The underlying causes are usually multifactorial and include; gravitational changes, loss of volume from the cheeks, changes in and repetition of facial muscle expressions and shrinkage of the jaw bones. Because so many factors are at play in causing drooping mouth corners, typically a combination of treatments is usually required to lift them back up.
We all have a muscle that travels from the corner of the mouth down toward the jawline. This muscle is called ‘depressor anguli oris’ and when this muscle contracts, it pulls the corner of the mouth down. In some people the action of this muscle can be excessive, and relaxing it with some injections of filler can weaken it and cause the corner of the mouth to come back up.
As we age we lose volume from the cheek. Loss of volume in the cheek causes the skin to sag, which can cause a deepening of the nasolabial fold and depression of the corner of the mouth. Correction of the volume loss in the cheek can therefore often result in an improvement in the appearance of the nasolabial fold and mouth corner as a by-product.
Adding volume to the mouth corner can sometimes help to elevate the angle of the mouth by a couple of millimetres. When taking this approach however the volume added needs to be very, very conservative.
Facelift surgery is excellent for removing loose skin in the lower face and neck. It tends to have a more modest effect on the mouth corner however and it is common to combine facelift surgery with filler injections if there is a significant downturn at the corner off the mouth.
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