Botox for Pez Muscles: Advanced Facial Harmonization

1. Most people discover the “Pez muscles” the same way: in photos. The smile looks tight, the upper lip jumps, the nose wrinkles more than expected, and the midface steals attention from the eyes. We chase crow’s feet or frown lines, yet ignore the small, overactive muscles around the nose and upper lip that can throw off harmony. When treated thoughtfully, botox for the Pez muscles can soften a harsh grin, reduce “bunny lines,” and balance the central face without freezing expression. This is a nuanced treatment. It demands precise anatomy, conservative dosing, and an eye for natural movement. Below is how experienced injectors approach it, what patients should know, and where this technique fits within a complete aesthetic plan. What we mean by “Pez muscles” In aesthetic slang, “Pez muscles” typically refers to the small perinasal elevators that tug the upper lip and scrunch the nose, reminiscent of a Pez dispenser’s lid popping open. In practice, this involves a cluster of muscles, often with overlapping action: Levator labii superioris alaeque nasi, or LL SAN, which elevates the upper lip and flares the nasal ala. Levator labii superioris (LLS), lifting the upper lip vertically. Nasalis, particularly the transverse portion, creating bunny lines on the bridge and upper side of the nose. Depressor septi nasi, which can pull the tip of the nose down during smiling, compounding the jumpy upper lip effect. No patient recruits these muscles in exactly the same way. Some show deep diagonal bunny lines, others reveal a slanted smile with too much gum, and some notice the nasal tip dip. The art lies in measuring which fibers are overworking and how that affects the whole face. How botox changes the picture Botox cosmetic works by blocking acetylcholine release at the neuromuscular junction. In practical terms, small, targeted botox injections dial down overactive muscle pull. Relax the transverse nasalis and bunny lines fade. Ease LL SAN and upper lip elevation softens. Tame the depressor septi and the nasal tip holds steadier in a smile. The goal is not paralysis. The best botox results preserve genuine expression. In perinasal work, too much product risks a flat smile, lip incompetence, or a nasal valve sensation that feels stuffy. Minimal, strategic units produce a change you notice in movement, not at rest, which is exactly what most patients want. Who benefits When I review pre-treatment photos and watch patients animate, several patterns emerge: The “scrunch smiler” with creases across the nasal bridge that deepen in laughter or when concentrating. They often report makeup settling in lines near the upper nose. The “gummy” grin due to strong levators, even if the teeth-alveolar relationship is normal. These patients might be candidates for a botox gummy smile approach, sometimes combined with lip shaping. The “dipping tip” where the nasal tip drags down during a big smile, often due to the depressor septi. This can make the nose look longer or the philtrum look shorter in motion. The “upper lip jump” where the central lip elevates more than the corners, creating a choppy smile that draws attention to the midface instead of the eyes. These cases frequently overlap with other concerns like botox for crow’s feet, glabellar frown lines, or a lip flip. The perinasal zone can be the missing piece, explaining why botox for the forehead or botox for face hasn’t quite delivered harmony for some. Mapping the anatomy on a real face A solid injection plan starts on video. I film the patient saying vowels, smiling naturally, then smiling broadly with teeth. I ask for a https://botoxinmorristownnj.blogspot.com/2025/10/understanding-botox-what-it-is-and-how.html sniff, a gentle flare, and a forced nose scrunch. The pattern reveals where to place units and in what sequence. For bunny lines, I palpate and mark the transverse nasalis on both sides near the superior alar crease, staying superficial and lateral enough to avoid intranasal diffusion. For a gummy smile from levator overactivity, I mark lateral to the nostril

2. sill and slightly inferior, aiming at LL SAN without drifting too medial. For a dipping tip, I locate the depressor septi insertion at the columellar base and apply extremely conservative dosing. These cues matter, because two millimeters make the difference between softening a crease and dulling a smile. The “Pez” region has thin soft tissue and a delicate web of function. It is unforgiving if you guess. Typical dosing and product options For most first-time patients, I start light. Think micro botox principles adapted to motion lines. Initial dosages vary by sex, muscle bulk, and animation strength. A very general starting point: Transverse nasalis for bunny lines: 2 to 4 units per side. LL SAN for gummy smile or upper lip over-lift: 1 to 3 units per side. Depressor septi for nasal tip dip: 1 to 2 units midline, sometimes split. Total botox units are often in the 6 to 12 range for the perinasal set, though strong movers may need more. I prefer to underdose, reassess at two weeks, and top up. This approach favors botox maintenance that feels natural and avoids the heavy, “I can’t smile right” sensation that puts people off injectables. Regarding product choice, botox vs Dysport vs Xeomin vs Jeuveau all perform well when technique is sound. Dysport can spread a bit more, which some injectors like for the nasalis. Xeomin has a cleaner protein load and may be preferred by those with sensitivities. Jeuveau is commonly used with dosing similar to botox cosmetic. For a first session, I match the product I know best to the pattern in front of me rather than chasing brand claims. What results look like over time You’ll usually see botox results begin in 3 to 5 days, with full effect near two weeks. Videos are invaluable at the follow- up appointment. The smile should look smoother, less scrunched, and more effortless. The nasal bridge lines relax, yet you can still flare and laugh. A common and welcome surprise is how the change shifts attention back to the eyes. Patients who once fixated on under- eye creasing notice that, with the midface quieter, the whole expression reads younger and more relaxed. This is one reason I discuss botox for crow’s feet and perinasal injections together. It is not about chasing every line, it is about directing focus to the features that define you. Duration typically runs 3 to 4 months in the perinasal area. Strong lifters may metabolize quicker and need a 10 to 12 week interval at first. With repeated botox treatment over a year, some people extend to 4 to 5 months between visits. If you are comparing botox how long does it last for different regions, the perinasal muscles often wear off a bit faster than the glabella, similar to the orbicularis regions. Safety, risks, and how to keep it smooth Botox safety in this zone is excellent when performed by a skilled botox provider. Still, you must respect a few pitfalls.

