Can you advise what I would need to stop my mouth from getting the "mad pucker" looking lips? (Photo)

I always look like I'm mad. My mouth automatically forms this position. What can I do?

Doctor Answers 7

Lip Augmentation

Thank you for your question. I suggest that you move forward with a consultation with a board certified facial plastic surgeon. Oftentimes, patients consider one procedure but learn that another procedure may be more beneficial. For example, a laser-assisted weekend necklift combined with Voluma - an FDA-approved injectable in the cheeks and midface - can work in combination to address laugh lines, crow's feet, smile lines, depressed scars, neck sagging and more. The result is a gently lifting of the face and the removal of neck fat for a more youthful appearance. 

Best wishes,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 93 reviews

Can You Advise What I Would Need To Stop My Mouth From Getting The "Mad Pucker" Looking Lips?

Thank you for your question and for sharing your photographs.  Based on your photos, I would suggest a combination of Botox and a filler such as Juvederm to treat your vertical lip lines.  I would also suggest Juvederm to correct the downturned corners of your mouth.  Beautiful and natural results can be achieved.  Please be sure to see an expert injector for an in-person consultation to fully discuss your goals and expectations in order to determine the best treatment plan.  Hope this helps and best wishes!  

What I would need to stop my mouth from getting the "mad pucker" looking lips?

 Hi,If you are referring to the photos show vertical lines around the lips with puckering of the lips.  These are best treated with an injection of Botox that is properly diluted.  If however, you are referring to the curved folds from the lower lip to the jaw line these are "jowls" and are an indication foursome type of a SMAS facelift as described below.

 I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties.  From the photos your cheeks are flat anteriorly (in the front),there is excess fat in front of and below the cheeks, as well as formation of jowls.  These factors combine to create a rectangular shaped face. 

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 "Jowls” are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Lips and "mad" look

I suggest fillers, Botox, and microneedling the lip line to improve the results.  Please consult an expert.  Best, Dr. Green

Improving the "mad mouth" look

There are several thing which can be improved with filler. The upper lip lines and downturn of the corners will respond to filler. Adding Botox to the perioral area and DAO muscles will also help. This is fairly routine.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

Mouth Lines/Wrinkles/Pucker--Best is Laser Resurfacing with PRP; Restylane Silk or Belotero Can Be used

Wrinkles in the mouth need laser resurfacing, less downtime is fraxel or viva (radiofrequency). You could also use fillers to improve lip symmetry. I suggest seeing an expert for an evaluation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Can you advise what I would need to stop my mouth from getting the "mad pucker" looking lips?

Thank you for sharing your question and photographs.  You can start with a small amount of Botox placed into the upper lip to help reduce the ridges that form from the puckered lip appearance, hopefully breaking the reflex of your mouth forming this position.  I would not advocate use of Botox into the lower lip as it may cause issues with speech and oral competence.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.