Severe nostril droop 2 years after getting Botox for gummy smile - what happened? (photos)

Question

I'm 40 years old and two years ago I had botox injected on the side of my nostril for gummy smile. The immediate effect was that not only did my upper lip droop heavily but my nostril on that side also drooped. While the lip droop normalised, the nostril droop is still very severe and doesn't seem to get back to normal. Any idea why this happened and how it can be fixed? Thank you

Eric M. Joseph, MD · Answer

Based on your photo, you appear to have thin nasal skin with nostril asymmetry, and a bifid nasal tip that is also asymmetrical. I suspect the effect of the BTX is not responsible for your nasal appearance since we have not seen any permanent negative sequelae in people after BTX treatments. If you have before and after photos, that would be helpful. At this point, if you are looking to achieve a more symmetrical, straighter tip appearance, you may wish to consult with several reputable rhinoplasty specialists. Hope this helps you. Dr Joseph

Camille Cash, MD · Answer

Botox is a neuromodulator that works by inhibiting the ability of the injected muscle to contract.  The effects of Botox are temporary, typically lasting three to four months.  If you are noting a droop of the nostril two years later it is likely attributed to a different cause.

Severe nostril droop 2 years after getting Botox for gummy smile - what happened? (photos)

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