A downward turn at the corners of the mouth can make a rested person look tired or unhappy. professional botox in Sudbury Patients often point to the corners in the mirror and say, “I feel fine, but I look annoyed.” In many cases, targeted Botox injections can soften that pull and help the lips sit more neutrally, sometimes with a subtle lift. The key word is subtle. This is fine muscle work at the edges of the smile, where a millimeter decides whether you look serene or tight. When done well by a skilled injector, the effect is natural and expressive. When done poorly, it can feel off, especially when speaking, sipping, or smiling.
This is a practical guide to what Botox can and cannot do for downturned corners, how it works in this area, what a typical treatment feels like, who is a good candidate, and how Botox fits into the larger toolbox that includes dermal fillers, energy devices, and habits that influence lower-face aging.
Why corners droop in the first place
Droopy oral commissures, the literal name for the corners of the mouth, rarely have one cause. Several elements converge with age and expression patterns.
There is an active muscle pull from the depressor anguli oris (DAO), a triangular muscle that runs from the jawline up to the corner of the mouth. Overactive DAO fibers tug the corners down every time we frown or clench. Some people recruit the DAO even at rest, out of habit or due to jaw tension. Over months and years, that adds up to a persistent downturn.
There is also passive sagging. Collagen and elastin thin with age, fat pads shift, and the ligament at the corner of the mouth loses support. The skin and soft tissue start to drape, and marionette lines deepen. If volume is depleted in the midface or around the chin, the corners can tilt downward even if the DAO is not overactive.
Then there is structural asymmetry. A stronger left or right DAO, dental bite issues, or a history of acne scarring around the chin can all bias one corner to sit lower. The aging neck can contribute as well. When the platysma bands pull downward and forward, the lower face follows, and the corners can look harsher.
Understanding which of these factors dominate guides whether Botox therapy will help and how much support it needs from other treatments.
How Botox works in the lower face
Botox, a brand name for onabotulinumtoxinA, blocks the nerve signal to muscle at the injection site. We use it to relax targeted fibers, not to paralyze an entire area. In the lower face, that distinction matters. The DAO shares space with muscles that help you speak, smile, sip through a straw, and hold saliva. So dosing is small, and placement is precise.
In practical terms, a provider palpates the DAO while you frown and say “eee.” They find the thickest strip of muscle a centimeter or so above the jawline and lateral to the marionette line. Tiny units of Botox cosmetic are placed into that belly on each side. The goal is to reduce downward tug, allowing the elevator muscles such as the zygomaticus to set the corner at a more neutral or slightly elevated resting position. Because you still need expression, the top fibers of the DAO and neighboring muscles are left alone.
Patients often pair this with a microdose to the mentalis if the chin puckers or develops a pebble-like texture. Relaxing the mentalis can smooth the chin and indirectly reduce downward pull. If platysma bands are strong and pulling the lower face down, small points along the upper platysma can also help, though that is decided case by case.
What kind of lift is realistic
This is not a lip corner “hoist.” Expect a softening of the downturn at rest, not a forced upturned smile. If you are a candidate with mild to moderate DAO overactivity, the resting corner can look a millimeter or two higher and less pinched. Smiles often look less strained, and lipstick sits more evenly. People around you may comment that you look fresher, not “injected.” That is the right target.
When the downturn is driven mostly by volume loss and ligament laxity, Botox alone will underwhelm. The corner can still sit lower, even if the DAO is quiet. In those cases, the lift comes from restoring support with a conservative filler strategy, sometimes along the lateral chin and the marionette shadow, then layering in low-dose Botox to prevent the DAO from dragging the filler’s work back down.
When the downturn is primarily from dental bite, an overactive masseter, or a deep retrusive chin, the plan may include masseter Botox for jaw clenching, a chin filler to balance projection, or referral to dentistry for bite work. The face is one system. Small adjustments in one area can help the corners indirectly.
What a typical Botox procedure feels like
A focused treatment for droopy corners is quick. You spend more time assessing in the mirror than you do under the needle.
