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Turning the Frown Upside Down

One aging change that is particularly bothersome to women (and men) is the turned down appearance of the corners of the mouth with aging.  This often creates a sad or angry look  and no one likes that.  Although numerous factors contribute to this, the main causes include sagging facial skin and jowl formation pushing down the mouth corners, sun damaged, wrinkled skin and atrophy of fat, and lip structures.

In severe cases, facelift and laser resurfacing can make a big difference, but virtually all patients can benefit from minimally invasive procedures to improve the aesthetics around the mouth, especially turned down corners.  The depressor anguli oris muscles are depressors of the lip and pull down the mouth corners.  By injecting Botox, Dysport or Xeomin in these muscles they can be relaxed and not pull down as hard.  This also allows the muscles that lift the corner of the mouth (leavator anguli oris) to elevate the mouth corners (oral commissures) more easily.  The effects of these injections are subtle and not as dramatic as injections in the upper face.  None the less, many patients treat this area as they do notice a definite difference.

The video below shows Botox Cosmetic injection into the DAO muscles.

In addition, treatment of the platysma muscle can also improve the corners of the mouth as the action of this muscle also turns down the mouth corners.

The video below show Dr. Niamtu injecting the platysma region with Botox.

The other treatment is to fill the lip corners and the corners of the mouth with injectable filler to inflate the saggy and atrophic tissues.  This also includes injecting (filling) the lines that go from the corner of the mouth to the jaw on each side (marionette lines).  When the filler is injected, the surgeon and patient can immediately witness the effect of upturning the corners of the mouth.

The image below shows the patient’s left side injected and turned up, while the untreated side (patients right) still shows the turned down frown effect.








To find out more about improving a frowning appearance through non-surgical injection treatments by Dr. Joe Niamtu, III in Richmond, Virginia visit

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

Office Address

Joe Niamtu III, DMD
11319 Polo Place
Midlothian, VA 23113

Office Hours

Monday - Friday
8:00am - 5:00pm

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