Can Botox be injected near the sides of the nostrils to prevent spreading of the nostrils during animation?

Question

I had a nose job 15 years ago and am generally happy with my nose at repose. However, the surgery didn't do much to prevent my nose from changing and looking terrible when I smile. Upon close consideration, my tip does not droop when smiling, but rather the nostrils spread and the alar seems to pull up and gives the illusion that my tip is lowered when it is in fact not. I would hate to undergo a revision rhinoplasty. Can't botox be injected into this area to stop the nose from spreading so much?

John Tang, MD · Answer

Based upon your description, I don't believe there is anything that can be done to stop the nose from spreading.

Philip S. Schoenfeld, MD, FACS · Answer

It sounds like overall you are very happy with your rhinoplasty.  Changes to the nostril width during smiling is inevitable.  If you are pleased with your nostril width in repose you should not do anything to manipulate the appearance or position of your nostrils.  Your nostrils and nose animate with the rest of your face and they cannot be separated from doing that.  Botox injections that would prevent your nostrils from spreading during smiling will also distort your smile and I don't think you will be happy with that.

Sheryl D. Clark, MD, FAAD · Answer

Dear Jill8944:I have successfully treated this problem with 1 unit of Botox to a branch of the levator labii superioris alaeque nasi muscle at the nasal ala.  Patients are happy with the result. I have not seen any airway compromise but would not treat someone with a deviated septum or narrowed nasal passages.
All the best,   Dr. Clark

Lisa Vuich, MD · Answer

Thanks for your interesting question. Yes this injection can be performed. It can take for example 10 units per side though you could start with less and add more. Be aware though that some who have this done do experience some noticeable change in their ability to breathe through the nose with heavy exercise as that is another time that the nose flares to allow more breath in. If you don't think that would bother you, give it a try.
Best,
Lisa Vuich, MD

Can Botox be injected near the sides of the nostrils to prevent spreading of the nostrils during animation?

Answers (4)