3. The first is lip incompetence from over-treating the levators. If LL SAN is shut down too far, smiling can feel awkward, and whistling or sipping may feel different. This usually softens as the product settles, but it is avoidable with restrained dosing. The second is nasal airflow perception. Very rarely, overly aggressive dosing around the nasal ala can create a stuffy feeling. The fix is prevention: stay superficial and precise, and avoid medial spread. Lastly, asymmetry can occur if one side scrunches more. This is why photographs and small, symmetric test doses matter. Bruising is possible because the area is vascular and patients may be taking supplements or medications that thin the blood. I warn patients about tiny pinpoint marks that fade in a few days. Headaches and tenderness are uncommon here, but possible within 24 to 48 hours. I counsel every patient on botox side effects and what to watch. If someone is prone to post-injection anxiety, I bring them back at the one-week mark for a quick check and reassurance. Over years, this approach has cut down on unnecessary touch-ups and built trust. Cost and value: how to think about price Botox cost depends on geography, injector experience, and practice overhead. In major cities, botox price per unit ranges widely. For perinasal work at 6 to 12 units, a session might be a few hundred dollars. That said, pricing by area rather than unit is common for small zones like bunny lines or a gummy smile because the units are predictable. Ask your botox clinic or botox center how they structure fees. Be wary of botox specials that promise dramatic savings but cut corners on time or assessment. The evaluation is the value. A careful botox consultation that includes video analysis of your smile and nasal motion is worth more than a discount. If you find botox near me through a search, read botox reviews, ask whether the botox doctor, botox dermatologist, or botox nurse injector performs this specific treatment frequently, and request to see botox before and after photos for perinasal cases. Look for motion videos, not just stills. How this fits with other treatments Pez muscle work rarely lives alone. It pairs well with: A conservative lip flip when the upper lip disappears in a smile, but you want to avoid filler. A small dose to the orbicularis oculi for crow’s feet to balance a heavy smile eye crinkle. A tiny lift to the lateral brow for patients whose midface now looks calmer and want the eyes more open. Select filler in the midface or lip for structural balance once muscle overactivity is toned down. I prefer to stage these rather than do everything at once. Start with the perinasal injections on day zero. Assess at two weeks. If the upper lip still inverts under the teeth, consider a micro botox lip flip. If the nasal tip remains stubborn, add a conservative touch to the depressor septi. The staggered approach prevents stacking side effects and makes the source of any change clear. The appointment experience A typical botox appointment for this area takes 15 to 25 minutes. I photograph at rest, soft smile, big smile, and scrunch. I mark lightly while you animate. The botox procedure itself is quick, with several micro injections using a fine insulin needle. Stinging is brief and tolerable, often rated 2 to 3 out of 10. If you are concerned about comfort, a cool pack and a breath cue during the poke works as well as numbing cream, which can distort the anatomy.

4. Aftercare is straightforward. Keep your head upright for four hours, avoid heavy workouts that day, skip facials and nose massages for 48 hours, and do not press or rub the treated spots. Makeup can go on gently after an hour. Expect to see change within a week. If you have a big event, plan your botox appointment at least two weeks ahead to allow for a touch-up if needed. Special situations and edge cases Men can benefit greatly, especially those with strong nasalis activity from sports or facial habits like squinting and nose scrunching. In men, doses may trend slightly higher because of stronger muscle mass. For botox for men, the same rules apply: keep expression, just turn down the excess. Patients with thin nasal skin must be handled delicately to avoid visible irregularities or track marks. Those with prior rhinoplasty may have altered anatomy and scarring around the depressor septi or alar bases. I contact the surgeon when possible and proceed extra conservatively. If you already have botox for forehead lines and frown lines every three to four months, align the perinasal timing with your routine to streamline botox maintenance. If you are brand sensitive or trying botox vs Xeomin or botox vs Jeuveau, switching products in this small area can be done safely, but I recommend keeping the same brand across zones for at least one cycle to simplify interpreting the results. For patients exploring botox alternative options like “natural botox,” creams, or serums, know that topical products marketed as botox cream or botox serum do not relax perinasal muscles. They can improve skin texture and hydration, which helps fine lines at rest, but they will not change dynamic creasing or gummy smile mechanics. If you prefer not to use injectables, discuss dental or surgical options for gummy smile, or neuromodulator-free skincare for skin quality, but set realistic expectations. Preventative strategy vs corrective dosing Younger patients with early bunny lines or a subtle upper-lip jump do very well with preventative botox. A two to four unit per side strategy a few times a year can keep those lines from etching in. In contrast, established deep lines need slightly higher doses initially, then a taper as the muscle learns a new baseline. If you are weighing when to start botox, the perinasal region responds especially well to early, light treatment because skin in this area is thin and creases imprint fast.

