Smiles, Sad Mouth & Other Small Areas

It is important to note that only a minimal dose of muscle relaxant can be administered to the above areas; the usual 3-4 months of effectiveness does not apply to these areas, especially for the first few treatments. Some anatomists have lectured on the long-term benefits of muscle relaxant treatment, viewing it as a ‘prevention’ and a short-term ‘treatment’ for wrinkles. Please book a face-to-face consultation with one of our practitioners for a personalized assessment.

Gummy smile

A minimal gum line showing is one of the most critical factors of a beautiful smile. Most people find the gum tissue display less attractive because it causes an asymmetrical smile. An overactive muscle above the upper lip can cause a gummy smile. The name of this muscle is called the Levator Labii Superioris Alaeque Nasi. Very few patients have feedback saying that they did not like the result of their smile after their muscle relaxant treatment. However, this has been less than 1% of cases. Usually, these patients choose to have dermal fillers in their lips instead of reducing the gummy smile and achieving other aesthetic outcomes.

Smoker lines

For vertical lines just above the lips, treatment with muscle relaxants can be highly effective in the early formation of the lines. Patients with a history of cold sores should be cautioned as any injection to this area can bring on the breakout of a cold sore. Treatment in this area may also temporarily cause difficulties in sucking through a straw and whistling; in rare cases, it may also cause a slight change in the patient’s speech. It is essential to point out that these side effects usually only last 2-3 weeks and are not generally noticeable by 3rd parties, mainly just the patients themselves. If these side effects concern you, dermal fillers should be considered for a better result.

Muscle relaxants in the top lip can deliver a more desirable cosmetic result after a few treatments. Patients have reported to have their upper lip more ‘lifted’, pronounced, and more defined without having dermal fillers.

Depressor correction/Sad mouth

The depressor anguli oris (DAO) muscle contributes to the ‘sad mouth’ and drooping appearance of the mouth corners. Pulling down the outer corner of the mouth is also referred to as the mouth frown. A small amount of muscle relaxant with multiple treatments can produce a more satisfying result in the long term.

A potential temporary side effect of this treatment is that very occasionally, the muscle relaxant medication can diffuse to one of the neighbouring muscles, causing a mild asymmetrical smile for 2-3 weeks. However, do not be alarmed; this side effect will pass without long-term implications. Please inform your practitioner if you have had a facelift, thread lift, or any surgeries around that area, as this could have caused the shifting of DAO muscle; the injector should consider this change of the muscle position when performing treatment.

Another cause of the ‘sad mouth’ appearance is the hollowing of the marionette area. The loss of fat pad in that area can be replaced with dermal fillers, which will produce more immediate results and higher patient satisfaction.

Chin dimples (Orange peel chin)

The hyperactivity of the mentalis muscle causes wrinkles in the chin area. These wrinkles might only appear when you are talking, smiling, eating, or expressing emotions; however, having muscle relaxants in this area early can prevent the formation of permanent wrinkles.

Nasal/bunny lines

These slightly diagonal lines on both sides of the nose bridge can appear when someone is smiling, laughing, or making a ‘disgusted’ look. We estimate about 1 in 20 patients report back that their treatment either did not work to their satisfaction or did not work at all. This is due to the complex group of muscles in this small area. According to medical literature and guidelines, the Nasalis is generally the muscle to treat. However, other adjoining muscles could be more dominant, causing unsatisfactory results. A follow-up after 2-3 weeks is often essential to improve the result so our practitioner can assess and make adjustments. Occasionally, dermal filler can be combined with muscle relaxants to enhance patient satisfaction. When practical, patients often have a much smoother look on their nose after a few treatments.