DOWNTURNED MOUTH/
marionette line treatment
anti-wrinkle injections
Treating the downturned corners of the mouth and marionette lines - the DAO muscle.
WHY DO THE CORNERS OF THE MOUTH TURN DOWN?
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As we age, we are losing collagen and elastin in our skin making it lose its ‘bounce”.
It also becomes thinner (around the mouth the skin is thinner than other areas of the
face). We are losing tissue support around the mouth, the corners of the mouth and
in the chin.
From as young as 20 years old skin changes appear and fine lines and wrinkles
develop. In addition to ageing, these lines can appear worse due to lifestyle choices,
excessive sun exposure, genetics, diet, environmental factors, ethnicity, as well as
habitual and animated facial expressions.
The lack of support combined with the repetitive muscle action and overuse of the
DAO muscle can cause the mouth to appear sad with the corners of the mouth
turning down and marionette lines appearing. The muscle responsible for the
downturn corners of the mouth is called the DAO- Depressor Anguli Oris.
WHAT ARE THE MARIONETTE LINES?
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These lines run vertically between the mouth and chin, giving the appearance of a
sad face, which can also create sagging and drag in the lower third of your face.
The term ‘marionette” comes from the lines and wrinkles appearing like the strings
on a marionette puppet.
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HOW TO PREVENT THEM
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There is no way to prevent them as they are a natural part of ageing and facial
expressions, but there are many treatment options to help minimise their appearance
and prevent them from getting deeper. The become more prominent from
approximately 40 years old and are a frequently requested treatment- to start to
combat them.
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HOW TO TREAT THE DOWNTURNED MOUTH AND MARIONETTE LINES
Small amounts of a purified protein are injected into the DAO muscle to relax it and
lift the corners of the mouth back up, as well as smooth out wrinkles. They are also
used to correct asymmetry and combat dynamic wrinkles around the mouth, chin
and jawline.
With time, weakening and overactivity of the DAO muscle can cause the muscle to
pull down, creating an everlasting frown, even when the face is at rest.
The result is a happier, more rested and youthful appearance, with no down time.
With regular treatments the visible signs of ageing are dramatically reduced.
Treating the DAO muscle is also commonly combined with a chin treatment- to
reduce the appearance of the wrinkles and dimpling of the chin.
WHAT OTHER TREATMENTS HELP?
Depending on the depth of the marionette wrinkle some patients will need
combination treatments and there isn’t a stand- alone treatment that works best.
The marionette wrinkle can be softened if the marionette lines are still visible after
relaxing the DAO muscle.
Some patients will require jawline volume loss to be replaced, to pull back the
marionettes in combination with filling the marionette crease.
As well as reducing the appearance of the wrinkles, and replacing lost volume, there
are additional treatments to improve the skin. Improving the skin quality with skin
needling, skin booster injections or PRP (Platelet Rich Plasma) injections will also
improve the appearance of the marionette wrinkle and the skin all around the mouth.
Chemical peels, laser, LED light therapy, daily use of active skincare as well as daily
SPF 50 will help to maintain these treatments and results.
WHAT ARE THE RISKS?
As with any aesthetics procedure there are associated risks. Redness, swelling and
bruising are the most frequent. See the detailed summary on the website to find out
more or book in for a consultation so they can be discussed in detail.
As the DAO muscle is responsible for mouth movement and eating and drinking, a
small dose in the hands of an experienced health care practitioner is important to lift
the corners of the mouth, without inhibiting any facial movement or affecting adjacent
muscles.
There is always a small risk of asymmetry and a frozen smile so adhering to post
treatment recommendations is vital.
HOW TO GET STARTED TREATING YOUR DAO'S & SOFTENING YOUR MARIONETTE WRINKLES
Booking in for a consultation is the first step- to determine your suitability for the
treatment, and so you can gather all the information needed to make an informed
decision, if this treatment is right for you. Click the “Book Now” button to go to the
booking page, where you can make your online appointment.
The first treatment to reduce the appearance of the wrinkle may be to relax the DAO muscle first, then a combined treatment strategy to soften and lift the marionette wrinkles. This will be determined after assessing your face, reviewing your medical history and discussing your treatment goals.
Please note: Not all patients are suitable for all treatments and each patient is
reviewed and consulted by a health care practitioner first, and depending on the
outcome of the consultation, may or may not lead to the provision of a treatment.