Could releasing Depressor Anguli Oris muscle really help downturn mouth?

Question

Hi Doctors, I am in my 30s and do not have obvious frown lines yet. But when I talk and laugh, the corners of my mouth/lips are pulled down by the DAO muscle as if I am sad or upset. Could releasing the DAO muscle help my mouth from pulling down so I could have a happier smile? If I had the DAO release, would I be drooling unconsciously or like having Bell Palsy? Would the surgery consider complicated ? I am looking for permanent solution, so Botox injection to the muscle would be my second choice.

Goretti Ho Taghva, MD, FACS · Answer

Hello rooky, thank you for your question.  There are patients who are candidates for DAO release/ "smile lift", but not every patient needs the DAO muscle release to create an upturn smile.  In some patients, corner lip lift/ volume augmentation may be sufficient.  Without photos, I'm afraid I will not be able to render you more specific recommendations.  The "smile lift" procedure takes approximately 30-45 minutes, performed under sedation/ local anesthetics.  It's been a very popular surgery in South Korea in the past few years, and the surgeons over there are more aggressive with the resection of the DAO and internal suturing.  In my experience, weakening of the DAO by surgical release produce good results without the risk of overcorrection.  It can be done safely when the anatomy is clearly identified before surgical release and that will minimize surrounding nerve/ muscle damage.  I agree that you should try Botox to see if that is the result you desire before undergoing the surgery.  Make sure your plastic surgeon is board certified and has experience in performing such surgeries.  Best wishes.

Robert M. Tornambe, MD · Answer

Not sure where you got that advice, but DO NOT consider that sort of surgery as it would most certainly cause deformity! Filler like fat or Juvederm near the corner of your mouth should easily do the trick Be sure to consult with a board certified plastic surgeon. Good luck!

Steven F. Weiner, MD · Answer

Often we as physicians are pressured to make more long lasting results. Unfortunately, patients don't think about the possible side effects all the time. I would stick to fillers and Botox/Dysport for downturning of the corners of the mouth. Eventually, your DAO's will weaken and your habits will change.

Sean Freeman, MD · Answer

Rooky, any surgoen that would recommend releasing the DAO would be DOA (dead on arrival) when they tried to explain the problem afterwards. Try Botox, fillers or perhaps a midface lift. Good luck!

Could releasing Depressor Anguli Oris muscle really help downturn mouth?

Answers (4)

Answer: Corner of mouth

Answer: Corner of mouth

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Could releasing Depressor Anguli Oris muscle really help downturn mouth?

Answers (4)

Answer: Corner of mouth

Answer: Corner of mouth

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Recommended reading

Everything you need to know about Lip Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.