Droopy Mouth

A downturned mouth, often described as a “droopy smile,” occurs when the corners of the lips pull downward, giving an unintentionally sad, tired, or stern appearance. It may result from overactivity of specific facial muscles, volume loss in the mid or lower face, or skin laxity.

At Haus of Ästhetik, we restore natural harmony to the lower face using precise neuromodulator and filler techniques, subtly rebalancing the muscles and volume to lift the corners while maintaining natural expression.

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Overview

A downturned smile can affect anyone, though it becomes more common from the late thirties onwards. It is equally prevalent in men and women and can be accentuated by habitual facial expressions, dental alignment, or weight loss. Many patients report that the change makes them appear sad or fatigued even when relaxed.
Corners of the mouth turning downward at rest

Fine lines or creasing at the oral commissures

Heaviness or shadowing along the jawline and chin

Flattening of the mid-face contributing to imbalance

In severe cases, marionette lines extending towards the chin
There is no specific NICE guideline for down-turned mouth corners. The BNF covers botulinum toxin generally but does not include this indication explicitly.
1. Botulinum Toxin (DAO Relaxation)

Small, targeted doses are injected into the depressor anguli oris to relax its downward pull.

This allows the opposing elevator muscles to lift the corners of the mouth naturally.

Results appear within 7–10 days and last around 3–4 months.

Procedure carried out in compliance with MHRA and BNF guidelines for POM use.

2. Teoxane RHA 2 or RHA 3 Fillers (Perioral Support)

Restores lost structure and softens lines around the corners of the mouth.

Adds gentle lift to the commissures and improves contour.

Formulated with Resilient Hyaluronic Acid for dynamic support that moves naturally during speech and expression.

3. Mesoestetic Nexha Filler (HA + Succinic Acid)

Ideal for mid and lower-face rejuvenation, replenishing support where tissue has descended.

Succinic acid boosts fibroblast activity and collagen synthesis, addressing laxity and oxidative stress that contribute to drooping.

Provides both immediate lift and progressive dermal strengthening.

4. mesoestetic Age Element Firming and Perioral Peels

Stimulate dermal renewal and firmness through peptides and antioxidants.

Improve skin texture and tone around the mouth, complementing injectables.

5. Combined Lower-Face Rebalancing Protocol

Integrates neuromodulation (DAO toxin) and filler support to create harmony between lift and structure.

Results are natural, expressive, and tailored to individual anatomy.
A consultation determines whether the cause is primarily muscular, structural, or both. Treatment is suitable for adults with mild to moderate downturning of the mouth corners. Contraindications include pregnancy, breastfeeding, active infection, or known neuromuscular conditions.

All injectable treatments are prescription-only and performed by medically qualified practitioners under CQC Regulation 12: Safe Care and Treatment, ensuring traceability, consent, and clinical safety.
Botulinum toxin: visible softening of downward pull within 1–2 weeks, lasting around 3–4 months.

Filler-based lift: immediate structural improvement with natural contour enhancement, lasting 9–12 months.

Patients typically describe their results as refreshed and more approachable, with the face appearing “at ease” rather than altered.
Avoid massaging the treated area for 24 hours.

No strenuous activity, alcohol, or heat exposure for 48 hours.

Maintain hydration and use SPF 30+ daily to support skin health.

Schedule review appointments every 4–6 months to maintain balance and lift.

Combine with collagen-supportive skincare such as mesoestetic Age Element Firming Concentrate or Teoxane Advanced Filler for ongoing maintenance.
Book a Lower-Face Rejuvenation Consultation at Haus of Ästhetik for a detailed assessment of muscle activity, volume distribution, and skin tone. We will design a bespoke plan combining precise neuromodulation and bio-regenerative filler support, guided by medical anatomy and NICE-aligned safety standards.

All treatments are conducted under CQC Regulation 12: Safe Care and Treatment, with clear consent, post-procedure monitoring, and aftercare guidance to ensure both safety and refinement.