Correcting a downturned smile with surgery? (Photo)

Question

I'm very unhappy about the way my smile looks. I'm no doctor but I think it has to do with some muscle pulling my mouth downwards and I wonder if it can be corrected with surgery. With a lot of effort I can smile "normally" but my face looks all worked out if I do that. When I smile in a spontaneous fashion my mouth is pulled downwards. Perhaps related to this, the muscles in my lower jaw seem to have developed quite bit, producing an effect which I dislike. (I'm a transgender person, btw.)

Daniel Thomas, MD · Answer

The range of responses you are receiving relates to the complexity of your question. Important to the answer is if you have had any previous surgical procedures or injectables (Botox or some form of filler). Allowing any injectable to dissipate prior to pursuing any option is absolutely necessary. If you have had previous facial surgery, you may have nerve or soft tissue issues that also may need time to resolve. If these factors aren't playing a role, an in-person consultation is really important because you are describing a very dynamic process that is difficult to capture with still photos. With that said, I would offer that my overall impression is to not immediately consider a surgical solution. The third photo you provide appears to be a very natural smile, and perhaps some some form of creative repetitive muscle training/exercise would be beneficial. While this would not be considered a textbook approach, there is no downside, and it taps into our natural muscle training potential. I hope this doesn't throw too much into the mix for you, but I thought an alternate approach may be worth considering. Best regards.

Ira Shapira, DDS · Answer

You are a candidate for Epigenetic Orthopedics/ orthodontics to grow your maxilla or a neuromuscular reconstruction.
What you are seeing is insufficient support of facial tissues.  Deep naso-labial grooves are usually relate to narrow maxilla.  
The is insufficient information from your photos to say more.  Do you snore, wake with headaches or have excessive tiredness?
You could roll up some gauze into rolls and place between your back teeth and slide your jaw forward.  You need lips to touch in relaxed manner and you can profile what can be done.  Ideally you wear trial appiances initially to see how muscles and body adjst over time.

Joshua A. Halpern, MD, PA · Answer

It appears from your picture that you have an over active DAOI muscle which is pulling down the corners of your mouth. You would be a  good candidate for botox. This takes only a few minutes to perform. This is not permanent. I hope you find this information useful.

Patric Cohen, DDS, FAGD · Answer

I would look into possibly botox and facial fillers before doing any kind of  surgery. A good cosmetic dermatoldogist or plastic surgeon may be able to give you what you are looking for without doing surgery. Good Luck.

Kourosh Maddahi, DDS · Answer

Hi:It is difficult to clearly see exactly what is the actual reasoning for the muscle pull, however, I believe it has more to do with narrow upper and lower arch.  Making the both arches wider with porcelain veneeers could be one solution. However, clinical exam,  and study models are necessary to evaluate properly.Best,Dr. Maddahi

Correcting a downturned smile with surgery? (Photo)

Answers (6)

Answer: Downturn smile

Answer: Downturn smile

Answer: Smile option

Answer: Smile option

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Correcting a downturned smile with surgery? (Photo)

Answers (6)

Answer: Downturn smile

Answer: Downturn smile

Answer: Smile option

Answer: Smile option

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Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.