I agree that the best non-surgical treatment is to use fillers like restylane, perlane or juvederm to support the corners of the mouth and below the corners if there is volume loss.
If you are a person who grimaces or grinds their teeth while you sleep, you may have a more active muscle pulling down the corners of your mouth that can be treated by injecting a very small amount of botox or dysport to relax the muscle and soften your lower face. Its important to look carefully at each person's natural expressions and to personalize your treatment suggestions. I am sure others agree that we have to look closely at your expressions and anatomy before providing the best options for your care. I hope this helps!
We correct downturned corners of the mouth with filler and have great results. This procedure really makes a huge difference in overall appearance, and often we have a good amount of product left to correct other lines in the face.
I totally agree with the combination concept of Botox at the DAO muscle and fillers. To be specific, the fillers should be injected at the marionette lines starting from just below the corners of the mouth.
I agree with the other doctors on this thread that Botox injections in the DAO muscle at the corner of the mouth can make a very noticeable improvement in downturned mouth corners. Caution must be used in this area, however, to avoid a crooked smile appearance. I also routinely place fillers such as Restylane or Juvederm in this area for best results. Good luck
Hi JC. Fillers are effective at the oral commissure (corners of the mouth). There are specialized techniques to inject filler that allows for elevation and "popping out" of the mouth corners. Hyaluronic (HA) fillers have the added benefit of being dissolvable. I hope this is helpful.
Botox can relax the muscles that pull down the mouth corners but this is in my experience very subtle and hard to show on a standardized before and after picture. Fillers, however, can make a big difference in turning up the corners of the mouth. The combination of Botox and fillers provides the best result in my experience.
Joe Niamtu, III DMD
Downturn of the corners of the mouth can be corrected by injecting the DAO with Botox but the best result will be also to add a filler like Restylane or Perlane. The Botox lasts only about 4 months max and won't have as dramatic a result unless the filler is also added. Steve Weiner, Facial Plastic Surgeon, Panama City Beach, Florida.
There is a muscle on each side of the corner of the mouth that works hard at pulling this area down. The name of this muscle is the Depressor Anguli Oris (DAO) and it can be identified to looking at yourself in the mirror and showing your lower teeth. If you see a bulge at each side below the corner of the mouth extending to your jawline while making this expression, you may be a candidate for this treatment. Treating this area with 2.5 to 5 units of Botox on each side can help elevate the corners of your mouth and give you a more cheerful appearance. In older individuals, combining this treatment with a filler to correct the loss of volume will give a synergistic benefit.
As a work of caution, you should see an experienced injector, preferably a Board-Certified Dermatologist or Aesthetic Surgeon, as incorrect placement of Botox in this area may result in a crooked smile - a mistake that can take up to 3 months to correct.
I hope this helps.