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

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