Downturned Mouth

They can be levelled rather than lifted, and the distinction matters because it sets what you should expect. Two things are holding a corner down: a muscle pulling it, and missing support beneath it. Relaxing the depressor anguli oris with a small dose of Botox takes the pull off, which lets the muscles that lift the corner win the balance, and the mouth sits more level at rest. Replacing the volume beside the corner with filler rebuilds what used to hold it level. Together those two produce a visible change in a resting face, which is what people are asking about when they say their face looks unhappy. What neither does is reposition the corner the way surgery can, so a deeply downturned mouth softens rather than turning upward. The aim is a face that reads as rested rather than as treated. How much is achievable on your face depends on how much of it is muscle and how much is lost support, and that is the first thing a practitioner separates out at the consultation by watching your face at rest and in movement. Surgery is a different conversation with a different kind of result, and a consultation will say plainly when that is the honest answer to what bothers you.

Not when the dose is small and the placement is precise, and that is why this area is treated conservatively by anyone experienced with it. The depressor anguli oris sits close to the muscles that move the lip and control the smile, so product that spreads beyond the target can affect how the mouth works: a smile that sits unevenly, a lip that feels different, or difficulty with certain sounds. Those come from dose and placement rather than from treating the area at all. A small amount placed at the correct depth and distance from the corner relaxes the downward pull while leaving the smile unchanged, and what you should notice is a mouth that sits more level when your face is doing nothing. The first week can feel slightly unfamiliar while the effect develops, and it settles as it finishes developing. If a previous treatment left your smile feeling off, say so before anything is injected, since it changes the dose rather than ruling out treatment. This is also an area where less is genuinely better, and a practitioner starting low with a review afterwards is working correctly. Eating and drinking are unaffected at the dose this area takes, since the muscles that close the lips are not the target.

Usually both, in a proportion that decides the treatment, and there is a check that gets you close. Look in a mirror with your face completely relaxed, then gently support the skin beside each corner of your mouth with a fingertip and lift a few millimetres. If the corner looks right with that small amount of support, missing volume is doing most of the work and filler is the main answer. If the corner still reads as pulled down even with support, the muscle is contributing more and relaxing it matters. Then watch yourself frown: a depressor that stands out strongly during a grimace is a muscle holding real tension. Most faces need something from each side, because the two causes feed each other, and a plan that treats only one is the usual reason someone comes back disappointed. A practitioner does this assessment by watching your face at rest, in a smile and in a frown, and by looking at what has happened to the cheek above the corner, since a mouth can fall because the midface has emptied rather than because of anything local. Do the check in daylight with your face at rest for a few seconds first, because a face that has just been talking is rarely as relaxed as it feels.

Cost depends on which cause is doing the most and how many areas are involved, so a number quoted before an assessment would be a guess. Botox for the depressor uses a small amount, priced by the units used, and it can be done alongside other areas at the same appointment, which changes the total rather than the cost of this part. Dermal filler is priced by the product used, and treating beside the corner and the line toward the jaw is a different figure from a plan that also rebuilds the midface above it. Sculptra is priced by the series. Where firming is part of the plan, HIFU and RF skin tightening are priced by area and session. Someone whose corner is held down mainly by muscle tension is looking at the cheapest version of this. The complimentary consultation is where the proportion gets worked out and the plan and cost are set out for your own face, including which part to do first. The two treatments also keep different schedules, so first-year cost and maintenance cost are different figures. Treating the muscle alone is the smallest version of this plan, and it is a reasonable way to find out how much of your own pattern is muscular before spending on volume.

Because a resting face is read by other people from a few fixed signals, and the angle of the mouth corners is one of the strongest. When the corners sit below the line of the lips, the face reads as unhappy regardless of mood, and people respond to that reading rather than to how you actually feel. That is what people describe when they ask about this, and it is a reasonable thing to want changed. Two causes produce it: a muscle that pulls the corners down and holds tension at rest, and the loss of the volume that used to hold them level. The deepening line from the corner toward the jaw adds to the impression by casting a shadow. Treating the corner angle changes the resting signal, which is why what changes is how a resting face reads rather than the shape of it. Nothing about this is vanity, and describing the effect it has on how people treat you is useful information at a consultation, because it tells the practitioner what you are actually asking to change rather than which line to fill. Candid photographs show the resting signal better than a mirror does, since a mirror catches a face that is paying attention to itself.