“Elvis Muscle” snarl, pinches one side only. Issue for many years and have had 3 rhinoplasties. Can it be fixed? (photos)

Question

“Elvis muscle” right side area of concern. “Snarl”and even feels strange. First rhino. 2011. Surgeon also cut something that would drop my lips a bit more, fix a slight gummy smile. Not sure if issue started then of after second rhino. in 2015. I can actually go into my mouth, upper lip area and press on the muscle/maxilla and it will temporarily reduce the “pinching” when I smile. Is this nerve damage? Will Botox help relax permanently?This gives me apparent asymmetrical smile/nasolabial folds.

Jason Emer, MD · Answer

It's difficult to say without a formal evaluation. Botox can be injected into these areas to create a softer look. The botox will essentially relax the muscles creating the appearance of atrophic muscles. The results will last up to 3-4 months hence you will have to re-inject roughly 3x per year. When administered by an expert injector you shouldn't have an issue with too much laxity. The biggest issue will be muscle weakness if you inject too large doses, which will be required in larger muscles (as compared to cosmetic forehead/face injections) See an expert. Best, Dr. Emer.

“Elvis Muscle” snarl, pinches one side only. Issue for many years and have had 3 rhinoplasties. Can it be fixed? (photos)

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