The pre-treatment conversation identifies your baseline resting expression, your smile preferences, and your risk tolerance for temporary lip heaviness. A good injector will watch you speak and smile from different angles. They may take “before” photos and mark injection points with a white pencil. If you clench your jaw, they might palpate the masseters. If your chin dimples when you talk, they will assess the mentalis.
The injections themselves use a very fine needle. Many practices do not numb this area because the stings are brief and numbing creams can distort the anatomy. You might feel one or two tiny pinches along each side, sometimes a shallow prick to the chin if that is being treated. Ice or vibration may be used for comfort.
The entire Botox procedure usually takes 10 to 15 minutes. You leave with small red spots that fade within an hour. Makeup can be applied gently after. Most providers advise avoiding vigorous rubbing, saunas, and heavy workouts for the rest of the day. Those precautions are conservative, but they are sensible after any Botox cosmetic injection.
Dosing, timelines, and what to expect
Most mouths need a low total dose. A common range is 2 to 4 units per side for the DAO, sometimes 1 to 3 units for the mentalis if indicated. Some mouths do better on the lower end to protect speech and sipping. Your injector may start conservatively, then adjust at a 2-week check if needed. It is easier to add than to take away.
Botox results begin to show in 3 to 5 days for most patients, with the full effect at around 10 to 14 days. The corner at rest starts to look less dragged down. The chin can feel calmer if it used to pucker. Smiling still feels like you, though you may notice a slight change in how the lower lip moves when you speak fast or drink through a straw. That often normalizes as you adapt.
How long does Botox last in this area? Typically 3 months, sometimes 4, rarely 2. Lower-face muscles move all day, so duration is often a touch shorter than forehead lines or crow’s feet. Plan on maintenance every 3 to 4 months if you like the effect. If the goal is to weaken a strong DAO over time, consistent treatments can reduce the baseline pull, and some patients can stretch intervals after a year.
Common side effects and how to avoid problems
The most frequent side effects are minor and short-lived: injection-site redness, pinpoint bruises, tenderness when chewing for a day, or a sensation that the lower lip is lazier than usual. Bruising risk rises if you take aspirin, high-dose fish oil, or certain supplements that affect platelets. Let your provider know what you take.
The side effects we work hardest to avoid involve function. Too much Botox or poor placement can cause:
- Difficulty with “p,” “b,” and “f” sounds or a sloshy feel when drinking. Saliva pooling or minor drooling at rest. A smile that looks tight or asymmetric because one side was weakened more than the other.
These risks are uncommon with a board-certified injector who uses conservative doses and respects anatomy. If any of these occur, they are temporary. As the effect wears off, movement returns. Mild speech changes from DAO treatment usually improve within a couple of weeks as you adapt and the Botox effect softens slightly, though full reversal tracks with the 2 to 3 month timeline.
Allergic reactions to Botox cosmetic are extraordinarily rare. Headaches can occur after any injection but tend to be more common after treatments such as a brow lift or forehead lines rather than around the mouth. Serious complications are not typical with the tiny doses used for the corners.
Who is a good candidate
Good candidates share a pattern: the corner turns down from muscle pull more than from tissue laxity, and they want a subtle, natural correction without adding volume. Younger patients in their 20s to 40s with a naturally frowny resting face often respond well. People with jaw clenching or a tight chin may also see a noticeable change when the DAO and mentalis are softened.
If you have deep marionette folds, jowling, or significant skin laxity, Botox alone will not do the heavy lifting. It can still help the expression look kinder, but you will likely need dermal filler support along the marionette shadows, lateral chin, or pre-jowl sulcus, and perhaps energy-based tightening to improve the frame. In more advanced cases, surgical options do the job better than injectables.
If symmetry is your main concern, nuanced dosing can balance sides, but perfect symmetry is not realistic and can even look uncanny. If your job requires precise speech or you perform with wind instruments, you and your provider need to choose ultra-conservative dosing and test tolerance.
How Botox pairs with fillers and other treatments
Think of the corner as a tug-of-war between tissue weight and muscle pull. Botox weakens the downward pull. Fillers and collagen stimulators replace support and soften shadows. Energy devices improve the fabric of the skin by tightening and boosting collagen.
