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Droopy Mouth
(Downturning of mouth
corners or oral
commissures) and
marionette line treatment

What is Droopy mouth?

‘Droopy Mouth’, or the down turning of the corners of the mouth (oral commissures), as well as the formation of the marionette lines, is a common age-related change which occurs as we get older. During aging, our skin and tissues lose their volume, compounded by bone loss, together can result in decreased support of the structures around the mouth. This can cause unwanted cosmetic effects, like the sagging and drooping, creating down turning of the mouth corners as well as marionette lines, which are lines that extend from the corners of the mouth down toward the jaw creating a ‘marionette’ appearance.

Luckily, these structural changes are quite treatable and can be corrected using Botox and/or Dermal Fillers.

Treating Droopy Mouth and Marionette Lines with Botox

Botox a neuromodulator has the unique ability to block muscle contractions, thus allowing the muscles around lines and wrinkles to relax. When injected, the muscles beneath can be mildly relaxed, resulting in fewer wrinkles and a smoother, more youthful appearance in the skin above. Two muscles pull on the corners of the mouth: the depressor anguli oris (DAO) muscle pulls them down while the levator anguli oris (LAO) muscle pulls them upward. By using botox on the DAO, the downward pull is reduced allowing for the LAO to have a greater upward pull on the corners of the mouth. This helps treat the down turning of the oral commissures and can also help reduce marionette line appearance.

Treating Droopy Mouth and Marionette Lines with Dermal Fillers

Wrinkles and lines around the mouth form from loss of volume and integrity of surrounding tissues as we age. The good news is that this can be reversed effectively by volume replacement with dermal fillers. These are specially formulated to provide hydration and volume to a treatment area. By strategically injecting dermal fillers in the mouth corners and the marionette lines, the skin can be restored to its smooth and even surface and help uplift these tissues. As the fillers work their magic, skin volume increases in the treatment areas, plumping and reinvigorating the skin’s integrity. This essentially ‘fills in’ the lines and wrinkles, doing away with bothersome marionette lines and drooping. Many cosmetic dermatologists use a very clever trick: subtle dermal filler injections in the cheeks can help create plumpness which may have a lifting effect on the jaw and perioral areas below.

What to expect

Dermal filler and Botox treatments are generally well-tolerated, quick, and quite safe. Treatments are administered after the area is cleansed and prepped for the procedure. Topical numbing can be applied to the desired treatment areas to minimize any discomfort. Dermal fillers themselves are medicated with a small dose of lidocaine which adds additional numbing to the treatment area as well.

Dr. Brandish is an expert injector with years of experience in administering high-quality treatment results with fillers, botox, and other injectables. All things considered, treatment should be quick and easy. For more information on what to expect, see our Dermal Fillers and Botox pages.

How do I get started?

If you’re interested in hearing more or in scheduling an appointment, contact our office at

and we’ll take care of you. We offer free consultation appointments as well if you’d like to simply go over any problem areas and see if dermal fillers, botox, or other treatment options may be the most effective solution for mouth drooping or marionette lines.