Comparative analysis of botulinum toxin injection after corrective rhinoplasty for deviated nose and alar asymmetry.

[BACKGROUND] Deviated noses and asymmetric nostrils can be corrected using corrective rhinoplasty. However, after proper correction, adjacent facial mimetic muscles can cause recurrence of asymmetry because of preoperative habits.

[OBJECTIVES] We performed this study to investigate the effects on botulinum toxin on the prevention of recurrence of asymmetry after corrective rhinoplasty.

[METHODS] From January 2016 to December 2019, 60 patients underwent corrective rhinoplasty and 30 received botulinum toxin type A injection (Botulax; Hugel Co.) at the depressor septi nasi and levator labii superioris alaeque nasi muscles, bilaterally. Vertical and horizontal deviations were compared preoperatively and postoperatively.

[RESULTS] Postoperative vertical deviation was 0.20° ± 0.65° in the botulinum toxin-injected group and 1.20° ± 0.53° in the control group (P < 0.0001). Horizontal deviation was 0.80° ± 0.52° in the botulinum toxin-injected group and 2.18° ± 0.42° in the control group (P < 0.005). Differences between preoperative and postoperative vertical deviations at 6 months were 2.30° ± 0.03° in patients who received botulinum toxin injection and 1.10° ± 0.22° in controls (P < 0.005).

[CONCLUSIONS] Botulinum toxin effectively restricted the paranasal muscles without any significant adverse events. We recommend injecting botulinum toxin after corrective rhinoplasty to prevent recurrence of deviation by facial mimetic muscles.