title: The use of botulinum toxin in the treatment of plunging nose: cosmetic results and a functional serendipity.
abstract: BACKGROUND
  Muscles of the nose are active in facial movements both with the other facial muscles. An active depressor septi muscle (DSN) can accentuate a drooping nasal tip and shorten the upper lip on animation, especially during smiling. Paralysis of the DSN allows the tip of the nose to be lifted up.
  
  
  METHODS
  Between January and June 2011 a double blinded, randomized study was performed on 40 patients for nasal defects as "plunging" tip. 20 patients underwent to Botulinum toxin injection (B), 20 patients were treated with placebo such as saline solution (S). Both aesthetic and functional results were evaluated using objective and subjective parameters at time 0, after 7, 15 and 30 days and values were compared using t Student test.
  
  
  RESULTS
  S group results were not significant from an objective point of view. In botulinum group, patients showed an increase in columellar-lip distance. Satisfaction of the Group B patients was an average of 6.3 on VAS (range from 4 to 9). VAS mean values were studied with t-Student test and were found significant.
  
  
  CONCLUSIONS
  Several authors recommend the incision of DSN muscle during rhinoplasty to correct the plunging tip. In patients with no needs for rhinoplasty this procedure is unnecessary and a quick and targeted injection of Botulinum toxin is the most convenient choice to improve aesthetic of the plunging tip.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, University Sapienza, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Cigna
authors.forename: V
authors.initials: V
authors.lastname: Sorvillo
authors.forename: G
authors.initials: G
authors.lastname: Stefanizzi
authors.forename: P
authors.initials: P
authors.lastname: Fino
authors.forename: M
authors.initials: M
authors.lastname: Tarallo
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000494:pharmacology*; D003357:Cosmetic Techniques; D004311:Double-Blind Method; D005152:Facial Muscles / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000494:pharmacology*; D009666:Nose / Q000002:abnormalities*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A