Dermal fillers can be placed just lateral and inferior to the corner to prop it subtly. Small amounts, around 0.2 to 0.4 mL per side, often suffice. If the marionette line is sharp, a hyaluronic acid filler with a balance of flexibility and lift can blur the crease. If the chin is retrusive or has a deep labiomental fold, a structured filler along the chin pad can level the stage so the corner sits better. For patients with prominent jowls, careful placement just anterior to the jowl can smooth the transition into the chin. Fillers last 9 to 18 months depending on product and area.
Energy-based devices like radiofrequency needling or microfocused ultrasound can firm the lower face over time. Results are gradual, so they are not a quick fix. For skin with etched-in fine lines around the mouth, a series of fractional lasers or microneedling sessions can improve texture and elasticity, which helps any lift look smoother.
Patients who grind their teeth and carry tension in the masseter may benefit from masseter Botox. Relaxing those muscles can soften a square jaw and reduce jaw clenching. It can also reduce the tendency to recruit the DAO when stressed. That said, masseter Botox is its own treatment with different dosing and goals, and it should be planned thoughtfully to maintain chewing strength.
The appointment flow I recommend
Most people do best with a measured start. Here is a concise flow that works in practice:
- Assessment and photos, including speech and smile from three angles to capture function as well as rest. Conservative dosing of the DAO on both sides, with or without 1 to 2 units to the mentalis if chin dimpling is prominent. Avoid chasing the corner too close to the vermilion border to protect lip function. A two-week review to fine tune. If the corner still pulls down, add a touch more. If it feels heavy, wait and reassess on the next cycle. At a later visit, layer in filler if the marionette shadow or lateral chin lacks support. Never flood the corner, as overfilling can look gummy and distort the smile. Maintenance every 3 to 4 months for Botox. Filler maintenance varies, often annually.
This rhythm lets you adjust gradually and maintain a natural look while you learn how your muscles respond.
Cost, value, and how to think about price
Botox cost is usually calculated per unit or per area. For the DAO, the total unit count is low, often 4 to 8 units total, sometimes up to 12 if the muscles are strong. Prices per unit vary widely by region and provider training, but the bill for the corners alone often lands at the lower end of a typical Botox visit. If you add the chin, the total might rise modestly. When you combine Botox with filler support, the cost increases because of the product volume and time involved. Expect a filler syringe to cost several times what a low-dose Botox treatment does, though a single syringe can often treat both corners and related shadows.
The best value comes from matching the tool to the problem. Spending small amounts on repeated Botox when the real issue is tissue deflation can feel wasteful. Conversely, buying a syringe of filler when the DAO is the culprit can feel heavy and wrong. An experienced injector will sequence your plan to test the hypothesis first, then build from there.
Affordable Botox is a fine goal, but be cautious with deep deals that pressure you to add services or offer unusually low per-unit pricing without clarity on product authenticity or injector qualifications. The corners sit in high-function territory. Precision matters more than a discount.
Safety and provider selection
Seek a certified Botox provider who treats the lower face routinely and can show you Botox before and after photos of mouths that look relaxed, not frozen. Board-certified dermatologists, facial plastic surgeons, plastic surgeons, and experienced nurse injectors who work under medical oversight tend to have the right training. Technique, not the brand alone, makes or breaks the result.
Ask about their dosing philosophy for the DAO, how they handle asymmetry, and what they do if the result feels too heavy. A thoughtful answer signals real experience. If your history includes facial nerve issues, prior surgery around the mouth, or dental bite work, share that upfront. It can influence both plan and risk.
Special scenarios worth discussing
First time Botox patients often want to fix several things at once: forehead lines, frown lines, crow’s feet, and the mouth corners. I usually separate the mouth for a first visit. It helps you distinguish whether any sensations around speech or sipping are from the lower face, not confounded by other treatments. If your schedule demands one visit, you can still treat the whole face, but keep lower-face dosing conservative.
Patients with significant hooded eyes or droopy eyelids sometimes benefit from a brow lift effect with Botox placed strategically in the forehead and glabella. That lift can brighten the face in a way that makes the mouth look less tense, even though the corners were not touched. The reverse is true as well. A softer mouth can make the eyes look friendlier. Facial harmony is the goal, not chasing every line.
