Hi: I got Botox couple of time on corner of my mouth to lift up a little , but each time I lost my normal smile.

Question

I am 54, and like to have Botox on the corner of my mouth for a fresher look, but each time I did it , I lost the normal motion of my smile. I am in Northern California , can you recommend a doctor that can do a good job on this area?

Jerome Edelstein, MD · Answer

You may want to consider having a
filler treatment done to lift the corners of your mouth, instead of Botox, as
it will not affect your ability to smile.

Martin Jugenburg, MD · Answer

Consider obtaining your treatment record and compare it with a the recommendation of an expert injector. The issue you had could have been technique or dosage. Speak with an expert injector to discuss your concerns. Best,

J. Jason Wendel, MD, FACS · Answer

Thank you for your
question.Botox can be injected off label in very small doses, very carefully and skillfully around the mouth to relax vertical lipstick lines.Yes, too much will affect your smile.

To be sure, see two
or more board-certified providers in your area for a complete evaluation to
make sure you are a good candidate and that it is safe for you to have these
treatments.

I hope this helps.

Andrew P. Trussler, MD · Answer

Botox can be injected in small amounts around the mouth. It is reliably effective for vertical lip lines and only small amounts are needed to help smooth them. The lift the corner of the mouth, the DAO should be injected at the jawline and not in the corner of the mouth. That is where the muscle belly is. Botox around the mouth can have a negative effect of saying certain words and can affect the smile, so small amounts are needed.

Michele S. Green, MD · Answer

Botox is a fabulous injection for reducing wrinkles around the face.  Only a very small amount of Botox is needed to turn up the corners of the mouth.  From your description you should consider consulting a physician about placing filler in that area to have the desired effect.  For the best results please consult a board certified dermatologist with a great deal of experience with facial cosmetic injections.

Michael H. Gold, MD · Answer

You can surely find a board-certified dermatologist or plastic surgeon in your area of Northern California, and that would be my first stop. Dermatologists have been injecting Botox longer than any other group and plastic surgeons know anatomy as well as anyone, so when treating the mouth area with toxins or fillers, find a dermatologist or plastic surgeon that really is an expert in what you are looking to have done.Botox can be injected into areas around the mouth — with caution as it is off-label — and by skilled injectors but you see what we all know to be true with too much toxin in that area — you lose the smile some. Fillers might be better here, and lasers and other procedures might give you the results you are looking for.  Find the right doctor, and you should be fine.

Jo Herzog, MD · Answer

I don't know any dermatologists  that use Botox in the corners of the mouth. We use it AROUND the mouth to relax wrinkles but for downturning mouth we can put Botox lower in face or we put filler in the corners. Filler in the corners will not effect your smile so you might want to ask your doctor about that. Go to a doctor that does a lot of this as they will be able to guide you with the most knowledge.

Dean P. Kane, MD, FACS · Answer

Dear blackcoral:This is a great question!Much like the center hub and spokes of a bicycle wheel, or the effects on the center of a "dreamcatcher"  when the sun-ray threads are pulled, the mouth and the eye are surrounded by circular and radiating muscles to produce the pursing and pulling patterns of expression that we experience.Any relaxation or weakness along the circle or the radiating muscles will have an effect on the whole. With regards to the mouth,  tiny amounts of Botox or Dysport are used along the circular muscle of the upper and lower lip to relax the radiating skin lipstick lines. A muscle relaxer in the DAO (depressor anguli oris) muscle on either side of the chin will release the downward tension of the hub and allow the frown to reverse by the pull of the zygomaticus muscle group in the cheek. In your case, Botox on the upper corners of the mouth will relax the pull upward allowing gravity and the chin muscles to pull down and lose "motion". It is all a trade-off, so choose your injector wisely. A well experienced, Board Certified Plastic Surgeon or Facial ENT is your best bet for this. I hope this was
helpful! All the best!

Thomas M. DeWire Sr., MD (retired) · Answer

blackcoral,    you are probably seeing a combination of a good feature, coupled with an unavoidable undesirable feature of Botox treatment.  Nerve function of the face, particularly around the mouth and the eyes, where you show so much expression, are closely coordinated, and not all can be isolated. in other words, paralyzing a muscle to eliminate one undesired motion, may remove the necessary input of the same muscle in another motion you do not wish to change.  Sometimes fillers, especially JuveDerm or Restylane can be injected at the outer corners of the upper lip, curling the corners of the mouth upward slightly, while not impacting motion otherwise.  I hope that this helps.    Best wishes,    Tom DeWire, MD, FACS

Robert Savage, MD (retired) · Answer

In my opinion if you wish to turn up the oral commissure well placed fillers are safer and last a lot longer than Botox.There is little room for error when Botox used around the mouth

Hi: I got Botox couple of time on corner of my mouth to lift up a little , but each time I lost my normal smile.

Answers (12)

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