Smile Makeover: How Botox Can Lift Downturned Mouth Corners

A smile is a powerful tool for expressing happiness, confidence and warmth. However, a downturned mouth can sometimes create an unintentionally sad or grumpy expression. If you feel like you’ve got a permanent frown etched on your face, there’s good news: Botox, the world’s most celebrated anti-wrinkle treatment, is a minimally invasive, temporary solution for this common concern.

Here, we’re exploring how Botox can be used in a smile makeover to lift downturned mouth corners. We’ll delve into the science behind Botox, its effectiveness in this specific application and the injection process itself–plus, discuss alternative treatment options, too.

Understanding Downturned Mouth Corners

Downturned mouth corners and marionette lines–vertical lines running from the corners of the mouth to the chin–occur for several reasons:

  • Genetics: Some people are naturally predisposed to downturned mouth corners due to the specific positioning of their facial muscles.
  • Aging: As we age, our skin loses collagen and elastin, key proteins for elasticity and volume. This can result in sagging skin pulling the corners of the mouth downwards.
  • Facial Expressions: Repeated facial expressions, such as frowning or pouting, can over time lead to the development of deeper wrinkles and a downturned appearance at the corners of the mouth.

How Botox Lifts Downturned Mouth Corners

Botox, a brand name for botulinum toxin, is a purified neurotoxin used in both medical and cosmetic settings to relax targeted muscles. By temporarily blocking the nerve signals that tell them to contract, Botox allows the muscles to relax and soften the appearance of wrinkles.

Botox and other neurotoxin brands like Dysport and Xeomin are most famous for their ability to smooth forehead lines, frown lines and crow’s feet on the upper face–but they have many uses on the lower face, too.

Botox for DAO

In the case of drooping mouth corners, a specific muscle called the depressor anguli oris muscle (DAO) is the culprit. This muscle, as its name suggests (depressor = to lower, anguli = corners, oris = mouth), is responsible for pulling the corners of your mouth downwards. 

By injecting tiny amounts of Botox precisely into the DAO muscles on either side of the mouth, we can achieve a targeted relaxation effect. With the DAO muscle relaxed, the constant downward pull on the corners of your mouth is lessened, resulting in a subtle yet noticeable lift and a more upturned appearance.

This targeted approach allows us to address downturned mouth corners without your ability to make facial expressions. You’ll still be able to smile and frown naturally, but with a more youthful and approachable overall expression.

Getting Botox for Downturned Mouth Treatment: What to Expect


To kick off your smile makeover, a consultation with a qualified injector is key. The injector will review your medical history to ensure Botox is a safe and suitable option for you, and you’ll discuss your desired outcome and expectations from the treatment is essential. The injector will assess your facial anatomy, the severity of downturned mouth corners and any other factors that might influence the treatment plan.

The Botox treatment

First, an optional topical numbing cream may be applied to minimize discomfort during injection. (Most patients skip this step.) Then, the Botox is injected in small amounts into predetermined injection sites in the DAO muscles, just below the lower lip. It’s a quick procedure, only taking a few minutes to complete.


There is minimal downtime associated with Botox treatment. You may experience slight redness or swelling at the injection sites, which typically resolves within a few hours.

Check out our aftercare tips for a smooth recovery process:

  • Minimize Touching: For the first few hours after your treatment, avoid touching or rubbing the injection sites. This helps prevent the Botox from migrating to unintended areas.
  • Gentle Cleansing: After a few hours, you can gently cleanse your face with lukewarm water and a mild cleanser. Avoid using harsh products or scrubbing the injection sites.
  • Minimal Makeup: You can apply makeup as usual, but be gentle around the injection sites.
  • Wait to Exercise: While strenuous exercise isn’t recommended immediately after treatment, light activities like walking are perfectly fine.
  • Stay Hydrated: Drinking plenty of water helps your body process the Botox and keeps your skin hydrated, promoting optimal healing.

Side effects and considerations

Botox is considered a safe and well-tolerated treatment. However, like any medical procedure, there are some potential side effects to consider:

  • Temporary Injection Site Reactions: Mild redness, swelling or bruising at the injection sites are common and usually resolve within a few days.
  • Headache: Some patients may experience a mild headache following treatment, which typically subsides on its own or with over-the-counter pain medication.
  • Asymmetry: Although uncommon, temporary asymmetry (unevenness) of the mouth’s appearance can occur if the Botox is not injected with precise accuracy. A skilled injector will minimize this risk or be able to safely correct it at a follow-up appointment if necessary.

Elevating Your Smile: The Magic of Fillers and Botox

Now, imagine combining the volumizing power of dermal fillers with the relaxing touch of Botox to uplift those corners and brighten your smile. This powerful combination lets you achieve more transformative results and rejuvenate the entire mouth area.

Fillers like Juvederm Voluma and Restylane Lyft are your go-to options for bringing back the plumpness and structure around your mouth, fighting fine lines, jowls, marionette lines and even sculpting a firmer jawline. You’ll want a filler that’s on the firmer side, yet still flexible enough to let you laugh, talk and smile naturally. For even more comprehensive rejuvenation, lip filler injections can plump up your smile and combat volume loss in the lips.

At the same time, a few well-placed Botox injections relax the DAO muscles, letting the fillers do their magic without being pulled down. It’s about getting that balance just right, so your smile looks lifted and lively.

Are you a good candidate?

Good candidates for this combination are those who see a noticeable droop in the mouth corners resulting from both lost volume and active muscles at play and have mild skin sagging. To know if this cosmetic treatment is right for you, schedule a consultation with a plastic surgeon or other dermatology expert.

Surgical Solutions for Downturned Mouth Corners: A Lasting Change

If you’re seeking a more permanent solution to correct downturned mouth corners that convey a sad or aged appearance, surgical treatment options might be what you’re looking for. These procedures aim to provide lasting results, reshaping the way your smile sits on your face and how you present yourself to the world.

Corner lift surgery

Corner lift surgery, often referred to as a “mouth corner lift,” is a specialized procedure designed to directly target and elevate the downturned corners of the mouth. This technique involves the precise removal of a small, triangular section of skin just above each corner of the mouth. By doing so, the surgeon can subtly lift the mouth, transforming a downward-facing smile into a more neutral or slightly upturned one. The procedure is relatively quick and can be done under local anesthesia, with recovery times varying from person to person.

Facelift surgery

While not specifically aimed at the mouth corners, facelifts can also have a beneficial effect on the lower portion of the face, including the mouth area. By tightening the skin and underlying tissues, a facelift can indirectly elevate the corners of the mouth, especially if sagging skin is contributing to the downturned appearance. It’s a more comprehensive approach that addresses overall facial aging and can be combined with other procedures for a more harmonious result.

Good candidates for surgical intervention

Surgical solutions are best suited for individuals who:

  • Are looking for a permanent or long-lasting solution to downturned mouth corners
  • Have pronounced sagging or drooping that might not be adequately addressed with non-surgical treatments
  • Are in good overall health and have realistic expectations

Choosing a surgical route is a significant decision that requires careful consideration and consultation with a qualified plastic surgeon. They can provide personalized advice based on your facial structure, skin condition, and aesthetic goals. For those who decide to proceed, surgical interventions can offer a profound and enduring enhancement, contributing to a more youthful and joyful facial expression that reflects how you truly feel inside.


If you’re looking to enhance your smile and boost your confidence, consider consulting with a qualified injector at a medical spa. We can discuss your goals and explore if Botox treatment, alone or in combination with other options, can help you achieve a brighter, more positive expression.

Disclaimer: This post is intended for educational purposes only and should not be considered medical advice.

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