How do I get rid of the bumps around my nose that pop up when I smile? (Photo)

Question

I have bumps that pop up between my smile lines and nose when I smile, and they're really noticeable. I haven't had any medical procedures or surgery on my face. I also can't find any information about what they are or what causes them. How can I get rid of them?

Anna Chacon, MD, FAAD · Answer

What you’re describing actually sounds like it may be a normal dynamic feature of the anatomy around the nose and nasolabial area, rather than something being “wrong” with your skin.

When you smile, several muscles that elevate the upper lip and move the nose and cheek contract at the same time. This can cause the soft tissue next to the nose to bunch or become more prominent, creating little bulges or bumps that aren't visible when your face is relaxed. The nasolabial area is particularly dynamic because the muscles and fat compartments in this region are closely interconnected.

This can be more noticeable in some people simply because of their individual anatomy. It doesn't require any previous surgery, filler, or other cosmetic procedure.

Could Botox help?

Potentially, but I would be very conservative with Botox in this area.

If the bumps are primarily caused by muscle contraction, strategically weakening the muscle responsible can sometimes make the prominence less noticeable. However, the muscles around the upper lip and nose are important for normal smiling and facial expression. Too much Botox in the wrong location can result in an asymmetric smile, altered lip movement, or difficulty moving the upper lip naturally.

So I wouldn't recommend simply injecting Botox into the bumps without first determining exactly which muscle is creating them.

What about filler?

I would not automatically fill the bumps.

If the prominence is caused by muscle movement rather than a true depression or loss of volume, adding filler may not solve the underlying problem. In fact, adding volume to an area that already becomes prominent with smiling could potentially make it look fuller.

Filler can be useful for true nasolabial folds or volume deficiencies, but the anatomy in this region is complex and includes important blood vessels. The facial/angular artery runs close to the nasolabial fold, which is one reason injections in this area require considerable anatomical knowledge and caution.

One thing I would consider important

Try looking at the area in three different positions: completely relaxed, a gentle smile, and a full smile.

If the bumps essentially disappear at rest and appear only with a smile, that strongly suggests a dynamic/muscular component. If there is a noticeable bump even when you're completely relaxed, then the differential is broader and could include the underlying fat compartments, the shape of the nasal base, or the nasolabial anatomy.

And honestly, some movement in this area is completely normal. The goal shouldn't necessarily be to make the area completely flat when you smile—doing so could make your smile look less natural.

If treatment is desired, I would favor identifying the specific anatomical structure responsible first and then using the smallest intervention necessary. In someone who has never had facial procedures, I would be particularly hesitant to start by adding filler simply because the area looks more prominent during smiling.

The good news is that what you're describing doesn't necessarily sound like a defect that needs to be “fixed.” It may simply be one of those facial features that becomes more visible with expression. The best cosmetic approach, if treatment is pursued, would be to soften it while preserving your normal smile and facial movement.

Charles Riccio, MD · Answer

Hi Serenarb,
Thank you for your question. While it is difficult to tell exactly what is causing the bumps without an in office consultation, it would appear that the bumps are likely being caused by the contraction of the muscles of facial expression. Oftentimes, this can be targeted and improved with a low-dose injection of botox into the area of concern, which works to decrease the activity of the muscle. As this is an off-label application of Botox, I would strongly recommend in person consultation with a board eligible or board certified plastic surgeon familiar with the procedure.
Hope this helps!
Charles Riccio, MD

How do I get rid of the bumps around my nose that pop up when I smile? (Photo)

Answers (2)

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