What Are the Side-effects from Injecting Botox at the Site of the Depressor Septi Muscles?

Question

I want to get Botox to stop my nose from drooping when I smile. I have read about the side-effects of Botox, but am wondering (1) what the most likely side-effects are from injection at that site. As well, are there (2) any tooth/mouth/lip-related problems? I am currently in the middle of an orthodontic treatment, so that is why I am concerned. Thank you in advance for your answers!

Ron Shelton, MD · Answer

when the muscle is treated with botox to prevent the tip of the nose from dropping, this could elongate the upper lip, failing to reveal as much of the upper teeth when smiling and making it difficult to say a few letters and difficult to get the toothbrush under the upper lip to clean the front incisors. This is temporary and only a couple of units of Botox should be used initially.

Scott Trimas, MD · Answer

Botox injections into the depressor septal nasi muscle can be an effective, albeit temporary way to keep the tip from pulling downward when a person smiles. Side effects are minimal, however, too much botox or botox injected into the wrong location can result in a flattened upper lip but this is also temporary. There should be no problems with internal orthodontic work being done at the same time. I hope this information helps.

Otto Joseph Placik, MD · Answer

While injection into the depressor septi muscle will produce some upturning of the tip excessive diffusion into the orbicularis oris or LLAN will produce some dropping of tghe upper lip.

Purvisha Patel, MD · Answer

Botox adminsitered to the nasal septum muscles is used to lessen the droop of the nasal tip when talking or smiling. The side effects if too much is administered or it is administered incorrectly/migrating of the product would be flattening of the upper lip, due to paralysis of those muscles, and could affect the normal ability to speak and smile. These side effects could affect your dental treatments if they occur- they are however temporary.

Darryl J. Blinski, MD · Answer

A flat upper lip, a droopy upper lip, asymmetric smile, just to name the most common ones. You should be very aware of the risk/benefit ratios. From MIAMI Dr. B

Steven Wallach, MD · Answer

Botox is sometimes injected into the depressor muscles of the nose to prevent the tip from plunging with smiling. It may help.

Peter A. Aldea, MD · Answer

All Botoxcomplications are caused by Botox injection or migration where it should NOT be. The Depressor Septi muscles are two tiny worm shaped muscles that attach to the septum of the nose and pull it down when smiling, in the process causing a transverse crease of the upper lip and upper gum show.

These muscles can be removed in the course of a Rhinoplasty OR weakened for a while with Botox if no surgery is needed or planned.

If Botox migrates out or away from these muscles, depending which other muscles are affected, you may end up with a lower lip and an alteration of your smile. If it tracks higher, it may affect the ability of the nose to flare on deep breathing. However, these should be rare complications in trained hands.

Good Luck.

Dr. Peter A. Aldea

George J. Beraka, MD (retired) · Answer

Hi.

	Botox has to placed precisely and in very small quantity (around 5 units).  Otherwise, upper lip can droop.

Michael L. Workman, MD (retired) · Answer

Injections into the Depressor Septi Muscle are either to elevate the tip of the nose or decrease the appearance of a "gummy" smile.  The most common complication is an over flatten appearance to the upper lip that may affect how you speak and smile.  To avoid such complications the injector needs to start low in the amount of units 4-6 and be aware of the facial anatomy.  Isolating the proper muscle involves having you make some facial expressions.  For example, by flattening out your upper lip it will show the injector where to inject as the Depressor Septi should become more prominent. 

	Remember however that the affects of neurotoxins are self limiting.  It will wear off eventually.  Talk with your orthodontist prior to injections and start off slowly.   Good luck!

What Are the Side-effects from Injecting Botox at the Site of the Depressor Septi Muscles?

Answers (9)

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