What treatment options are available to fix a downturned mouth? (Photos)

Question

I had Sculptra injected into my nasolabial and melolabial folds. However, it did not seem to make a difference in the downturn of my mouth. Is there another injectable to fix this? Do I need Dysport or Botox for that area? Is surgery my only option?

Jacob Sedgh, MD · Answer

Strategic placement of neurotoxins such as Botox or Xeomin can have a modest improvement in elevation of the corner of the mouth. If more drastic changes are desired then a surgical treatment such as facelift in the form of full facelift or midface lift will be more effective.

Jonathan Kulbersh, MD · Answer

Judging from your photos, there is a strong downward tug on your mouth muscles that could be alleviated with Botox. This neuromodulator will relax those muscles so they release the tension that is holding your mouth down, which will then allow the corners of your lips to lift. You may also need skin resurfacing plus dermal fillers such as Restylane or Juvederm to fill in the creases. I hope this helps.

Mitchel Goldman, MD · Answer

Your downturned mouth can be corrected with a neuromodulator that will relax the muscles that are dragging it downward. Botox, Dysport or Xeomin could all improve your expression, if administered by an expert. In addition, strategically placed filler, like Restylane or Juvederm can also lift and fill in this depressed area with results that last over a year. Often we use both of these techniques together for an amazing result. Please be sure to consult a board-certified dermatologist who has many years of experience using neuromodulators around the mouth; you want to get a beautiful result without impeding expression or motion.

Harold J. Kaplan, MD · Answer

Hi SDN.  Yes, absolutely there are options for downturned corners of the mouth. Rather than Sculptra, which is injected very deeply into the skin, we would have used a product like Restylane which is injected into the dermal tissue near the surface.  Placing this product under the indentation at the corner of the mouth would have helped to address your concerns.  If that was not enough, we can inject a muscle that pulls the corner of the mouth down with Dysport (Botox).  When we do this, the muscles that pull upward in the same area take over and you see an improvement.  To see an example of a patient that had these two injection procedures, click on the link below.

Ramandeep Sidhu, MD · Answer

There are different options to address that issue and they include: botox, filler and non surgical tightening like ultherapy. Best would be a in person consult to determine the ideal treatment option.

Jason Emer, MD · Answer

This can be improved with fillers with or without botox. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Benjamin Barankin, MD, FRCPC · Answer

Other than a facelift which more people are avoiding due to cost/pain/downtime/risks, a bit of Botox injected into the DAO and/or fillers in the marionette areas and/or cheeks can be quite helpful. Ensure optimal dentition is important as well. Best to speak with a highly trained cosmetic expert such as a dermatologist to ensure optimal results & safety.

Kurt Kuhlman, DO · Answer

Botulinum toxin (Botox, Dysport, Xeomin) 4-5 units into the DAO muscles on each side of your chin will help for a few months. There are multiple dermal fillers that can be injected into this area and will help for about a year.

Shoib Myint, DO, FAOCO · Answer

Hello sdnatvbb,Your best option would be to relax the muscle which turns the corner of your mouth downwards. That muscle is the depressed anguli oris ( DAO). Best way to do this is to use Botox or Dysport or Xeomin. Additional fillers could augment this. Hope this helps.Cheers

Wayne Wertheim, MD · Answer

we have been very successful over the years using hyaluronic based fillers to correct this issue. it should be done by a well experienced  injector. to augment the treatmet you want want to discuss adding botox / dysport to the dao (depressor angularis oris) muscle

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