As we age the nose tip will droop. This causes a less appealing appearance on profile. Also often previous rhinoplasty causes a droopy nose tip
A droopy nose tip can be treated with muscle relaxing injections. The injections relax the muscle which pulls down the nose tip. Treatment will give the mouth a more youthful and pleasing appearance.
In my practice dermal filler is the first line treatment for nose tip lifting. However a small dose of muscle relaxing injection may be added to improve the effect
MUSCLE RELAXING INJECTION TREATMENT OF DROOPY NOSE TIP
After dermal filler has been used to lift the nose tip, antiwrinkle injections (due to Australian regulations, we are not allowed to name the drugs used) , may be used to lift the nose tip even further
Small injections using a very fine needle are performed into the muscle which pulls down the nose . Typically about 1-3 injections will be performed
The consultation for antiwrinkle injections for nose tip
History-taking is very important in the treatment of nose tip. The following should be explored:
Previous history of rhinoplasty
Is there a genetic component? ie are there others in the family who have a droopy tip? How has this progressed?
Has the patient had treatment before?
Were they happy every time?
Did the effect of the antiwrinkle injections last well?
Which area came back first?
How is the patient’s metabolism? Do they exercise? Are they very muscular? Do they have trouble putting on or losing weight?
Have they every had any complications with previous treatment, eg strange smile, asymmetry of the mouth etc
The doctor will examine the face and nose area. In particular, she will look at many features, such as:
How the nose looks at rest, and during animation and speech
Whether there is an asymmetry.
IS there any post-rhinoplasty deformity
Choosing the dose of toxin
The doctor will assess the face and decide on the best dose after taking a history and examining the patient.
If the patient has a history of poor longevity, or needing high doses or wanting maximal effect, then a higher dose may be suggested
If a patient has a history of complications with muscle relaxing injections, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen.
Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Most patients do not bother with numbing cream because it takes so long to work and because the treatment isn’t very painful anyway.
Ice is always used to decrease pain and to reduce the risk of bruising.
Very rare patients will use Penthrox for frown line treatments
Nitrous oxide / Happy gas is available to patients
If the patient requires dermal filler, then typically local anaesthetic may be injected in the area first
What happens during the nose tip lifting treatment itself?
The face will be cleaned with alcohol.
Ice will be applied to the area briefly before treatment
The doctor will inject approx 1-3 sites around the nose, injecting the muscles which are responsible for pulling the nose tip down. Then pressure with gauze will be applied.
The procedure itself takes less than 5 minutes.
How do I look afterwards?
Sometimes there is nothing to see. Sometimes there can be redness, small lumps, which can look like mild acne and usually resolve quite quickly.
Most people could come during their lunch break during work and go back without their coworkers noticing anything
Side Effects and risks of antiwrinkle injections for nose tip lifting
In general, treatment nose tip lifting is very low risk.
Headache happens in around 10% of new users.
Bruising occurs in a significant number of cases.
Infection is a very rare complication, but always a possibility when the needle goes into the skin.
It is possible that speech or the smile may be affected. However at the typical doses used this is very uncommon. The cutaneous lip may also lengthen. The risk increases with larger doses
Instructions for care afterward
No makeup for 4 hours
No massage that day
No heavy exercise that day
No lying down for 4 hours
Lay off the acid face products for 24 hours
What to expect after nose tip treatment?
The effect of the injections will not start to occur for 2-8 days.
The maximal effect of the drug will be at 3-4 weeks, so a review should be booked in at 3 weeks (only after the first treatment, for subsequent injections, a review appointment shouldn’t be required)
What do I do if at 3 weeks post treatment I think the nose tip could be further improved?
The doctor will assess this
A top up dose may be performed at the review appointment.
Dermal filler will also be considered
How long will the treatment last?
The answer to this is very individual and depends on the patient’s metabolism, the dose, the placement etc.
Typically this is what happens:
At 3-4 weeks, there is a maximal effect
at 8 weeks, movement starts to return
at 12 weeks, 50% of movement should be back
at 16 weeks 80% of movement should be back.
With an adequate dose, for most patients, this is very close to what occurs.
When should I have my next treatment for nose tip lifting?
Patients should be retreated when the movement is between 50%-80% back ie sometime from 3-4 months.
Some patients have treatment every 8 weeks
Price for antiwrinkle injections in nose tip
Typically $260. If other areas being treated then it will be cheaper
Other procedures which would be suitable to combine with antiwrinkle injections for nose tips
* Dermal Fillers for nose