Downturned smile in Edinburgh

A downturned smile can be effectively corrected with anti-wrinkle injections (botulinum toxin) targeting the depressor anguli oris (DAO) muscle, which is the most common and effective non-surgical treatment for this concern. The DAO muscle pulls the corners of the mouth downward, and when it is overactive or dominant, it creates a sad, unhappy or stern resting expression even when you feel neutral or content. Anti-wrinkle injections work by relaxing the DAO muscle, reducing its downward pull on the mouth corners, allowing the natural upward-lifting muscles to work unopposed, and creating a more neutral or slightly upturned mouth position at rest. The treatment involves small injections of botulinum toxin into the DAO muscle on each side of the mouth, typically using 2 to 6 units per side; takes just a few minutes to perform; causes minimal discomfort; and produces results within 3 to 14 days that last 3 to 4 months. Other treatment options include dermal fillers, which can be used to add volume and support to the mouth corners, lifting them and reducing the downturned appearance; combination treatment using both anti-wrinkle injections and fillers for comprehensive correction; and in rare cases, surgical options for severe cases not responding to injectables. For most people with a downturned smile, anti-wrinkle injections provide excellent, natural-looking correction with minimal risk. The treatment is quick, requires no downtime, and can dramatically improve resting facial expression, making you appear happier and more approachable. Consult with an experienced aesthetic practitioner who can assess your facial anatomy, determine the cause of your downturned smile, and recommend the most appropriate treatment approach for your specific concerns.

If you have naturally downturned lips that affect your smile, anti-wrinkle injections offer an effective solution to improve both your resting expression and your active smile. Rather than trying to consciously adjust how you smile, which is difficult and often looks unnatural, treating the underlying muscle imbalance provides lasting improvement. Anti-wrinkle injections work for downturned lips by targeting the depressor anguli oris (DAO) muscle, which pulls the mouth corners downward; relaxing this muscle reduces the downward force; allowing the levator muscles that lift the mouth corners to work more effectively; and creating a more balanced, natural smile with less effort. The treatment helps with both resting expression, where your neutral face appears less sad or stern; natural smiling, which becomes easier and more symmetrical; photographs, where you look happier and more approachable; and overall facial harmony, creating better balance between lifting and depressing muscles. The procedure involves small injections into the DAO muscle at the corners of the mouth, takes only a few minutes, causes minimal discomfort, and produces noticeable improvement within 1 to 2 weeks. Results typically last 3 to 4 months, after which maintenance treatments are needed. For some people with downturned lips, dermal filler may also be beneficial, either alone or combined with anti-wrinkle injections, to add volume and structural support to the mouth corners. This combination approach can provide more comprehensive correction for significant downturn. Rather than constantly trying to adjust how you smile, which is tiring and often unsuccessful, treating the underlying cause with anti-wrinkle injections allows your natural smile to appear brighter and more positive without conscious effort. Most people find that after treatment, they no longer need to think about their smile because their resting and smiling expressions naturally appear happier and more inviting.

A downturned smile, sometimes called a sad smile, resting sad face or marionette mouth, refers to a facial appearance where the corners of the mouth turn downward, creating a sad, unhappy or stern expression even when the person feels neutral or content. This creates a disconnect between how you actually feel and how your face appears to others. The condition is caused primarily by the activity and dominance of the depressor anguli oris (DAO) muscle, a facial muscle that pulls the corners of the mouth downward. When this muscle is overactive, strong, or dominant compared to the muscles that lift the mouth corners, the result is a persistent downward turn at the mouth corners. A downturned smile can affect your resting expression, making you appear sad, angry, disapproving or unapproachable when your face is relaxed; your active smile, where even when smiling, the corners may not lift as much as desired; first impressions, as people may perceive you as unhappy or unfriendly; and self-confidence, causing self-consciousness about appearance and how others perceive you. The condition can be natural and genetic, present from youth due to facial structure; age-related, developing or worsening with facial volume loss and skin changes; muscular, caused by overactive or hypertrophic DAO muscles; or combination, involving multiple factors affecting mouth position. Many people with a downturned smile report being asked why they look sad or angry when they feel perfectly fine, or receiving comments about appearing unfriendly or unapproachable. This can be frustrating and affect social and professional interactions. A downturned smile is a common concern that affects people of all ages, though it often becomes more pronounced with ageing as facial volume decreases and skin loses elasticity. Fortunately, effective treatments exist to correct this concern and create a more pleasant, approachable resting expression.

