The intra-oral approach is less painful but it may be considered more difficult by some to inject into the correct level. The same needle may be used; however, the injection must preferably be undertaken in two sites right beside the frenu-lum. The m. depressor septi nasi fibers are intertwined with the orbicularis oris, so at least half of the 30 gauge needle should be inserted with its bevel directed to the columella base. A total dose of 1-3 U Botox or 3-7 U Dysport at each side should be injected.

Treatment of the m. depressor septi nasi

Technique 1

• Two transcutaneous lateral injection points (Fig. 5.59)

Fig. 5.60. Transcutaneous approach: one injection point at the base of the columella

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