My mouth naturally turns down at the corners and more so as I have aged. Botox in the Cupid bow area has actually increased this downturn by puffing up the very center of my lip. Would Botox in these puppet lines and outer corners of the mouth help to stop accenting the downward pull of my lips?
Will Botox in my 'Marionette Lines' and Corners of Mouth Help to Uplift the Profile of my Mouth in General? (photo)
Doctor Answers (26)
Botox for Marionette Lines
Botox in combination with a hyaluronic acid filler would help create a happier appearance to your face. As we age, the depressor anguli oris muscle (DAO) continues to pull the corners of our mouth down creating a sad look. Relaxing these muscles with a neurotoxin such as Botox will stop this downward progression and allow for a slight upward release of the corners. Hyaluronic acid fillers such as Juvederm and Restylane would be placed in and around the marionette lines to add physical support to the corners of the mouth.
Botox for Marionette Lines
Web reference: http://www.plasticsurgeryoftheface.com/pages/injectables.htm
You Have Great Non-Surgical Options to Improve Your Smile and Mouth Area
The reason the mouth turns down at the corners are a combination of loss of fat and bone in the area. As fat and bone is lost, there is poor support of the corner of the mouth and it turns down. To replace the lost support, I perfer to place fillers, Restylane or Perlane, in the area. There is also a muscle that pulls down the corners of the lip, depressor anguli oris. If this is weakened with Botox, Dysport, or Xeomin, it can cause the corner of the mouth to lift.
I hope this helps!
Web reference: http://www.carolinafacialplasticsurgery.com/facial-fillers/
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Botox in Marionette Lines. Viable Option?
Botox placed in this area is an "off label" use. Having said that there is literature to support the practice. Some patient will benefit from Botox placed in the DAO muscle. Often, a filler will also be used. Please seek out an experienced and well trained injector.
Web reference: http://www.jjrothmd.com/face-and-skin/botox
Corners of Mouth and Botox
I often perform a combination of Botox and fillers for the downturned corners of the mouth. Botox will relax the muscles that pull the corners of the mouth down which will create elevation of the mouth. It appears you also have volume loss of the upper face/mid cheeks and lateral lips which contributes to the "puppet" lines. Fillers, such as Radiesse and Restylane, can address this volume loss and help smooth out prominent lines. Replacing upper face volume will help lift the lower face. I would recommend consultation with an experienced board-ceritified physician trained in fillers and neurotoxins. Best wishes.
Combination of botox and filler
Botox, if correctly injected, can help raise the corners of your mouth a few millimeters at most. Fillers, in actuality, are going to be the real work horse in raising the corners of your lips. You will need fillers injected around your mouth to "push up" the corner of your mouth and in your cheeks "pull up" the corners of your mouth. I like larger particle hyaluronic acid fillers (Juvederm ultra plus, Perlane) for this purpose.
Corners of mouth downturn corrected with Botox and Filler
The extent of your downturn requires both Botox and fillers (Radiesse or Restylane). I also notice people that have similar issues have a habit of making an expression of turning their corners down. You need to recognize you are doing it and try to stop. You have built up these muscles over the years and it will take time to make them weak. Botox is injected in the DAO's and filler is injected into the corners of the lips and marionettes.
This is a very common request in my clinic and I am often able to achieve excellent results using a combination treatment. I use a neurotoxin such as Botox, Xeomin, or Dysport, to treat the depressor anguli oris muscles and a filler to treat the age related volume loss below the corners of the mouth. My filler of choice in this region is Radiesse because of its longer duration than the typical hyaluronic acid filler.
Jacque LeBeau, MD
Marionette lines and Botox
For lines like yours I would use a combination of Botox or Dysport to the muscles that depress the corners and a filler such as Restylane or Radiesse to elevate the corners. My choice of fillers would depend on what else I was doing at the time for you as either would do fine, as would Juvederm or Belotero.
Botox and Puppet Lines
Yes, Botox at the corners of the jawline can stop your mouth corners from turning down. Sometimes this is all you need to get those mouth corners up.
However, you still may need some filler such as Juvederm or Restylane to complete the look. You can do the Botox first and evaluate in 2 weeks. If it is not completely fixed then you can add the filler. However, I have lots of happy patients that are able to fix the problem with only Botox or Dysport. Be sure you are going to an experienced injector for this treatment.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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