Botox treatment for bunny lines

What are bunny lines?

Bunny lines are the slightly diagonal creases that extend from both sides of the nose, on the bridge. Sometimes known as the nasal sidewall “scrunch line,” this facial crease is quite prominent when patients smile or laugh. Though bunny lines look endearing, they often convey a false feeling of distaste or anger. Bunny lines are named as such as they loosely resemble rabbit whiskers.

What muscles control bunny lines?

Just like most of the facial wrinkles (marionette lines, perioral wrinkles, nasolabial folds, etc.), bunny lines develop due to aging. Skin aging is a complex process that is caused by 2 components: intrinsic aging and extrinsic aging. Intrinsic aging is a biological process that is regulated by genetics and is the reason as to why some people have youthful looking skin even though they are older while other people experience premature aging. Intrinsic aging determines the rate of renewal and repair of various skin cells like collagen, hyaluronic acid, and elastin.

Extrinsic aging is the external components that affect the aging process of the skin due to free radicals. Some examples of extrinsic aging are excessive sunlight exposure, cigarette smoking, pollution, and an unhealthy diet. These sources of extrinsic aging contribute a lot of reactive free radicals that accelerate the skin aging process. Bunny lines are a product of skin aging as well as continuous facial movements, such as frequent crinkling of the nose while laughing or squinting. The muscle that is involved in the formation of bunny lines is the nasalis muscle, especially the transverse portion. The contraction of the levator labii superioris alaeque nasi muscle may contribute to the formation of bunny lines as well. These lines become very prominent when the fibers of the nasalis muscles are subjected to greater pressure in the presence of weaker muscles in the same region of the face.

Will Botox injections between the eyebrows cause bunny lines?

Though Botox injections are meant to erase facial lines, a possible side effect of botulinum toxin administration is the inadvertent formation of bunny lines. This condition is believed to happen especially after muscles in the glabellar region are injected with botulinum toxin. Since the muscles become temporarily paralyzed, other muscles are used for facial expressions; hence, bunny lines may start to appear. That being said, not everyone who is treated with Botox injections will display bunny lines.

What are the best Botox techniques to treat bunny lines?

Botox is actually a type of neuromodulating drug that contains botulinum toxin type A powder, human albumin, and sodium chloride. This neurotoxin is isolated from the Hall strain of Clostridium botulinum bacteria that is fermented with casein hydrolysate, glucose, and yeast extract. Botox contains only a therapeutic amount of the toxin and can treat disorders and aesthetic imperfections associated with muscular contractions.

Prior to intramuscular administration, the toxin powder must first be reconstituted with sterile, preservative-free saline solution (9mg/ml or 0.9% sodium chloride solution). The reconstituted solution can then be injected intramuscularly into the regions with bunny lines. The procedure must only be conducted by a certified physician who is experienced with preparing and administering botulinum toxin injections with strict adherence to aseptic medical standards. The proposed treatment area is cleaned, sanitized, and marked. Physicians can then inject the solution into the sides of the bridge of the nose or the area displaying maximum wrinkling. The injection is placed superficially in the skin overlying the nasalis muscle. Doctors must also avoid injecting the botulinum toxin laterally or inferiorly as it could affect the levator labii superioris alaeque nasi muscle that extends from the sides of the nose to the upper lip. Once the procedure is completed, the skin marks are wiped off and used medical supplies (e.g. needles, syringes, gloves, etc.) are discarded.

What are the best fillers for bunny lines?

Besides botulinum toxin injections, bunny lines can also be corrected using intradermal implants. These implants, usually known as dermal fillers, are made of various materials such as hyaluronic acid, collagen, poly-L-lactic acid (PLLA), and calcium hydroxylapatite. However, the best filler for erasing bunny lines are hyaluronic acid-based fillers. Some of the most popular brands are Juvederm and Restylane. Both of these brands contain hyaluronic acid molecules that have been harvested from fermenting bacterial cultures. The major difference between these brands is the texture of the gel. While Juvederm is made of tightly cross-linked monophasic hyaluronic acid gel, Restylane is composed of biphasic hyaluronic acid particles that are suspended homogenously in the gel. Following implantation, the injectable gel will plump up and erase the bunny lines.


[1] Dartmouth Undergraduate Journal of Science, Why Does Your Skin Age?

[2] Pandora Dermatology Clinic, Botox for Bunny Lines on the Nose

[3] Mamamia, Botox Bunny Lines

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Disclaimer: These articles, and any views and opinions expressed, are not endorsed by Raskel Medical. The articles are strictly for informational purposes and should not be considered medical advice. Raskel Medical does not check or edit the content of these articles for medical accuracy. Contact your medical practitioner for any medical advice needed.