Botox

Lower face

Downturned mouth treatment at SONÜ

Botox for a downturned mouth in Hale, Altrincham

A softer, happier-looking expression, with less of a downward turn at the corners of your mouth.

You can be in a perfectly good mood while the corners of your mouth suggest otherwise. A downward turn can make you look sad or stern, especially when your face is relaxed.

DAO Botox relaxes the muscles pulling those corners down, giving the muscles that lift your smile less resistance to work against. The corners can sit a little higher, helping your resting expression look softer and a little more smiley. Dr Alex will look at your mouth in movement and at rest to see where treatment could help.

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With Dr Alex, who teaches botulinum toxin treatments to doctors, dentists and nurses and often uses ultrasound to guide placement in the DAO muscles.

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Treatment cost
£200
Main benefit
A happier-looking expression
Results develop
Around 2 weeks
Recovery
Usually back to your day

What you have noticed

Looking sad when you feel perfectly fine?

Sometimes it is the expression your mouth seems to give you, rather than a particular line, that you would like to change.

Your resting expression looks unhappy

Your mouth turns down when your face is relaxed, making you look sad or a little stern. You would like those corners to sit a little higher, without having to keep a smile on your face.

The corners pull down strongly

You notice a strong downward pull when you talk or make certain expressions. Relaxing that pull can give the muscles that lift your smile more of a chance to do their job.

Shadows below the mouth corners

You notice a small crease or shadow beneath each corner that makes the downturn look stronger. Dr Alex can assess how much comes from muscle pull and how much from a deeper fold or lost support.

At a glance

The details you'll want to know

Often called DAO Botox, this treatment can soften a sad or stern-looking resting expression.

Treatment cost
£200
Consultation is £75. Any additional treatment is discussed and priced separately.
Main benefit
A happier-looking expression
Relaxing the downward pull can let your mouth corners sit a little higher.
Results develop
Around 2 weeks
Results develop gradually, with the full effect usually visible after around two weeks.
Recovery
Usually back to your day
Small injection marks, tenderness or bruising can occur.
Duration
Around 3-4 months
This is the average Dr Alex advises. The effect wears off gradually as muscle movement returns.

The result

A little more smile in your resting expression

The change can be subtle, but it is the expression you notice: less downturned, less sad-looking, a little more smiley.

When the downward-pulling muscles relax, the muscles that lift the corners of your mouth have less resistance to work against. The corners can sit a little higher, so your mouth looks softer even when you are not actively smiling.

Dr Alex also finds that some people see less shadowing just beneath the mouth corners as that pull reduces. This is different from filling a deeper marionette fold, which may need added support. At consultation, he will show you which part of the change is likely to come from relaxing the muscle.

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Mouth corners that sit a little higher

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A softer, happier-looking expression at rest

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Less downward pull when you make a sad face

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Possible softening of shadows just below the mouth corners

Is it the right treatment?

Muscle pull, lines or lost support?

These can look similar in a photograph but need different treatment decisions.

Active downward pull
DAO Botox may suit you if a strong muscle pull turns your mouth corners down, giving you a sad or stern-looking expression.
Changes around the lower face
You may have both muscle pull and changes in skin or volume. Treatment can address the muscle component, with other options discussed if needed.
Deeper marionette folds
A little shadowing may soften when the downward pull is reduced. A deeper marionette fold running from the mouth towards the chin may also need support from a different treatment.

What it can change

This is a mouth-corner treatment

It is not a treatment for lifting the whole lower face or tightening jowls. Dr Alex will show you the area where a change is realistically possible.

How it works

Giving the muscles that lift your smile less to work against

The DAO muscles help pull the corners of your mouth down. Other muscles pull them up when you smile.

Botulinum toxin relaxes the DAO muscles, reducing their downward pull. The muscles that lift your smile can then have more influence over where the corners sit - a little like letting the smile muscles take over.

You may find it harder to pull the corners down into a sad face, while your resting mouth looks less downturned. Nearby muscles also control the lower lip, so Dr Alex checks how the whole area moves when planning your treatment.

Your appointment

Let Dr Alex see your mouth in motion

Talking, smiling and relaxing your face all help him assess the muscles involved.

Consultation

Point out the change you have noticed

You discuss the mouth-corner position, any lines or folds, and what you would like to improve. Previous toxin or filler treatment is reviewed too.
Assessment

Assess the muscles and guide placement

Dr Alex checks the downward pull, any difference between the sides and how your lower lip moves. He often uses ultrasound to identify the DAO and nearby muscles, helping guide precise placement.
Treatment

Relax the relevant muscle

Small injections target the downward-pulling muscles. There can be a brief sting. The agreed plan is based on your movement and anatomy.
Afterwards

Allow the effect to develop

You receive aftercare instructions and advice about assessing the result. Contact SONÜ if you notice an unwanted change in your smile or lip control.

Why Dr Alex?

