What are the indications for a Botox ® injection to change the nose?

Botulinum toxin injection is mainly indicated to correct a plunging nose tip, when it is due to hypercontraction of the lowering muscle.

What is a plunging nose?

A plunging nose is defined in relation to thenaso-labial angle, the angle formed by the joining of two tangents, that of the columella and that of the upper lip.
This angle is generally between 110° and 120° for women, and between 90° and 100° for men. When the angle is smaller, the nose is said to be plunging.

Beyond the aesthetic aspect, which gives the impression of a nose that’s too long when smiling, the plunging nose can alter expressions: it partially masks the smile, which diminishes positive facial expressions, giving a soft, sad and lacklustre appearance.

How does botulinum toxin injection work in the nose?

Botox injection is indicated to inhibit hyper-contraction of the depressor septi nasi muscle, which pulls the nose down when smiling. Injecting botulinum toxin A into the columella blocks acetyl-choline and relaxes the muscle within 4 to 10 days, reducing the downward contracture and giving the nose a more harmonious shape.

What are the disadvantages of botulinum toxin for nose reshaping?

However, changing your nose without surgery with Botox comes up against two limitations:

• The intensity of muscle contraction is variable and difficult to assess a priori, resulting in a sometimes disappointing result after injection.
• The effect of botulinum toxin on the nose is short, often not exceeding 2 months, compared with around 6 months on the skin muscles of the face.

That’s why surgery-free nose reshaping prefers to use another technique, with the injection of a filler.

What are the indications for hyaluronic acid injections in the nose?

Hyaluronic acid (HA) injections are widely used in aesthetic medicine, where this naturally-occurring filler provides a more or less volumizing effect thanks to its affinity for water.

How does hyaluronic acid injection work in the nose?

The larger the HA macromolecule, the greater its “molecular sponge” effect, and therefore its volumizing effect. The practitioner’s art lies in selecting the right hyaluronic acid in terms of molecular weight and viscosity, in order to reconcile the volumizing effect, natural appearance, resistance to gravity and, if possible, slow resorption.
There are two elements that guarantee against the risk of “overloading”:

• It is possible to inject the product in small volumes, with a main injection and a touch-up 15 days later;
• Hyaluronic acid can always be broken down further with a 100% natural enzyme, hyaluronidase.

What are the advantages of injecting hyaluronic acid into the nose?

This non-surgical nose reshaping is an augmentation plasty that adds volume to correct imperfections and enhance the contours of the nose:

• Smooth out a small osteo-cartilaginous bump;
• Correct nasal asymmetry or slight deviation without affecting the septum;
• Fill in a hollow nose by adding volume;
• Raise the tip of the nose to give the impression of shortening it.

As the nose is not very mobile, hyaluronic acid has a lifespan of at least two years, before its resorption requires a repeat of the medical rhinoplasty.
It can be used for primary rhinoplasty, in the first instance, as well as for secondary rhinoplasty to correct imperfections resulting from nose surgery (saddlebags, inverted V shape, Corbin’s nose…).

What are the advantages of injecting hyaluronic acid into the nose?

This medical rhinoplasty is for aesthetic purposes only, to beautify a nose and perfect facial harmony. Under no circumstances can it replace a functional rhinoplasty, which involves a surgical procedure.

Aesthetic rhinoplasty also requires an experienced practitioner, whose analysis must be subtle and experience certain. Bringing back volumes can be a trap if you don’t consider the harmony of volumes as a whole. For example, smoothing the bridge of the nose to reduce a nasal hump should not lead us to forget to treat the frontal nasal ridges if necessary, to maintain balance and harmony.

Medical rhinoplasty using volumizing hyaluronic acid injections is the ideal way to achieve a prettier nose, without surgery or pain, and above all without altering the very essence of a person’s identity.