What can be done for drooping mouth corners?
A woman had a perma-frown her whole life. The corners of her mouth remain downturned at all times, even when smiling.
She wanted to know is there anything that can be done to fix downward turned lips.
New York oculoplastic and reconstructive surgeon, Amiya Prasad, M.D., explained how the outer corners of the lips can be lifted with the help of fillers or Botox:
You refer to your condition with your mouth as having perma-frown or a permanent frown that’s present even when you are smiling.
What I suspect you are referring to as the way the outer corners kind of point downward, even when you smile and you are looking for a solution.
I can certainly give you some guidance on how I explain the options to my patients who share this similar type of situation, whether it is genetic or result of facial aging.
So let’s just discuss how we address drooping mouth corners.
So in terms of the movement of the mouth and the relative position of the outer corners of the lips, there are basically two approaches: one is to use a neurotoxin such as Botox, Dysport, Xeomin to relax muscles to allow unopposed action of other muscles.
And the second thing is to use fillers and what do fillers do?
Fillers essentially provide volume in places where volume enhancement can actually create the perception of a subtle and significant enough change.
So let’s start with the neurotoxin concept.
There are several muscles that are around the lips that determine the position at different areas of expression or times of expression.
One of the things we do is something called a Botox lip lift and what that means is injections are placed in an area from the outer corner of the mouth and right near the jawline to relax some muscles.
This muscle is called the depressor anguli oris muscle and what that does is because that muscle depresses the outer corners of the mouth and when it’s relaxed, the outer corners slightly elevate.
So that when you are smiling, the outer corners will come up a little bit. So it’s referred to as a lip lift or using the most common and the most popular neurotoxin, Botox.
Now of course this is something that has to be done consistently. It wears off, the neurotoxin does wear off anywhere from 3-6 months, so consider this in factoring in whether you like to do this with any frequency.
But I think it’s reasonable to try out because if you don’t like it or if things don’t go in the way that you want, it wears off and that’s pretty nice about non-surgical procedures.
The second option I would consider is the use of a filler to try to soften the depth of the line and to try to create a little bit of fullness at the junction and typically I would use a softer hyaluronic acid filler something in the Restylane or Juvederm family.
Now that can create a little bit of a support almost like a pillar to lift the outer corners of the mouth. So I think that combination will give you a little bit more of a smile than without anything.
It doesn’t make a total change but I think it will make enough of a change and you can at least see if you like that and then you can do that with some consistency.
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Before and After
There are surgical procedures and different types suspension procedures that generally I’ve been trying to do something more permanently. But from my perspective, I don’t find those to be that beneficial and consistent.
I still feel the injectable fillers have the most significant and reproducible role in this and of course it is something that’s not surgery, it’s an office visit.
There are a lot of ways to enhance the area around the mouth and there are many different ways to enhance the different areas outside of the outer corners and so a more global look at your whole face and the anatomy may also open up some opportunities to consider.
So meet with qualified, experienced doctors who perform these types of injectables and learn more about your options and then take the first step in trying something out so you can see if you like the result and if you are willing to keep that type of procedure ongoing so you may maintain a certain look.
More About Fixing Drooping Mouth Corners With Botox & Fillers
From birth till about 15 years, the corners of our mouth have natural upturn look.
From 15 to about 25, the corners stay neutral. After 25, they can either stay neutral or can depress lightly or dramatically. This will depend on your genetics and family history.
Why droopy mouth corners happen?
There are multiple reasons, but the main factor is a discordance between your soft tissue tensile and your muscle strength.
When we are talking about soft tissue, we are talking about collagen and elastin in your skin. These two things naturally start depleting over time
Instead of having even tug between soft tissue tensile and muscles, the depletion of elastin and collagen results in the muscle fibers becoming stronger and they start doing all the work.
We’re talking about depressor anguli oris muscle:
That muscle starts pulling down because you are losing volume in that area.
What can you do to fix downturned mouth?
You need to a relax that muscle and restore some volume there.
Fillers are one of the best options because they are effective, they give you a little bit more of a natural result and they are also longer-lasting.
You can use filler and Botox at the same time, just be careful you don’t have a dramatic reverse that can cause that Joker effect.
You can restore the volume that was lost here with hyaluronic acid filler.
A variation of techniques can be done.
Some people provide a little volume right under the corners of the lips and then some people volumize the whole marionette zone to get an equal result.
The reason why is because you’re just providing structure there. The muscle can now relax, it’s not pulling down any longer and it goes back to its neutral position.
If you still feel you need a little extra, then you can get Botox and it will correct a little bit more.