Ultrasound to help target the right muscle

Dr Alex teaches botulinum toxin treatments to doctors, dentists and nurses and is an international Key Opinion Leader for Evolus, an aesthetics company that supplies botulinum toxin.

For DAO treatment, he often uses ultrasound to see the muscle beneath the skin and distinguish it from the muscles moving your lower lip. That helps him guide placement precisely, with the aim of reducing unwanted effects on your smile or lip movement.

The assessment also looks at what you want to see in the mirror: a less sad-looking mouth, a slight lift to the corners or softer shadows beneath them. He will explain which changes toxin can help with and whether a deeper fold needs a different treatment.

GMC-registered doctor · 7072776

Full Member of BCAM

International toxin trainer

Aesthetics Awards winner 2021

Safety

Possible side effects around the mouth

The muscles in this area are involved in smiling, speaking and keeping the lips together.

Possible side effects

Bruising, tenderness and small injection marks are possible. If nearby muscles are affected, you may notice an uneven smile, a change in lower-lip movement or difficulty with certain sounds, drinking or keeping the lips sealed.

These changes are temporary, but can take weeks or longer to settle as the toxin wears off. Let SONÜ know if you notice a change in function or are unhappy with how the area is settling.

When to seek urgent help

Get urgent medical attention for difficulty swallowing or breathing, widespread weakness, or symptoms of a severe allergic reaction. These are rare reactions to toxin treatment.

When treatment may not be suitable

Botulinum toxin is not recommended during pregnancy or breastfeeding. An active infection at the injection sites needs to settle first. Tell Dr Alex about any muscle or nerve disorder, problems swallowing, previous toxin reactions and all medication you take.

Assessment includes your existing smile and lower-lip movement, as well as your medical history.

Treatment pricing

Downturned mouth treatment costs

DAO Botox for both corners of a downturned mouth counts as one area and costs £200. Two areas cost £280, three £350 and four £430. Dr Alex will confirm your plan before treatment.

1 area
£200per agreed appointment
2 areas
£280per agreed appointment
3 areas
£350per agreed appointment
4 areas
£430per agreed appointment
Dr Alex will confirm which areas are included before treatment. Forehead and frown lines count as two areas when treated together.
A consultation with Dr Alex costs £75. If you choose to have treatment within 3 months of your consultation, you can put this fee towards it, including at a later appointment. It cannot be used towards skincare products. If you decide not to have treatment, the fee covers your consultation.
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If lost volume or skin laxity also needs addressing, Dr Alex will explain the options and costs before you choose what to do.

Your questions

Questions about DAO Botox

What it can do for the mouth corners, and what belongs to a different treatment.

What does DAO mean?
DAO is short for depressor anguli oris, the muscle on each side of the lower face that pulls a mouth corner down. DAO Botox reduces that downward pull.
Can it help with 'resting bitch face'?
If you use that phrase to describe mouth corners that make you look unhappy or stern, DAO Botox may help. Relaxing the downward pull can let the corners sit a little higher, giving a softer, happier-looking resting expression.
Will it remove marionette lines?
It can sometimes soften the shadow just below a mouth corner by reducing the pull on that area. It does not replace lost volume, so a deeper marionette fold may need a different treatment. Dr Alex will assess both at consultation.
Is this the same as lip filler?
No. DAO toxin changes muscle movement around the mouth corners. Filler adds support or volume where appropriate. Dr Alex can explain whether either, or a combination, would suit your concern.
Can you treat one side more than the other?
The plan can take existing differences into account. Dr Alex will assess both sides at rest and in movement; making them perfectly identical is not a realistic promise.
Could my smile look different?
Yes. An unwanted effect on nearby muscles can cause an uneven smile or altered lower-lip movement. This is discussed before treatment and is a reason for assessing the surrounding muscles carefully.
Will it tighten my jowls?
No. It targets the pull at the mouth corners. Loose skin or heavier jowls need their own assessment and should not be expected to tighten from DAO treatment.
When will I notice a change?
Results develop over the days after treatment, with the full effect usually visible at around two weeks. Follow your aftercare advice about review, and contact SONÜ if you have concerns.
How long will the result last?
Around 3-4 months on average. Movement gradually returns as the effect wears off, and you can discuss further treatment if you would like to maintain the result.
Can I carry on with my usual day?
Usually. You may have small injection marks or bruising. Follow the aftercare advice provided and contact SONÜ if you notice difficulty using your mouth or an unexpected change in your smile.

Your next step

Let your resting expression look a little happier

Book a consultation with Dr Alex at SONÜ in Hale, Altrincham to discuss the change you would like around your mouth and whether DAO Botox could help.

Book a consultation Contact the clinic
SONÜ Medical Aesthetics

34 Hale Road, Hale, Altrincham, WA14 2EX

Doctor-led treatment in a relaxed, private clinic

Close to Hale station and easy to reach from Altrincham, Manchester and Cheshire