How can the shadowing at the corners of my mouth be best addressed? (photos)

I have (amongst other issues of which I am, sadly, very aware) puffy little pockets at the corners of my mouth that are driving me crazy. What can be done to address this (short of a mid-face lift)? Would a filler like Radiesse to the apples of my cheeks, coupled with Perlane around my mouth work to slightly lift and disguise them? They are really depressing me, and cause my entire face to look tired and older. Someone please shine a ray of light on this situation….I find it very upsetting.

Doctor Answers 5

Puckers at the Corner of The Mouth

The reason you are noticing this puckering is due to a variety of changes that occur with aging.  First is loss of volume, which is typically from loss of fat and downward decent of fat in the mid and lower face areas.  This can be address by adding volume, in the right amount and in the right vectors to get you lift.  Specifically to lift the corners of your mouth.  The second thing you are seeing is recession of your chin and jaw, and this is typically a bony change that occurs over time or something you have always had but never has been so apparent.  I have great success using fillers along the jawline and chin on the bone area to lift the underlying tissues and give more prominence.  This interns makes the lip corners and mouth appear more lifted and happy rather than droopy.  However, a proper assessment is needed as some people benefit more from a chin implant or jaw surgery.  I am not saying you are a candidate for this, filler may be all that is needed, but a proper formal evaluation with a cosmetic dermatologist or plastic surgeon experienced in facial contouring and volumization is what is needed.  I treat many patients like this daily and have excellent success using fillers alone.  I wish you the best of luck, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Juvederm or Restylane

The problem area you mention (corners of mouth and below) is an extremely common problem area.  As we age, the face begins to fall vertically leaving us with "marionette lines" and deep nasolabial folds.  A hyaluronic acid filler like Juvederm or Restylane is an excellent choice to smooth out the contours around your mouth.  Typically I also recommend having some filler placed in the cheeks as well as this can help rebuild that youthful cheekbone - giving you back the youthful facial shape we all desire.
Find an injector who is experienced with all of these areas and best of luck!

Erica Linnell, MD
Bellevue Dermatologist
4.5 out of 5 stars 10 reviews

Shadowing at corners of mouth

In my practice every cosmetic patient is addressed separately as there are no "cookbook" approaches even after almost 20 years of filler experience.We use many different fillers in the same patient to achieve a optimal correction in the corners of the mouth. I would recommend you discuss with a dermatologist board certified and experienced in fillers in your area.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Fillers for corner of the mouth

This combination for this situation has worked well for me: a little filler in the C-shaped area in front of the little pouch and a little Botox in the pouch itself which shrinks a little muscle inside. Fillers in the apples of your cheeks will definitely enhance the cheeks but will do nothing for the pouches.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 38 reviews

Dermal Fillers for Corners of Mouth

Hi Kflow.  Yes, dermal fillers are a good option for you.  In the area around the sides of the mouth and below the mouth where you see shadows, Restylane or Perlane would both be good options to add a little more volume making the area convex (sloping outward) rather than concave and this would hopefully give you the effect you are looking for.  

Take a look at the pictures below for an example.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 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.