Can Botox help with the sagging skin on the corners of my lips? (Photos)

Question

I’m wondering what these sagging folds of skin are under my bottom lip and how to treat them. I’m very self conscious of them as well as my nasolabial folds. Can Botox help with the sagging skin?

Jason Emer, MD · Answer

Morpheus8 provides both skin tightening and skin resurfacing improvements. The technology uses radiofrequency deep subdermal heating to effectively tighten skin and remodel the superficial texture, such as scarring and enlarged pores. Combining Morpheus8 with lasers can give both complexion and laxity improvements in one treatment, so it's an ideal add-on treatment for those who care about preventative sagging or scarring improvements. You can also add this on to liposuction or internal heating to get more improvement in the areas treated.  I suggest getting a formal evaluation with a cosmetic dermatologist to develop a treatment plan that works for you. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Thank you for your question. Botox does not treat sagging skin, but it can help reduce lines and wrinkles around the lips, including nasolabial folds, and with the downward pull at the corners of your mouth. Dermal fillers can also be used to treat nasolabial folds and marionette lines. Dermal fillers and Botox can be used together to provide custom and natural results. An injection specialist can work with you to create a personalized treatment plan that achieves your cosmetic needs.

Alan Gonzalez, MD, FACS · Answer

Hello @anniestarr80, thank you for your question. Botox should not be applied in areas of movement because it can affect facial harmony. I suggest developing a non-surgical protocol with injectables and technology based on your expectations . For more information and recommendations, consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Jennifer Thomas-Goering, DO, MBA · Answer

Hi, thank you for sharing your photos. Toxin can definitely help your your marionette lines. This is a common area that women begin to notice as they age. The area around our oral commissures begins to lose its support and we also develop laxity in our facial ligaments causing this deformity. Injecting toxin into the depressor anguli oris muscle, (DAO) with help relax that tension and gently lift that area up to soften that depression. To get complete facial correction, I would also address your mid face (cheeks) to lift up, I can see from the limited views that your anterior cheek projection has flattened. This usually corrects the nasolabial folds without needing filler there.Good luck and thank you for your question.

Nelson Lee Novick, MD · Answer

The kinds of issues seen here are practically everyday problems treated in any active cosmetic dermatology practice. A robust HA filler placed appropriately in the cheek region will not only help to create a more ideal, feminine heart-shaped oval face, but will likely also improve the smile line issue. Another appropriate HA filler can easily address the droopy marionette lines at the corners of the mouth. Both treatments can be performed, if so desired in the same treatment session, and in experienced hands should take no more than about twenty minutes. The results are immediate and typically elicit an immediate "Wow!" reaction. Botox best reserved for facial muscle related wrinkles, like crow's feet, horizontal worry lines and frown ("eleven")  lines between the eyes. Can't see any reason at this point to jump to aggressive, invasive and expensive surgeries that involve significant post-treatment downtime. Make sure to consult with a board certified cosmetic dermatologist and best of luck.

Harold J. Kaplan, MD · Answer

Hello Annie.  In your photos, it appears your concern is the fold or shadowed area below the corners of the mouth.  These indentations are called oral commissures and they are fixed using dermal fillers like Restylane Lyft, Radiesse, Juvederm, etc.  Botox relaxes muscles rather than adds volume, so your best bet is one of those fillers.  Best of luck.

Luis A. Perez, DO · Answer

You will benefit from a combination of different treatments. Botox, fillers and Microneedeling ( for new collagen formation/regeneration) will yield the best results. Hope this helps. 
Dr. P

Begin Anew Med Spa · Answer

Hi! Thank you for providing pictures so we are able to better assess. As always when I answer these questions, I find it best to go for an in-person consultation to thoroughly assess & ensure you are a candidate for treatment. However, from the pictures you provided, I think you would benefit greatly from a combination of neurotoxin & filler. Neurotoxin can help lift the corners of the mouth to prevent a sagging appearance. Filler can be placed in the area to fill the deficit, as well as added to the nasolabial folds and/ or cheeks to help provide a subtle lift to the area.

Camille Cash, MD · Answer

The best treatment for the corners of the mouth as well as the nasolabial folds is fillers.  They add volume and support  to improve the appearance of the area.  See an expert injector near you for an evaluation and recommendation.

William C. Harris, MD · Answer

Hi,
Botox can help with a lot of areas of the face and can help reduce the downward pull at the corners of the mouth if injected into the right depressor muscles. This will help with down turned corners, but there is more to this issue. Botox is not good for treating nasolabial grooves or commissure-mandibular grooves (little grooves from corner of mouth towards jawline). Dermal fillers are best for the grooves and will offer a more lasting and noticeable changes to these areas.