Botox To Stop The Sad Face

emmett-kellyMany people notice the development of a pulling-down of the corners of their mouth that usually begins in their late 30’s.  This unwelcome gravitational pull results in an inadvertent appearance of anger or sadness.

There are several reasons for this sad-appearing look, including the loss of collagen in the lower face over time combined with a muscle active in that area.  This muscle responsible for the downward pull on the corners of the mouth is called the depressor anguli oris, or DAO for short.

The DAO muscle is certainly important for many facial expressions, especially for sadness.  However, when this muscle is strong and you are losing the collagen that forms the foundation of that area, an expression of perpetual sadness develops which most of us do not like to have, especially if we are not actually sad.

daoDuring my initial consultation for this problem, I evaluate a patient’s lips, chin and mouth, both at rest and in motion.  I ask the person being consulted to grit their teeth and to make a pout while I watch for the movement of the DAO muscle.

I also palpate or feel the muscle when it is in tension to assess how strong this muscle is and how much it contributes to the depression of the mouth corners.  After the consultation and inspection of the problem and its muscular cause, I inject small amounts of Botox into the thick portion of the DAO muscle.

Our goal here is not to completely relax this muscle as we do with the glabellar muscle between the eyes.  I simply want to weaken this muscle slightly so it does not pull down as strongly on the mouth corners, but still allows you speak and move your lips normally.

Occasionally, the loss of collagen in this area is too great, and the use of Botox to the DAO muscle is not enough.  In these cases, the use of a dermal filler such as Juvederm is most appropriate to plump up the line forming from the mouth corner to further down the chin.  Frequently, I combine both the use of Botox and Juvederm to this area to prolong the benefit of the filler.

botox_frown_b&aAs I have discussed in the last several blog posts, judicious use of Botox in the lower face and in small doses can achieve many aesthetic goals.  If you have any questions concerning the use of Botox for any of your cosmetic or aesthetic concerns, call us at (207) 873-2158 for a free consultation.

Also, if you are either new to Botox, are not new to Botox but wish to have it injected into a new area, or you want to add Botox to your next Juvederm treatment, we at Maine Laser Skin Care still have $50 off coupons available until the end of March 2016, or until they run out.  Call us soon to reserve your Botox coupon as they do go fast!

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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