Correction of droopy mouth corners
Posted:10:37 a.m. Friday, Aug. 2, 2013
By Anita Mandal, M.D.
Question: The corners of my mouth have begun to turn downward. People say I look sad even though I am a happy person. I do not want surgery. Are there any effective non-surgical options?
Answer: Droopy mouth corners are often treated without surgery in my practice, whereas sagging jowls more likely require surgery.
While the use of filler injections to lift sagging mouth corners is a common treatment choice, the effectiveness of Botox or Dysport in raising the mouth corners is often overlooked. Whereas fillers such as Radiesse, Restylane and Juvederm can be injected to fill and raise the mouth corners, Botox is injected into the depressor muscles responsible for causing a downward pull on the mouth corners. Botox can weaken the depressor muscle action, such that the remaining elevator muscles take over, resulting in a lifting of the mouth corner.
In mild cases, fillers or Botox alone are effective. In patients with moderate to severe sagging of the mouth corners, a combination treatment with Botox and fillers can give enhanced results.
The choice of filler used depends on the degree of mouth corner sagging. A slight downturning of the mouth corners can be treated with Botox or Restylane alone. When a droopy mouth corner is accompanied by a groove that extends inferiorly from the mouth corner, giving the appearance of “puppet lines,” a deeper filler such as Radiesse can be more effective when used in combination with superficial fillers such as Restylane to fill in both the deep and superficial mouth corner lines.
A cookie-cutter approach to correction of a droopy mouth corner can give unsatisfactory results. Because everyone ages differently, your facial plastic surgeon should offer the full array of injectable options based on the degree of aging in the region of the mouth corner. A thorough consultation is the first step to selecting the proper treatment approach.