How many Botox units would you suggest putting in the DAO muscle to corrct droopy mouth corners? Will it affect my smile or speech?
Botox Units for DAO Muscle to Correct Droopy Mouth Corners?
Doctor Answers 10
"Droopy mouth corners" - ? BOTOX and/or JUVEDERM
The "droopy mouth corner" you describe may be a result of a combination of several things.
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Botox for droopy corners of the mouth
A few units of botox into the DAO muscle can help raise the corners of the mouth. This is often subtle when done alone. If combined with a filler to the corner of the mouth, it will have a more dramatic effect. I agree with the other comments, this something you want to have done by a board-certified Facial Plastic Surgeon or Plastic Surgeon or Dermatologist. Good Luck.
Conservative Botox dosage advisable for marionette lines/DAO muscles
2-3 units in the hands of experienced board-certified dermatologist or plastic surgeon. You do want to be conservative as excessive amount can lead to subtle change in your phonation and speech. You can always do touch-up later if you are getting the lift along the marionette lines. I totally agree that filler and botulinum toxin is a great combination for marionette lines.
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Droopy Mouth Corners...
Be sure to seek the services of an experienced physician injector. I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin and see the actual muscles themselves. For me, this helps guide where to inject and where not to. However, with that said, I know many Dermatologists who know the anatomy well despite not operating in that area, and get great results.
5Units in Each DAO
The droopy corners of the mouth respond well to about 5units of Botox in each
DAO. You can also use 10-15 unis of Dysport in each DAO.
It is better to start with a smaller dose for the first time. This minimizes the chance of any effects on speech or smile.
Botox units vary for volume problem or muscle problem, or a combination
One must asses whether the problem is a volume problem or one caused by muscle action. This can be relatively easily determined on physical exam. For a downward pull cause by an active muscle Botox in small doses is usually effective. Volume problems of course require fillers.
Options for a droopy or downturned mouth
Two to 4 units per DAO muscle is a typical starting dose.
In 15% of people this can be due to hyperactivity of the platysma muscle.
Fillers are a reasonable alternative or supplement to help correct a downturned mouth.
Surgical options include a corner lift or facelift
2 to 4 units Botox to correct droopy mouth corners
Depending on the bulk of the depressor (DAO) muscle, you need a conservative 2 to 4 units of Botox per side.
Two to 4 units of BOTOX is the dose
The Carruthers invented this treatment. There is actually a US Patent describing this treatment. The typical dose is 2 to 4 units of BOTOX per side in the depressor anguli oris muscle. It is possible for this treatment to create muscle imbalance if it is not properly placed. However, generally, I find that it is much better to fill this area to lift the corner of the mouth. Treatment usually lasts about 3 or 4 months with BOTOX but if the corners are filled with Perlane, treatment can last over a year and a half.
My preference is to drop 4 units into each DAO muscle. This should be practiced by a physician with some experience since if the orbicularis oris or DLI (depressor labii inferioris) muscles are inadvertently hit, the appearance can be unsightly and you possibly could drool...not good.
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