Botox to DAO muscle and platysma - do these muscles that depress the lower face become more active as people age?

Thank you for your question, a downturned smile or permanent frown can be improved with a combination approach, including neuromodulators (such as Botox, Dysport, and Jeuveau), injectable fillers, and radiofrequency skin tightening treatments such as Thermage or Venus Legacy. I recommend getting a formal evaluation with an experienced cosmetic dermatologist to develop a treatment plan that works for you. Best, Dr. Emer.

Many times, the corners of the mouth are not actually turning down but what happens is that the weight of nearby drooping skin of the face pulls the corners downwards. Losing facial volume as we age further exacerbates this problem. Botox helps to relax the DAO muscle which normally holds the angle of the mouth in place. By relaxing the muscle, the corners can lift slightly to compensate for the downwards slant that comes with aging. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon

There are a several different factors that contribute to the downturn of the corners of the mouth and loss of jawline definition that occur with aging. One of these factors is the downward pull of the platysma and DAO muscles on the corners of the mouth and jawline. Volume loss is another factor. That is why a combination neurotoxin (Botox or Dysport) and fillers can improve these characteristic signs of aging. 

 There are many reasons that the corner of the mouth turns down and jowls form. Gravity and loss of tissue integrity are the major reasons. The platysma and depressor anguli oris (DAO) occasionally can contribute also. The DAO can also cause increased marionette depressions. Treatment of either of these muscles is done on an individual basis after specific evaluation. When done expertly, excellent results.