Do I need Botox? Or is there any other way to get rid of this around my mouth? (Photos)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. What you’re describing—puffiness or slight sagging at the corners of the mouth—is often related to early marionette lines, minor muscle imbalance, or mild volume changes in the lower face, even at your age. At 25, it’s unlikely to be true age-related sagging; instead, it may be caused by the orbicularis oris and depressor anguli oris muscles pulling the corners down, which can create shadowing or a “pulled” appearance. Botox can help subtly by relaxing the depressor anguli oris (DAO) muscles, allowing the mouth corners to lift slightly and reduce tension, but it must be done very conservatively to avoid a frozen or unnatural look. In addition, small amounts of hyaluronic acid filler along the marionette lines or just lateral to the corners can smooth the area and reduce the appearance of puffiness or shadow without overfilling. I hope this helps and best of luck!

In my experience, this is not that uncommon. I have had success using a malleable, cohesive, low viscosity HA filler to soften the shadowing and smooth and elevate the depression that the puffiness creates to the rear of it. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector expert. Hope this helps and best of luck

What you’re describing is something many people start to notice in their mid-20s — a subtle fullness or puffiness at the corners of the mouth that can make the lower face look a bit heavier or tired, especially in certain lighting or angles. This area, sometimes called the marionette zone, can be influenced by natural facial structure, mild volume loss, or even how expressive your smile muscles are.

At your age, Botox is not always the first solution. Often, gentle approaches that restore balance—like small, precise amounts of filler to support the corners of the mouth or improve contour—can help. Sometimes even small lifestyle adjustments, like staying hydrated and maintaining a consistent skincare routine with ingredients that boost collagen (like retinol or peptides), can make a visible difference over time.

If muscle activity is contributing to the puffiness or downturn, a touch of Botox can help relax the area subtly, giving a smoother, more lifted appearance. But the goal is always to keep your expression natural while addressing what bothers you most. What you’re seeing is very common—and with a few tailored adjustments, that balance and freshness you’re looking for can absolutely be achieved.