Downturned mouth corners at a glance
- What they are: mouth corners that turn downward and give the face a sad, displeased or tired expression even when the person is relaxed
- Causes: loss of collagen and elastin, weakening of the lower-face support structure, and overactivity of the depressor anguli oris (DAO) muscle, which pulls the corners down
- Treatments: botox in the DAO relaxes the muscle that pulls the corners down; hyaluronic fillers restore support in the mouth-corner and chin region
- Protocol: a short outpatient procedure with no downtime; the botox effect is visible after about two weeks
- Duration: botox 3-4 months, fillers 9-12 months; the best result is often their combination
Why do mouth corners turn down?
Downturned mouth corners are a natural sign of ageing. As the skin loses collagen and elastin, the support structure of the lower face weakens and the corners turn downward. Genetic factors, smoking and sun exposure accelerate the process. The second cause is the depressor anguli oris (DAO) muscle: its frequent or strong contraction pulls the corners down and over time creates a permanently downturned expression.
The result is often a misread message – the face looks sad, displeased or angry although the person feels none of that.
How do we treat downturned corners?
Treatment depends on what predominates. When an overactive DAO muscle is the main cause, botox relaxes it and the corners stop being pulled down – the expression becomes more neutral and rested. When loss of skin support and volume predominates, hyaluronic fillers restore support in the mouth-corner, marionette-line and chin region. In most patients both mechanisms are present, so the treatments are combined.
Botox, fillers or a combination
Botox acts on movement, fillers on support. Younger patients with a strong DAO muscle often respond very well to botox alone. In more mature skin with lower-face laxity, filler support is also needed. The exact combination is defined at the examination, with analysis of the face at rest and in motion.
Frequently asked questions
Does botox in the mouth corners affect the smile?
A properly measured dose in the DAO muscle does not change the smile – only the muscle that pulls the corners down is relaxed. Precise application is therefore essential.
When is the result visible?
The botox effect develops over two weeks; the filler result is visible immediately and final once the swelling subsides.
Can downturned corners be fixed in one treatment?
It depends on the cause. Mild cases are resolved with a single botox treatment; more pronounced changes require a combination and repetition.
Read more
- Botox: relaxing muscles and softening expression lines
- Hyaluronic fillers: restoring volume and support
- Chin correction with hyaluronic fillers
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