1. A ‘bunny line’ is a horizontal wrinkle which forms across the ridge of the nose or at the side of the nose, and is often more prominent during facial expressions such as laughing or frowning. They result from contraction of part of the nasalis muscle, the muscle that is responsible for compressing the cartilage of the nose, resulting in flaring of the nostrils. ‘Bunny lines’ tend to become increasingly visible with ageing following years of facial expression. However they can also result from the treatment of other parts of the face such as the forehead and glabella, the area between the eyes, with Botox. This is because immobilisation of other parts of the face using Botox injections causes increased use of the nose in facial expression. Treatment of ‘bunny lines’ is by injection of botulinum toxin high up on the outer aspect of the nose, typically with 4-8 units. In order to avoid complications such as drooping of the upper lip, injections are made away from the fold of skin where the outer aspect of the nose meets the cheek.
  2. Botox can be used to enhance the tip of the nose. The depressor septi muscle is a small muscle on the underside of the nasal septum which is responsible for lowering the tip of the nose and constricting the nostrils. The action of this muscle can therefore worsen the natural drooping of the tip of the nose that occurs with ageing. Injection of botulinum toxin just beneath the septum of the nose can produce lift of the tip. The typical dose is 2-3 units of Botox.
  3. Repeated nasal flare. Some patients are bothered by widening of their nostrils or rhythmical contractions on certain occasions. Injection of Botox on either side of the nose above the outer flares of the nostrils can correct this. Doses are typically 4-20 units of Botox.
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