Mouth Droops at Corners
Dr Yang,
Would a filler on the top make the droop more noticeable or is there can it help with the drooping and if so where would the filler be injected?
Would like to have corners of the mouth turn up instead of down.
“My top lip is thin and my mouth droops at the corners.
Would a filler on the top make the droop more noticeable or is there can it help with the drooping and if so where would the filler be injected?”
You can have a hyaluronic acid filler (Restylane or Juvederm) to define the borders of the lips as well as augment the red portion of the lip. Filling the upper lip will not change the corners of the mouth. Most people have some marionette shadows which makes the corners of the lips appear to be downturned. Filling this area can help to improve this appearance.
“Would like to have corners of the mouth turn up instead of down.”
This is a common request. I think that the corners of the lips should be neutral and should not be turned upwards or downwards at rest. In youth, the mouth is neutral, and there is no evidence of much of any marionette shadows or lines which can make the lips appear otherwise. Just as we don’t want people to think that we are frowning all the time (when we are not), why would we want to be smiling all the time (when we are not.) People will start to ask you, “What’s so funny?” Wouldn’t that be equally annoying.
Although there are definite examples of people with mouths that are actually frowning, I think that most people with a marionette lines appear to have a frowning mouth, but the corners are actually neutral. The extension of the marionette lines from the corners or the mouth make the mouth appear to be frowning. I believe the in most cases this is an optical illusion. Also, when looking at pictures, a person may actually be frowning slightly.
Here are some examples of older lips that I found on Google. These before and afters show improvement of the “smoker’s lines” on the upper lip after medical needling (another topic.)
Here is an example of a common optical illusion. Which line is longer?
Let’s look at some young women as examples of youthful faces. Here are two examples of young women with there faces at rest, without showing any emotion.
I don’t think that the corners of their lips are upturned.
If fillers don’t fill the marionette area as an isolated procedure, a lower facelift can help to smooth out any jowling and improve the marionette lines. If there are any lines left after a lower facelift, this residual is more easily filled.
Not all marionette lines can be completely filled, which leaves a dilemma. Since there seems to be no more options. This is where a corner lip lift or anguloplasty comes in. I think that if a corner lip lift is properly performed, it should make the lips appear neutral and not upturned.
The only plastic surgeon that I have seen before and after photos online is Dr. Robert Flowers. He calls his the Valentine anguloplasty, named after the shape of the skin removal along the upper part of the corner of the lip (shaped like a heart.) He has some very nice results. Here is the link:
http://www.flowersclinic.com/galleryThu … ategory=22
I think that most appear to place the lips in a neutral position. There are a few that a bit upturned for my taste, but with every procedure there is some variation based on the patient’s anatomy and their desires. I don’t know how these lips would look in person. It is one thing for it to look good in pictures, but if it looks odd when a person is talking, eating, or showing emotion, that would also be a tell-tale sign that something was done.
Excellent question. I hope this helps.
Best,
Dr. Yang
