Many patients attribute their aging mouth appearance to their teeth alone. However, changes in the lip tissues and the loss of fat and drooping around the mouth play a huge role as well. The lips and area around the mouth age in predictable and reversible ways. There are several temporary and more permanent fixes for the aging smile. Temporary fixes: 1. Juvederm to the lips, to the marionette areas. This enhances the lost volume and fills in "nooks and crannies" that result from volume loss 2. Botox (careful now!) to the frown muscle. This must be very judiciously placed, and can help reduce the action of a main frown muscle, the DAO (depressor anguli oris). More permanent fixes: 1. LiveFill or fat injection to the lips and marionette areas. LiveFill (the patient's own tissues, unprocessed) may give longer lasting results than fat injection. 2. Division of the DAO (depressor anguli oris) muscle. The frowning muscle can be divided, resulting in a subtle uptick in the corner of the mouth. This is often requested in patients who notice that they are frowning more over time 3. Reduction in jowls and tissues that droop and collect around the mouth with minilift or facelift techniques 4. Lip-lifts- Often the upper lip becomes very long, obscuring the upper teeth and allowing the lower teeth to show, the "old person's smile". In suitable patients, the lip-nose distance can be reduced by a gull wing upper lip lift, literally removing tissues from the natural lower nasal contours and restoring the smaller lip-nose distance of youth 5. Corner Lip lifts- In the right patients, downgoing upper corners of the lip can be elevated by careful removal of corner upper lip tissues. Great care must obviously be taken to preserve the normal borders of the lip that make lip tissue so unique.