I smile, it looks like a totally different nose. It also slightly dips down when I talk. Will Botox help this and make a noticeable difference? Would a filler to add a lift to my tip also help in my nose staying put when smiling? I’m hoping that my only hope isn’t just rhinoplasty. I’m looking to try non permanent solutions first Thanks

John M. Hilinski, MD · Answer

There are patients who benefit from injection of Botox to help with a drooping nasal tip. If targeted properly, the tip just won't droop as much. But there are other factors involved in the nose looking like it droops down that won't be affected by Botox.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. When we smile, the muscles that connect our lip and nose cause our nostrils to move backwards, which can make it appear that the nasal tip is drooping even though it generally stays in the same position. Botox can be very cautiously used (in small doses and by a very experienced injector) to relax that muscle. I recommend you to schedule a consultation with a board certified plastic surgeon to discuss Botox or possibility of a rhinoplasty to address your concerns.

Giuseppe Fiore, MD · Answer

Hi Thanks for your question.The treatment could be non surgical or surgical. In my professional opinion it is safer to try first the less invasive procedure that involves the combination of anti wrinkles injections and filler in the right place/layer and appropriate dose. This non-surgical treatment can give you a subtle and natural improvement.I would recommend to seek the advice of an expert doctor with extensive knowledge of the facial anatomy and experience in facial assessment and treatment. Best Wishes, Dr Giuseppe Fiore, MD

Jonathan Kulbersh, MD · Answer

I appreciate your question. It is possible that injections of Botox or a dermal filler could improve the downward point somewhat. However, if you want to achieve dramatic, permanent results, a rhinoplasty procedure is probably your best bet. I encourage you to schedule a consultation with a board-certified facial plastic surgeon who has extensive experience in rhinoplasty techniques. Through an in-person assessment, your surgeon can help you determine the best option for you.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Yes you should be able to place a small amount of botox and the base of your nose to help limit this down turned appearance.  Hope this helps.

Matthew Bridges, MD, FACS · Answer

It is possible to weaken the depressor septi muscle with Botox.  This muscle attaches right where the lip and nose come together.  In my experience, the effect is pretty subtle.  It's certainly worth a try before considering rhinoplasty.  If you do consider rhinoplasty, make sure you understand what the surgeon is going to do to correct this.  Lots of surgeons nowadays will put a stiff piece of cartilage in the columella to try to stiffen the nose, sometimes even rib cartilage.  This doesn't really work and makes the nose very abnormally stiff.  There are other ways to fix this issue without excessive stiffness. Good luck!

Dana Goldberg, MD · Answer

You will likely get some subtle improvement by using a few units of Botox between your nose and upper lip to weaken the muscle that pulls down the top of the nose. If this doesn’t work, I would skip filler and just consider rhinoplasty. It’s the most extreme of your options, but it’s also permanent. Good luck

Niro Sivathasan, MBBS, MRCS, DU (Plast), FAACS · Answer

The 'animation' (beaking of the tip) of your nose is due to the action of a pair of muscles called depressor septi nasi. 
This may be addressed in two ways: - Non-surgically with the use of botulinum neurotoxins injected into the muscle; - Surgically by way of either resecting (cutting) those muscles or as part of a rhinoplasty. 
Botox is most likely to improve your predicament, but be aware that the central part of your upper-lip may sit lower than previously. Adding filler to the nasal tip shall be of no use; however, adding filler to the base of the nasal spine may help to accentuate the change which you're looking for.

Camille Cash, MD · Answer

A small amount of Botox may give you a subtle improvement.  It is certainly worth trying before considering surgery.  Keep in mind that it can take up to 14 days to see the full effect of your Botox treatment.

Sheryl D. Clark, MD, FAAD · Answer

Hello racheldove:Botox or Jeuveau places at the base of the nose will weaken the ability of the depressor septi muscle to pull your nose downward when you talk or smile. It is an inexpensive, safe procedure with no downtime so if you were my sister I would definitely recommend trying it before considering surgery. I do not believe you would benefit from filler in the tip of the nose, as it would probably make your nose appear long when you are not animating.Wishing you well from my dermatology practice in NYC,Sheryl Clark MD FAAD

Will Botox help my nose from pointing down when I smile?

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