DAO Botox Pros and Cons - will this help the downturn in my lips? (Photos)

Hi, I’m Lauren, the aesthetic injector at Colorado Plastic Surgery Center. The DAO muscle pulls the corners of the mouth downward. Injecting Botox into this muscle can soften the downward pull and slightly lift the mouth's corners.

Dr. Özge Ergun,
For frown lines, Botox injections into the depressor anguli oris (DAO) muscle can be an effective treatment. If you do not have any facial asymmetry before the procedure, it is unlikely to develop after the injection.
I hope this helps! If you have any other questions, please feel free to ask.

Hello and thank you for your question. Botox to the DAO muscle helps to minimize the downward pull on the corners of the mouth giving a subtle lifting effect. When placed precisely by an experienced provider smile asymmetry would be rare and jowling is typically not associated with DAO treatment. Temporary smile asymmetry can occur if the Botox is inadvertently injected or diffuses into the nearby DLI muscle. Again this would be a very rare occurrence when treated by a skilled injector. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

DAO Botox injections will help with the downturn of the lips but they won’t help with the crease. To correct the crease you may consider Skinvive injections. Asymmetry and jowelling are always possible but should not be an issue if injections are administered correctly.

Hello and thank you for your question! DAO (Depressor Anguli Oris) Botox is often used to address downturned corners of the mouth, which can give the face a sad or frowning appearance at rest. In your case, following a lip lift that left a crease and downturn, DAO Botox could offer a subtle improvement without the use of filler. One of the main advantages is that it's minimally invasive and temporary—typically lasting 3 to 4 months—making it a low-risk way to test whether this type of correction helps your concerns. When injected carefully, it can soften the frown lines and improve facial harmony. However, there are some drawbacks to consider. Over-relaxation of the DAO can lead to smile asymmetry or changes in how the mouth moves, particularly during speech or eating. In some cases, it may even contribute to increased jowling, especially if there's preexisting laxity in the lower face. It’s important to manage expectations as the effect is modest and won’t provide the dramatic results of a facelift. If you choose to proceed, it’s best to start conservatively and work with an experienced injector who understands facial balancing—especially given the changes from your previous lip lift. Combining DAO Botox with treatments in nearby muscles, such as the mentalis or platysma, may also enhance the outcome depending on your facial anatomy.
Best of luck!
Genie Alexander, RN BSN
for Anna Petropoulos, MD FRCS
Center for Classic Beauty
Boston & Danvers, MA

Hello, thank you for your inquiry. The downward turn in the mouth is a result of natural aging from decreased cheek volume, bone resorption and the DAO muscle pulling the corners of the mouth down over time. Optimally, Botox, fillers and laser can be used to treat the area. If fillers are unwanted, DAO Botox can be used to prevent the area from worsening. There is a risk that the DLI muscle, a muscle that is used to smile, can be injected because it is so close to the DAO muscle. However, if this happens, the other DLI muscle can be hit to make the smile appear more even. Increase jowling would potentially come from masseter Botox because if we slim the jaw, skin laxity can still persist. Overall, DAO Botox has significant benefits but you may need more intervention depending on how much correction you are looking to achieve.