Botox for the Lower Face in Washington, DC
While the majority of wrinkle relaxer treatments focus on dynamic wrinkles of the upper face, advanced injection techniques utilizing neuromodulators have been developed to address muscle related concerns of the lower face. These include gummy smile, downturned corners of the mouth, chin dimpling and crepiness(chinulite), downturned nasal tip, and the popular ‘Botox Lip Flip’. As advanced injection techniques lower facial uses of Botox require advanced training and extensive knowledge of facial anatomy and muscular activity.
Botox Treatment for Gummy Smile
When we smile a number of small to medium size muscles (the ‘strap’ muscles) in our cheeks contract, lifting the the cheeks and upper lips upward and outward. A small muscle with a big name, levator labii superioris alaeque nasi, or LLSAN for short, is located adjacent to the nostrils and is responsible for pulling up on the medial portion of the upper lip during smiling. In certain anatomies the activity of the LLSAN results in excessive lifting of the upper lip, leading to exposure of the teeth as well as the gums, leading to the aforementioned ‘gummy smile’. Precise injection of small amounts of Botox into the LLSAN can reduce the activity of this muscle, leading to less contraction upon smiling and less exposure of the gums during smiling.
Botox for Downturned Mouth
Overactivity of two small muscles in the corner of the mouth, the Depressor Anguli Oris, or DAO for short, can result in downturned corners of the mouth when at rest, leading to a ‘permanent frown’ look. Careful injection of small amounts of neuromodulator into these muscles can reduce the resting overactivity of these muscles, allowing the the corners of the mouth to resume their natural position. As an advanced injection technique, this should only be performed by advanced injectors, as inadvertent injection into surrounding muscles can cause asymmetric smile or other unnatural side effects.
Botox for Chin Dimpling
A common complaint for many patients is dimpling of the chin during speaking or other facial expressions. This is due to overactivity of the mentalis muscle of chin, which results in a dimpled or often ‘cellulite-like’ appearance to the chin during facial expressions. Treatment of this muscle of the chin with Botox can lessen the overactivity of this muscle, leading to smoother, less dimpled skin of the chin and an improvement of ‘chinulite’.
Botox for Downturned Nasal Tip
In contrast to the muscles which pull up on the upper lip when smiling, a small muscle at the base of the nose contracts to pull down on the nose and nasal tip. Often this leads to a noticeable downturn of the nasal tip or ‘beaking’ of the nose when smiling or laughing. Through careful injection this muscle can be relaxed releasing the nasal tip from this pull lessening the beaked nose effect when smiling or laughing.
Botox Lip Flip
While true volume enhancement of the lip can only be achieved through lip augmentation with filler, a popular non-filler treatment to provide the illusion of enhanced lip volume is the ‘Lip Flip’ procedure. By carefully injecting neuromodulator along the upper lip, a muscle can be relaxed which results in enhanced upper lip ‘show’. The net effect of this is a more pronounced upper lip line with more visible ‘red lip’, with a visual result of a seemingly more full upper lip. Compared to lip fillers the effects of the Botox lip flip do not last nearly as long, however this procedure is very popular prior to a large event such as a wedding, and is often used in conjunction with lip augmentation with filler to further enhance the volumization effect of these treatments.