Downturned Corners of the Mouth:  How To Fix Them

One of the banes of women’s existence is the downturned corners of the mouth. Whether they are mildly present or severe, almost every woman regardless of age is overly focused on them to their own detriment. I often think that the reason for this is that women look too closely at the mouth when they put on lipstick and then have this weird association where they think minor aging of the lips reminds them of their mother, causing psychological panic that is typically disproportionate to the problem at hand.

I have tried everything for these downturned corners without perfect success. In the past I would perform a corner of the lip lift, a surgical procedure to lift it, but without great success. I have tried facelifting the area but without success. The only thing that I have had success to improve but not to eliminate the fold is with fillers like Restylane injection procedures (temporary) and Bellafill(Artefill) permanent injectable filler.

Downturned Corners of the Mouth
Improvement in the “puppet line” and downturn of the lip but not full correction, which is oftentimes impossible to achieve

What I typically can accomplish is to make the fold change in shape from 45 degrees downward to near horizontal in non-extreme conditions; but I cannot entirely get rid of it.  This limitation is very important for you to understand before I begin trying to fix the problem.  As a complement to that treatment, injection of the depressor anguli oris (DAO) with Botox treatments can sometimes atrophy the muscle enough that the corner can lift somewhat as well but not with the reliability as I have with injectable facial fillers.  Combining both techniques can be more effective.  The goal with the Botox injection of the DAO is to atrophy the muscle, i.e., weaken it, so that over time the corner may lift for a longer period of time if not indefinitely.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. Call 972.312.8188 to schedule a consultation or to ask Dr Lam a question please visit our plastic surgery forum.