What Can Be Done About Sagging Around Mouth Corners?

Question

I have a small face with high cheekbones, I don’t have wrinkles but have noticed my face is sagging a little and to me it’s noticeable around the corners of my mouth. What can I do?

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

A downturned smile or permanent frown can be improved with a combination approach, including neuromodulators (such as Botox, Dysport, and Jeuveau), injectable fillers, and radiofrequency skin tightening treatments such as Thermage or Venus Legacy. I recommend getting a formal evaluation with an experienced cosmetic dermatologist to develop a treatment plan that works for you. Best, Dr. Emer.

Stephen Prendiville, MD · Answer

There is a simple and a more complicated way to address this.
For mild to moderate drooping, and assuming that a patient is not interested in surgery, one can use a filler (Radiesse or Juvederm) to provide volume to the oral commissure (corner of the mouth), combination to a small amount of Botox to the DAO's (muscle that pulls the corner of the mouth down).  This is a temporary solution.
Assuming you are willing to have surgery and you have further indications (jowls and changes to the neck), a Facelift may address some of your concerns.  However, it is important to note that too much tension on the corners of the mouth is one of the tell tale signs of an overdone Facelift.

David Shafer, MD, FACS · Answer

Without pictures, it is impossible to give you specific advice. If your cheekbones are nice and you are mostly concerned about the area around your lower face and mouth, then a lower facelift may be the answer. Good luck.

Peter A. Aldea, MD · Answer

It all depends on the extent of the lateral oral commissure sag and the cause of it.
If accompanied by jowls, the solution to both would be either a Mid Facelift or a MACS Facelift which would lift the cheek unit causing this drooping.
On the other hand, a little corner lift of the corner of the mouth can be done as well but it will leave a scar along the junction of the lip and lower cheek.
Another way, depending on your presentation is to weaken the muscle which actively pulls the corner of the mouth down (Depressor Anguli oris) with Botox and if needed put some filler in the crease to fill it up. This works extremely well in most people but I would recommend you have it done by a doctor with a good knowledge of facial anatomy - NOT by an "injector"
Good Luck.
Peter A Aldea, MD

George J. Beraka, MD (retired) · Answer

Hi!  There are two non invasive treatments to lift the corners of the mouth, and there is also an operation.
1)  Botox can be injected below the corners (tiny amounts!), to relax the muscle that pulls the corners down.
2)  Fillers such as Restylane can be injected under the corners to create "buttresses" which support and lift the corners.
3)  More definitively, a mid facelift done through the mouth will lift the corners of your mouth for a long time.

What Can Be Done About Sagging Around Mouth Corners?

Answers (6)

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