Best Procedure for Me? (photo)

I am looking for the best procedure to raise the corners of my mouth and get rid of the folds. I have already had Botox in DAO (4 units each side). There was improvement, but not enough. Thank you.

Doctor Answers 7

The best treatment for the corners of your mouth is a dermal filler

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The DAO treatment with Botox was a fine idea.  However your primary problem is loss of volume around your mouth.  I would suggest treatment with Juvederm or Restylane.  If performed by an experienced cosmetic physician, either should give you a very natural result and a nice improvement.


Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 26 reviews

Botox and filler

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it looks to me as though the Botox is working very well.  The corners of your mouth are not turning down.  What you need now is volume replacement in the creases below the corners of the mouth and along the jaw beside the chin to stop the "jowlly" appearance.  The hyaluronic acids such as Restylane, Juvederm and Perlane all work well here as does Radiesse which I think would even be better.

Peter J. Jenkin, MD, FAAD
Seattle Dermatologic Surgeon
5.0 out of 5 stars 4 reviews


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Perlane is a hyaluronic acid filler with larger gel particles. It is used for moderate to severe wrinkles and injected deeper into the skin than Restylane. Perlane is a great filler for a midface lift and age -related facial depressions, such as marionette lines or nasolabial folds.
Perlane is widely used by practitioners for facial reshaping and facial volume restoration as well. Correction of the cheek area and chin reshaping with Perlane results in dramatic improvement in the facial appearance.

Tatiana Khrom, MD
New York Dermatologic Surgeon

Ultherapy and Radiesse for the lower face - Los Angeles

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I would recommend a combination of Radiesse stimulatory filler and Ulthera treatment to raise the corners of the mouth and the lower face. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

A robust filler for the corners of the mouth

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I agree that you need more than just botox oftentimes to address the marionette lines, and corners of the mouth.  Adding volume with a robust filler such as Perlane or Radiesse should give the area support to help maintain the strengthen the upturned looks. 

Ritu Saini, MD - Account Suspended
New York Dermatologic Surgeon

Perlane and corners of the mouth

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You would benefit from any dermal filler in this area - assessment with a well-trained and experienced provider will help you determine which one and the amount you'd need to improve the area.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Treatment for Marionette Lines, Mouth Frown

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Hi sfodor.  Thanks for the pictures, this helps a lot.  Botox (or Dysport) are a great option for creating a lift at the corners of the mouth.  Glad to hear this helped.  The next step is to replace lost volume. 

We are not sure if your injector suggested this, but 1 cc of Restylane or Juvederm would go a long way to correcting the crease below the corners of the mouth.  We would normally estimate the product to last about 6 months.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.