Athletes and frequent sauna users often metabolize Botox a bit faster. If your results wear off quickly, your provider may suggest slightly higher units or shorter maintenance intervals. On the flip side, very light users who want barely-there subtle Botox may be happiest with microdoses that take the edge off without noticeable changes in function.
Jaw fillers for a square face build structure, but if your goal is a slimmer lower face, Botox for the masseter can gently contour over time. Reducing masseter bulk can also lessen clenching, which decreases DAO recruitment secondarily. The change is gradual over two to three cycles and best evaluated with photos.
For patients battling under eye wrinkles, fine lines, and texture issues, a smoother eye area can make the mouth look softer by contrast, but it will not change the mechanical pull of the DAO. Treat each area for its own reason, then enjoy the combined effect.
What not to expect from Botox at the corners
Botox is not a substitute for surgical lifting when laxity is advanced. It will not erase deep marionette grooves or fix jowls. It is not a permanent solution to a gummy smile, though Botox can be used in that area separately with careful dosing. It will not tighten skin or shrink pores. Think of Botox as a functional rebalancer. It reduces certain pulls so other structures can rest in a more flattering position.
If your main complaint is skin texture, acne scars, or oily skin, Botox does not treat those directly in the mouth corner context. Some clinics offer Micro Botox or a Botox facial to shrink pore appearance and reduce oil, but those techniques involve superficial microdroplets over broader areas and are not the same as DAO injections. Different tools for different jobs.
Maintenance habits that help the result last
Small daily habits support the medical work. If you clench, consider a night guard and jaw stretches. Keep hydration steady. Work on posture, because a forward neck can tighten the platysma and lower face. Manage chronic sinus congestion if it makes you purse your lips or tense your chin. Be careful with straws in the first week after treatment to give the lower lip time to adapt. If you smoke, the repetitive pursing undoes a lot of good work at the corners and around the lips.
Skincare does not move corners, but healthier, thicker skin frames the area better. Peptides and retinoids can improve elasticity over months. Sunscreen protects your investment. If you are doing energy-based tightening, commit to the full series and the recommended maintenance. The gains are incremental, then compounding.
How this fits into a broader Botox plan
Most patients who treat the corners also address foundational expression lines: frown lines between the brows, forehead lines, and crow’s feet. A smoother upper face with a gentle brow lift makes the lower face look less burdened. Conversely, if your upper face is very still and the mouth is tense, the imbalance can look odd. The art is in calibrating all regions so expressions feel like you.
Face slimming with Botox, whether for the masseter or the trapezius for posture and neck line, sits adjacent to this conversation. If the lower third of your face feels bulky or tight from clenching, you may see better mouth corner behavior once that tension is reduced. If your neck bands are strong, low-dose Botox for platysma bands can take pressure off the lower face. Again, sequencing and restraint are key.
A practical path to decide if it is right for you
Start with an in-person assessment. Ask the provider to show you in the mirror how the DAO contracts. If lightly pinching the DAO and asking you to smile makes the corner sit higher without changing your words, you are likely to like the effect. If your corner collapses when they lift your cheek or the chin looks hollow, plan on adding filler support.
If you choose to proceed, set a realistic goal: a neutral, kinder resting corner with natural motion. Agree on conservative dosing for the first round. Book a two-week review. Live with the result for a full cycle before escalating. If you decide to add filler, do it when the Botox is at steady state so you can see how the muscles behave.
The best outcomes feel like a change in mood rather than a change in anatomy. You look less stern sudbury botox when you are not, and your smile looks like it belongs to you. That is the promise of well-done Botox for droopy mouth corners, especially when paired thoughtfully with supportive treatments and good habits.
If you are weighing Botox vs filler, or wondering whether a lip flip, chin dimpling correction, or marionette line softening should come first, bring reference photos of yourself at ages when you liked your expression. They help your provider see your natural blueprint. Layer the plan to preserve that blueprint rather than overwrite it.
With measured dosing, careful mapping, and honest expectations, Botox can be a quiet ally for the corners of the mouth, restoring the ease that time and tension slowly took.