What options do I have for downturned mouth? (Photo)

Fillers such as versa, or restylane can fill in the grooves which make the mouth look sad and do it for only $650 for 1 syringe and immediately look better.

for significant downward turned mouth and lower face and neck sagging you need a face and neck lift. if you want "improvement" ... morpheus, threads, fillers, thermage can all be performed. start at home dermarolling now to build collagen (see link).

if you want a dramatic change necklift/facelift, Implants and fillers will give you that. noninvasive will improve the area and facetite, threads, morpheus, and fillers can be used.  start at home dermarolling to tighten you skin, see emeragecismetics.com where we do free skincare consults daily and recommend MTS roller with anteageMD ampules daily (see dermarolling package).

With significant neck sagging you would need a neck/face lift with muscle tightening (platysmaplasty). at the same time lasers (fraxel,  co2 or erbium( or microneedling RF (fractora, intensif) can be . performed to improve the crepe skin or wrinkles.  You need a formal consultation, as the neck can be treated with a combination approach:
1. micro needling and lasers for texture
2. botox, disport or xeomin to help platysmal bands
3. intensif or fractora RF microneedling for crepe skin and lifting
4. fillers like belotero, restylane silk, juvederm volbella to improve lines and folds
5. neck/face lifting if sagging is prominent or early starting +/- platysmaplasty (muscle tightening)
6. J plasma/Renuvion, thermiRF, inmode facetite for internal tightening
7. ultherapy and thermage for external tightening
8. regular Venus legacy, exilis ultra, or inmode forma treatments with facials to maintain tightness
9. PDO novathreads or silhouette instalift cone threads for lifting and long-term collagen production
see an expert for a full evaluation and treatment plan based on your individual situation and goals.
Best, Dr. Emer

You will find the best results from a combination of treatments. Botox and fillers can be used to improve the downturned appearance of your mouth that concerns you. See an expert injector near you for treatment.