Bunny Lines: Treating Wrinkles on the Sides of the Nose

Bunny lines are the small diagonal creases that fan out across the upper sides of the nose when you laugh, smile broadly or scrunch your face. They come from a thin muscle called the nasalis, and a very small dose of neuromodulator placed in that muscle can soften them for a few months. Because the area sits close to the muscles that lift the upper lip, careful placement matters more than the size of the dose.

Where bunny lines come from

The nasalis muscle runs across the bridge and sides of the nose. Its upper part, sometimes called the transverse portion, compresses the nose and pulls the skin inward when you wrinkle it. Each time it contracts, the skin above folds into short slanted lines that point down toward the cheeks.

Almost everyone makes these lines with a big expression. They become a concern for some people when they look prominent in photos, start to linger after the expression relaxes, or seem more noticeable than lines elsewhere on the face.

A few factors make bunny lines more visible:

• Habitual expression: some people naturally scrunch the nose when they laugh, squint or concentrate.
• Thinner skin with age: as collagen declines, repeated folding leaves a more lasting mark.
• Sun exposure: years of ultraviolet light weaken the skin on the nose, which gets more sun than most areas.
• Treatment elsewhere: when frown lines or crow's feet have been relaxed, some people recruit the nasalis more strongly without realizing it, so bunny lines can appear more obvious afterward.

How the treatment works

Treatment uses botulinum toxin type A, a prescription medicine that temporarily reduces the signal from a nerve to a muscle. For bunny lines, a physician typically places one small injection on each side of the upper nose, high on the side wall and away from the groove beside the nostril. If you are new to this kind of treatment, What Is a Neuromodulator? explains the basics.

The dose is small compared with areas such as the forehead or frown, because the muscle is thin. The goal is to soften the scrunch, not to stop the nose from moving entirely. Most people still have a natural expression; the lines simply form less deeply.

The effect usually starts to appear within 3 to 14 days and commonly lasts around three to four months. Bunny lines are often treated at the same visit as frown lines or crow's feet, since these muscles work together when you smile or squint.

The main risk: spread to the upper lip

Just below and to the side of the nasalis sit the muscles that lift the upper lip and help shape the smile. If the medicine is placed too low, injected too deeply in the wrong spot, or spreads farther than intended, it can weaken those muscles.

When that happens, people may notice:

• An upper lip that sits a little lower or looks longer
• A smile that seems uneven or less lifted on one side
• A feeling that the lip is slightly heavy when talking or eating

These effects are temporary and fade as the medicine wears off, but that can take weeks. To lower the risk, injectors keep the dose conservative and the injection point high on the nose. Avoiding rubbing or pressing on the area for the rest of the day is also usually advised. Our article on neuromodulator aftercare covers the general precautions.

Who it suits, and who should wait

Bunny line treatment may suit adults who:

• Have visible diagonal lines on the nose that bother them when smiling or in photos
• Notice the lines more after treating nearby areas
• Prefer a subtle change and are comfortable with a temporary result that needs repeating

Treatment is generally avoided or postponed if you:

• Are pregnant or breastfeeding
• Have an infection, rash, cold sore or active acne near the injection site
• Have a nerve or muscle condition such as myasthenia gravis or Lambert-Eaton syndrome
• Have had a reaction to a botulinum toxin product before
• Take certain medicines that interact with nerve-muscle signalling, such as some aminoglycoside antibiotics

Let your physician know about all medicines and supplements, including blood thinners, which can raise the chance of bruising. Do not stop any prescribed medicine on your own to prepare for treatment.

Other side effects to know about

Most side effects are minor and short-lived. Small bumps, redness or tenderness at the injection points usually settle within an hour or so. Bruising is possible, as the nose has a good blood supply. Some people get a mild headache on the day of treatment.

Less often, results can be uneven, with one side softening more than the other. A follow-up about two weeks after treatment allows your physician to check symmetry and note any adjustment for next time. For a fuller overview, see side effects and risks of neuromodulator treatment.

What treatment will not change

A neuromodulator only acts on muscle movement. It will not reshape the nose, smooth a bump on the bridge, or treat redness, broken capillaries or enlarged pores on the nose. Lines that are etched into the skin even at rest may soften only partly, and skin-quality treatments such as laser resurfacing or a good sunscreen habit may help more over time.

It is also worth knowing that some people are happiest leaving bunny lines alone. They are part of a genuine, full smile, and many people see them as a sign of warmth rather than something to correct.

Frequently asked questions

Can I treat bunny lines on their own?

Yes. Some people treat only this area. Others find the lines appear mainly because nearby muscles have been relaxed, so your physician may look at your whole upper face before suggesting a plan.

Will my nose look frozen?

With a conservative dose, the nose usually still moves. The aim is to soften the deep scrunch while keeping your expression recognizable.

What if the effect is too strong?

There is no way to reverse a neuromodulator once it has taken effect, so starting with a small dose is the usual approach. Any unwanted weakness fades as the medicine wears off.

How soon can I wear glasses or makeup?

Light makeup can often be applied later the same day once the injection points have settled. Glasses that rest on the upper nose are generally fine, but avoid pressing or massaging the area for the first several hours.

Talking it through

If bunny lines bother you, a consultation is a chance to look at how your nose, cheeks and upper lip move together and to decide whether treatment makes sense at all. At HealthPark Medical Aesthetics, your physician will explain the expected change, the risks and the alternatives, including the option of no treatment, before you decide.