A downturned smile can result from several factors, often working in combination. Understanding the cause helps determine the most appropriate treatment approach. The most common causes include overactive depressor anguli oris (DAO) muscle, which is the primary cause in most cases, where the DAO muscle that pulls mouth corners down is stronger or more active than the muscles that lift the corners, creating persistent downturn; genetic facial structure, as some people are born with facial anatomy that predisposes to downturned mouth corners, including bone structure, muscle attachment points and natural muscle balance; ageing and volume loss, where decreased facial fat, collagen and bone density with age reduces support for the mouth corners, allowing gravity and the DAO muscle to pull them downward; skin laxity, as loss of skin elasticity allows tissues to sag, contributing to downturned appearance; and habitual expressions, where repeated frowning or negative expressions over years can strengthen the DAO muscle. Additional contributing factors include weight loss affecting facial volume; sun damage accelerating skin ageing; smoking contributing to premature ageing and muscle changes; dental issues affecting jaw position and mouth appearance; and neurological conditions affecting facial muscle balance in rare cases. The downturn often becomes more noticeable with age because natural ageing processes like volume loss and skin laxity compound existing tendencies; the DAO muscle may become relatively stronger as lifting muscles weaken; and marionette lines (vertical lines from mouth corners) develop, accentuating the downturn. Regardless of the cause, anti-wrinkle injections into the DAO muscle are typically the first-line treatment, effectively addressing the muscular component of a downturned smile. For volume-related concerns, dermal fillers may be added to provide structural support. A consultation with an experienced aesthetic practitioner can assess your specific facial anatomy, identify the primary causes of your downturned smile, and recommend the most appropriate treatment approach, which may include anti-wrinkle injections alone, fillers alone, or combination treatment depending on your individual situation.

Before anti-wrinkle treatment for a downturned smile, people typically have mouth corners that turn downward at rest, creating a sad or unhappy appearance; a stern, disapproving or unfriendly resting expression; marionette lines or shadows running from the mouth corners downward; frequent comments from others asking if they are sad, angry or tired; difficulty appearing approachable or friendly in photos; and self-consciousness about how their face appears to others when they feel fine internally. The disconnect between feeling content and appearing sad or stern is often the primary concern driving people to seek treatment. After anti-wrinkle treatment for a downturned smile, typically assessed 2 to 4 weeks after injection when the full effects have developed, most people experience noticeable, natural-looking improvement. Common results include mouth corners appearing more neutral or slightly upturned at rest; more pleasant, approachable resting facial expression; softer appearance with reduced stern or sad look; more natural, balanced smile when actively smiling; improved photographs with happier-appearing expression; fewer comments about appearing sad or unfriendly; and increased confidence about facial appearance. The degree of improvement depends on the severity of the initial downturn; the strength and size of the DAO muscle; the dose of anti-wrinkle product used; whether filler is also used for volume; and individual response to treatment. Some people achieve quite dramatic transformation from sad-appearing to pleasant-appearing resting face, while others experience more subtle but still meaningful improvement. The change develops gradually over 1 to 2 weeks as the anti-wrinkle treatment takes effect. The DAO muscle progressively relaxes, allowing the mouth corners to lift naturally. Full results are typically visible by 2 to 4 weeks. During the treatment timeline, days 1 to 3 show minimal change as the treatment begins working; days 7 to 10 reveal noticeable relaxation of the DAO and early lifting; and weeks 2 to 4 demonstrate full effect with optimal mouth corner position. If dermal filler is used in combination, volume and lifting effects are immediate, while anti-wrinkle effects develop over the following weeks. Results typically last 3 to 4 months before the DAO muscle regains function and the downturn gradually returns. Regular maintenance treatments every 3 to 4 months maintain the improved appearance. Some people find that with regular treatment over time, the DAO muscle weakens and results may last longer. Before and after photos from practitioners should show realistic, natural-looking improvement in mouth position and resting expression. The goal is not an exaggerated, artificial upturn but a natural, pleasant neutral expression where the mouth corners sit in a balanced position rather than being pulled downward. Most people are very satisfied with anti-wrinkle treatment for downturned smile, finding that the simple, quick procedure provides meaningful improvement in how they appear to others, with many reporting that they no longer receive comments about looking sad or being asked what is wrong. The treatment allows their external expression to better match their internal emotional state, improving both appearance and confidence in social and professional situations.