Bunny lines are the small diagonal creases that appear on the sides of the nose when you scrunch it, laugh or smile broadly. They cover a small area, but they can be noticeable. At Shield Dental Care in Burke, VA, Dr. Ghorbani treats bunny lines as part of our Botox service.
What causes bunny lines
Bunny lines sit on the upper sides of the nose, running at an angle. They are made by small muscles that wrinkle the nose: the nasalis, which crosses the bridge of the nose, and the upper part of the levator labii superioris alaeque nasi, a thin muscle that runs down the side of the nose and also helps lift the upper lip. Anatomy studies differ on which of the two does more of the work, and it varies from person to person, which is one reason we watch how your nose moves before deciding where to inject.
Some people notice creases on the nose more after nearby areas, such as the frown lines, have been treated. Anatomy researchers describe nose wrinkles becoming more obvious as the face rebalances how it moves. If that has happened to you, bunny lines can be treated on their own or at the same visit as your frown lines.
How Botox helps
A very small dose is placed high on each side of the nose, above the crease where the nose meets the cheek. Relaxing the muscle there means the skin creases less when you scrunch or laugh. Published guidance describes around 2 units of BOTOX per side, and your dose depends on how strongly the lines form.
Botox only softens lines made by movement. It does not change the shape of the nose, and it does not treat fine lines from sun damage or the texture of the skin.
An off-label use
No botulinum toxin product is FDA-approved for bunny lines. BOTOX® Cosmetic is approved for frown lines, forehead lines, crow’s feet and neck bands, and Dysport and Daxxify for frown lines only, so treating the nose with any of them is off-label. That is legal and common, and we explain it as part of consent before treatment.
What to expect
- Consultation. We watch the lines form as you scrunch your nose and smile, and review your medical history and medicines.
- Treatment. One small, shallow injection on each side of the nose. It takes a minute or two.
- Afterwards. You can go straight back to your day. We give you written aftercare, which includes not rubbing or massaging the area.
The change starts to show within a few days and builds over about two weeks. Movement then gradually returns over the following months. Treatment should not be repeated more often than every three months.
Side effects
A small bruise or bump at the injection point is the most likely thing you will notice. The side effect specific to this area is a droopy or uneven upper lip. The muscles that lift the upper lip start just below the injection points, and if the product spreads down to them, one side of the lip can lift less when you smile. That is why we inject high and shallow on the nose and use a small dose. Like any Botox effect, it wears off.
All botulinum toxin products carry an FDA boxed warning: rarely, the effect can spread away from the injection site, causing trouble swallowing, speaking or breathing, vision problems or general muscle weakness, hours to weeks after treatment. These are medical emergencies. If they happen, get help immediately.
Who should wait
- Anyone pregnant or breastfeeding. Cosmetic botulinum toxin has not been adequately studied in pregnancy, so we recommend waiting.
- Anyone allergic to a botulinum toxin product, or with an infection or skin problem where the injections would go.
- Anyone with a nerve-and-muscle condition such as myasthenia gravis, Lambert-Eaton syndrome or ALS.
- Tell us if you take blood thinners, have recently taken aminoglycoside antibiotics, or have had any botulinum toxin treatment in the last four months.
Bunny lines can be treated at the same visit as crow’s feet and frown lines.
Frequently Asked Questions
Why do I notice bunny lines more since my frown lines were treated?+
Some people notice nose creases more once nearby areas are treated, as the face rebalances how it moves. The creases can be treated too, on their own or at the same visit.
Will Botox change the shape of my nose?+
No. It relaxes the small muscles that wrinkle the skin on the sides of the nose. It does not change the shape of the nose itself.
Can Botox for bunny lines affect my smile?+
It can. If the product spreads to the muscles that lift the upper lip, the lip can lift unevenly for a while. We keep injections high on the nose and the dose small to avoid this.
Is Botox for bunny lines FDA-approved?+
No. It is an off-label use for every brand. That is legal and common, and we explain it before treatment.