You are quite correct that DAO Botox would not be appropriate for what sounds like parallel laugh lines or what you are calling lower facial "accordion" lines, which typically are located parallel to the mouth in the lower face and become more pronounced with smiling. And there is also little surprise that microneedling did not work, since its primary value is for treating superficial, surface color and textural and is of little value for deeper lines or for lines that arise from the dynamic motion of the underlying muscles of facial expression. (As an aside, and for the benefit of other readers of this response, there is especially little benefit from RF microneedling, since the RF, due to the heating of the skin, primarily adds to the expense and to the risks for adverse reactions). The use of an appropriately low viscosity, cohesive, malleable filler fanned properly and in the correct direction beneath the accordion lines can work quite well for this condition. I have been using this approach with satisfying results for quite a few years already. You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.
