A doctor asks a question about Botox.

I've been injecting Botox for patients for a few years with very good results. Recently a petient returned after her treatment with a horizontal line above the bridge of her nose which was more prominent after the Botox treatment.The forehead and 11 lines of the glabella are fine. What would you suggest. Thanks, Dr Steve W

Dr. Steve –  As a doctor you are always welcome to call my office number and ask my staff to take a message.  I’m happy to call you to discuss also.   In general, if that horizontal line at the nasal root gets worse with Botox in the glabella, it’s one of two things.  Your patient may have a  strong procerus muscle – have her scrunch her nose hard and you can see it – and she just needs some Botox along the procerus too.  Or sometimes, especially in older patients, the volume under the glabella may be collapsing and relaxing the glabella causes sagging at the nasal root.   A reasonable strategy is to try positioning your injections for the glabella a little higher.   Don’t try to add volume here unless you are an expert, very experienced, board certified dermatologist or plastic surgeon.    Dr. I

Dr. Brandith Irwin, MD

Ask me your skincare question!

Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

  • All our content is written and researched by myself.
  • My medical office in Seattle has treated thousands of patients for 15+ years.
  • This site is not affiliated or financially tied to any product, treatment or device.
Ask Me Something
SkinTour Skincare
One of the best investments in your skin is your daily skincare. Why? Because you can prevent many problems with blotchy skin color, lack of glow, texture, some types of acne, and fine lines with good skincare products. You can also correct some of these problems with effective skincare products. Great skincare is often more expensive because quality ingredients are expensive. Some companies spend on research/development which benefits all of us and adds to the cost. Are they worth it? In general - yes! I have handpicked some of what I consider to be the best skin care products, and offer them for sale on SkinTour's shop. This is based on my team and I's testing and research at our clinic. Many of the products are in my own regimen. What could be better than using skin care products a dermatologist uses?!