Will injecting Botox into the depressor anguli oris cause atrophy of the modiolus or weaken the orbicularis?

Question

I’m considering getting Botox in my DAO and platysma muscles because I feel my mouth pulling down on the sides and my family members have really droopy mouth corners as they age. I’m worried because I heard anything below the eye is harder to predict with Botox. Will injecting into the DAO cause significant atrophy of the Modiolus or give me weird mouth movements over time if my overall orbicularis is weaken?

Scott C. Sattler, MD, FACS · Answer

I inject the DAO muscles with Botox - it should be done carefully to not distort the smile. Nice results can be achieved with 4-6 units of Botox per side.

Steven H. Williams, MD · Answer

Hi,Thank you for your question.When done properly, botox treatment for the DAO should not affect the orbicularis. The DAO inserts into the modiolus but the bulk of the muscle is lower so that should be the target injection area.Hope this helps!

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  If placed appropriately, Botox should not cause atrophy of the modulus or weaken your orbicularis muscle. This is a more advanced injection technique so definitely seek out an injection specialist in consultation.

Chase Lay, MD · Answer

Injecting botox to the DAO and platysma muscles are safe without causing atrophy to the modiolus. Make sure you are consulting with an experienced injector that knows their facial anatomy. Thank you, Chase Lay, MD

Richard Ort, MD · Answer

When properly performed, injecting the depressor anguli oris (DAO) muscle should not cause problems with the modiolus or affect the orbicularis oris muscle. I inject the DAO all the time using low doses of Botox. It is important to see an experienced injector who has an excellent understanding of the underlying anatomy.Regards,Dr. Ort

Will injecting Botox into the depressor anguli oris cause atrophy of the modiolus or weaken the orbicularis?

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