5. Baby botox or micro dosing is the sweet spot here. It aims to soften, not erase. Heavy-handed correction often reads as strange because the nose and lip are critical to identity. Keep the cadence of your smile intact. The realistic timeline People ask how long does botox take to work, and whether there is any downtime. In this area, expect: Minimal downtime. Tiny marks or faint redness fades in hours. Occasionally a small bruise lingers for a few days, easily covered. Onset within a few days, full effect by two weeks. If we need a botox touch-up, it is typically 2 to 4 units. Duration of 10 to 16 weeks for most. Plan two to four sessions a year, depending on metabolism and aesthetic goals. Hydration, smoking status, and fitness level can affect duration. Highly active people sometimes metabolize neuromodulators faster. A steady schedule beats sporadic “big fixes.” What a strong plan looks like If I were advising a friend, I would structure their perinasal journey like this: Begin with a careful consult that includes video and a smile analysis. If your botox provider does not watch you move, keep shopping. This is not a static-zone treatment. Start with low units targeted to your dominant pattern, then reassess at day 14. Resist the urge to do more everywhere on day one. Precision now prevents problems later. Consider staged add-ons like a lip flip or small crow’s feet doses if your goal is full smile harmony rather than a single-line fix. Maintain every 3 to 4 months for the first year. Photograph each visit. Adjust the map as your muscles adapt, not just the dose. Revisit goals annually. Maybe you shift focus to the jawline or neck bands, or you pause perinasal work if your lines are staying soft. The plan should evolve with your face. A note on training and choosing the right injector Pez muscle work lives in the gray zone between simple line chasing and full smile design. If you are an injector, invest in botox injection training that covers dynamic perinasal anatomy and live assessments. Courses that include cadaver dissection help translate theory into safe practice. If you are a patient, ask your botox doctor or botox nurse injector about their approach to gummy smile, bunny lines, and nasal tip dynamics. The willingness to say “let’s start lighter” is a green flag. Certification matters, but so does repetition. A botox clinic that performs many perinasal cases will have a refined sense of dosing and avoidance of pitfalls. That experience is what turns a few units of botox cosmetic into a refined result, not just “botox for wrinkles.” Frequently asked questions my patients actually ask

6. Does botox hurt here? These are among the least painful facial injections. Expect brief pinches. If needles make you nervous, a cool pack and slow breathing help more than numbing cream, which can muddle your anatomy. Will I look stiff? Not if dosed properly. Your smile should look like you on your best day. If anyone can tell you had something done, it should be because your expression seems more relaxed, not because it is limited. How often to get botox for this area? Plan three to four times a year at first, then adjust. If you prefer seasonal treatments, aim for spring and fall touch-ups. Is botox safe near the nose? Yes, when performed by an experienced injector with conservative units and precise placement. The main risks are temporary and dose related. Can I combine this with fillers? Yes, but stage them. Start with neuromodulation, then add filler only if structural support is needed. It is easier to add volume than to reverse it. When botox is not the solution If gummy smile is driven mainly by dentoalveolar height or short upper lip anatomy, botox will only partially help. In those cases, dental work, surgery, or lip lengthening techniques may be more appropriate. Similarly, etched-in lines at rest might benefit from skin treatments like laser, microneedling with radiofrequency, or targeted filler support in addition to botox treatment. For functional issues such as significant nasal obstruction, botox is not a fix. Get evaluated by an ENT or facial plastic surgeon. Cosmetic priorities should never override breathing or bite health. Final perspective from the chair I have watched patients light up when they see their smile in motion after a refined perinasal plan. The face stops fighting itself. Your eyes read first, then the smile follows, with the lip and nose supporting rather than competing. That subtle reordering of attention is the essence of facial harmonization. If you are browsing botox reviews or asking friends for referrals, seek a provider who talks as much about movement as they do about lines. A few well-placed units in the so-called Pez muscles can do more for your overall expression than chasing every wrinkle across the map. It is not the volume of product that matters, it is the judgment behind it. And if you are nervous, start modestly. Take a set of “before” and “after” videos two weeks apart. See how it affects your selfies and how it feels to laugh. If the result makes you forget about your nose scrunch or that upper lip jump for months at a time, you will have your answer about the value. When done right, this treatment becomes an easy, reliable part of maintenance, not a dramatic makeover, and that is the point of botox rejuvenation in the first place.