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    Where do drooping corners of the mouth come from?

    Relaxed or raised corners of the mouth signal calm, open-mindedness and friendliness. Hanging corners of the mouth convey sadness, tiredness and a pre-aged appearance. Eight different muscles unite at the sides of the corners of the mouth. The common approach of the muscles in this area is called modiolus. The muscle whose tension predominates shifts the corner of the mouth in the direction of traction. Two muscles can lift the corner of the mouth: the Musculus zygomaticus major and the Musculus levator anguli oris. In contrast, the lowering of the corner of the mouth is controlled by the muscle depressor anguli oris and the platysma.

    The shape of the upper jaw changes with age. This increases the distance between the nose and mouth. The skin of the mouth area is also subject to the aging process. The skin becomes thinner and loses collagen. The skin’s elasticity decreases. These changes are accelerated by cigarette smoking. One of the first signs of aging is the sinking of the upper lip and the corner of the mouth. These changes cause the lips to lose fullness. The skin above the upper lip hangs and folds. The red of the lips becomes thinner. The face loses its youthful contours and the corners of the mouth fall off. Patients in whom the corners of the mouth are sagging due to aging or heredity can benefit from a correction of the corners of the mouth.

    Lifting the corners of the mouth without surgery

    The corner of the mouth is lowered by the predominant tension of a muscle, the musculus depressor anguli oris. When this is relaxed with the neuromodulator substance, the corners of the mouth lift under the influence of the antagonists. The muscle depressor anguli oris, which lowers the corners of the mouth, lies 8-15 millimeters below the corner of the mouth. Two to four units of the neuromodulator substance active ingredient are superficially injected per side. Depending on the extent of the drooping corners of the mouth, it is injected into one to three areas. The effect lasts four to six months.

    Hyaluronic acid fillers give the lips more volume and a beautiful shape. Wrinkles on the upper lip as well as lateral wrinkles in the mouth can be smoothed. The targeted injection of filler below the corners of the mouth can lift hanging corners of the mouth again. Using a very fine needle, 0.05 to 0.1 milliliters of Filler are injected along the lip red border of the lateral lower lip. Then 0.1 to 0.15 milliliters of hyaluronic acid are injected just below the corner of the mouth. Injecting in this area is very effective in compensating for vertical wrinkles at the corners of the mouth, the so-called marionette wrinkles or mentolabial folds. To obtain a natural, sweeping shape of the corners of the mouth, 0.2 to 0.3 milliliters of filler are injected into the outer upper lip. The treatment only takes a few minutes and lasts for about six months.

    We strongly advise against lifting the corners of the mouth with a thread lift. The benefits of this treatment are very controversial and the risks are not insignificant.

    What can you expect during a consultation for a Corner of the mouth lift?

    The plastic surgeon will first listen to you carefully to understand your concerns. In addition to your specific concern, you will also be asked questions in order to recognize any risks in good time and to be able to better prevent them. Since many personal characteristics influence facial expressions, the examination also extends to other areas. The surgeon takes into account the nature of the skin, facial muscles, jaw malposition, the length and depth of skin wrinkles, the volume of the lower lip and upper lip, and the alignment and position of the corners of the mouth. Slight lateral lip imbalances even when laughing are not unusual but worth noting.

    After an exact finding has been made and your expectations have been discussed, approaches to solutions are developed. Since many parameters influence a treatment result and every person is unique, there is no standard solution for everyone. As plastic surgeons specialized in facial surgery, we can offer you the most suitable treatment from the possible conservative as well as operative methods. During the consultation you will be shown which goals can be achieved with the respective treatment. Since every treatment is also associated with certain risks, the advantages and disadvantages of the procedure and the treatment costs will be discussed with you in detail. Since questions may arise after a comprehensive consultation, we always offer a second consultation before the procedure.

    How is a corner of the mouth lift performed?

    The lifting of the corners of the mouth is performed in a short procedure under local anesthesia. An overnight stay at the clinic is not necessary. Before the procedure, the new position of the corners of the mouth is marked with a fine marker. The surgical plan is meticulously recorded, measured and checked several times. The local anesthetic is injected with a very fine cannula. The previously marked excess skin is removed under magnifying glasses. A small part of the muscle that lowers the corner of the mouth is removed. The skin is meticulously and precisely closed with very fine sutures. Clamp plasters are applied, which are renewed the next day. Before you leave the clinic, you will be given a report in which, among other things, precise behavioral measures are recommended. This report will also contain appointments for follow-up and a telephone number where you can reach your surgeon at any time in an emergency.

    What are the risks of a corner of the mouth lift?

    Every treatment is also associated with certain risks, which will be discussed with you in detail in advance. Correction of the corners of the mouth is accompanied by a scar, which in most cases heals well and is hardly visible after a few months. Scars can be raised and reddened in the first months. Microsurgical techniques and fine suture material prevent bulging scars from forming. Due to the nature of the condition, scars can be visible despite consistent care. Cortisone injections can be helpful to reduce scar growth. Perfect symmetry is always strived for, but cannot be guaranteed 100 percent. If you have already had cold sores in the past (herpes inflammation), lip herpes can recur after an operation. In these cases the preventive use of Acyclovir should be considered. The risk of wound healing disorder or inflammation is less than one percent, but is generally increased in smokers (Jeong T.-K., 2020, Plast Reconstr Surg Glob Open).

    What should be considered after a corner of the mouth lift operation?

    Especially in young patients, a stronger scarring is occasionally observed. Various measures can reduce this risk. Fine, tension-free sutures, staple plasters, scar massages and consistent sun protection have a positive effect on scar formation. A wide mouth opening, for example when yawning or laughing, should be avoided in the four weeks after the operation. The skin sutures are removed between the sixth and seventh postoperative day. Make-up should be applied on the tenth day after the surgery.

    What does a corner of the mouth lift cost

    On our costs page, we provide information on the magnitude and composition of costs. The duration of an operation and the amount of treatment required vary depending on the findings. Following the initial consultation, we can prepare a quotation tailored to your needs.

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    The author

    Dr. Adelana Santos Stahl

    “Our goal is to provide the best, most discreet and precise treatment based on our extensive expertise in plastic surgery. „

    Dr. Adelana Santos Stahl is distinguished by a unique international perspective with a feminine view of plastic surgery. Her personalized and detailed approach is key to the beautiful and natural results she achieves. Having trained in Brazil, one of the largest and most well-known countries for aesthetic and reconstructive plastic surgery, she understands her patients’ desire to look and feel their best.She completed her medical studies and her training as a specialist for plastic and aesthetic surgery in Brazil. In 2009, she also successfully passed the German equivalence examinations for the medical state examination. Two years later, in 2011 she received the German and in 2012 the EU specialist recognition (EBOPRAS) for plastic surgery.From 2009 to 2013, she deepened her knowledge of aesthetic and reconstructive facial surgery with world-renowned representatives of plastic surgery such as Professor Gubisch at the Marienhospital and Madame Firmin in Paris.A VDÄPC Fellowship (continuing fellowship for graduate students) in Switzerland, France and the USA has further enriched her professional experience.Dr. Santos Stahl is active in several prestigious professional societies. Besides the DGPRÄC and DGBT, she is also a member of the Brazilian Society of Plastic Surgery – SBCP.She is also the author of several scientific articles and, together with her husband, is dedicated to research and clinical studies in the field of plastic surgery.

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