It’s a common misconception that Botox is used only for lines and wrinkles in the upper half of the face, such as frown lines, forehead lines and crow’s feet. Botox can safely and effectively be used in the lower half of the face as well. Careful placement of small doses of Botox around the mouth can help with upper and lower lip lines, chin creases, chin dimpling, and it can even raise the corners of the mouth in people with down-turned smiles.

Let’s first review the anatomy of the area so that we can understand how Botox can achieve these goals. Vertical upper and lower lip lines, or “smoker’s lines” as they’re commonly referred to, are caused by over-activity of the orbicularis oris. The image below shows you the action of this muscle, and you can see how over time the lines will form in the skin where it is creasing due to the action of the muscle.

The orbicularis oris is a muscle that encircles the mouth just under the skin, and it allows you to “pucker-up”, as they say. Activities like kissing, drinking through a straw or whistling are common actions that use this muscle. Not just smokers get these lines; age, genetics, sun exposure and a host of other factors can lead to these lines even in people who have never smoked. The image below shows the anatomy of this muscle.


Botox, in doses of 2-5 units, can be injected in two or four injections sites along the upper lip, right at the border between the lip and the skin. This then slightly relaxes the orbicularis oris muscle, softening the lip lines. The effect of the Botox can also cause the upper lip margin to drift upward slightly, created the effect of a larger, fuller, more youthful upper lip. Botox, also in doses of 2-5 units, can be injected at three injection sites along the lower lip to achieve the same softening of lower lip lines. It’s important to keep in mind that when Botox is used in this muscle, some people can experience temporary sensations similar to numbness as well as temporary difficulty with actions like sipping drinks through a straw. These side effects are usually limited in time to one or two weeks after injection.

Over-activity of another muscle in the lower face, the depressor anguli oris, can lead to the appearance of a down-turned smile in certain people. This can be distressing because affected individuals feel that they look as though they’re always sad or frowning. The image below is an example of this phenomenon.

The depressor anguli oris does what its name says. It depresses the angle of the “oris”, which is the latin root word for mouth. This muscles allows you to pull down the corners of your mouth, as when you grimace or cry. It’s often called the “cry-baby” muscle. This muscle is triangular in shape, with the apex at the mouth corner and the base of the triangle along the angle of the jaw. The anatomical image below shows you this muscle.

Botox, when injected in one or two injection sites into the belly of this muscle, will relax the muscle. The dosing can vary from as little as 5 units to as many as 10 units into each muscle. Then, the corners of the mouth will drift slightly upward in the resting state. This improves the appearance of a down-turned smile. The action is not enough to actually curve the lip corners upward, but this effect can be achieved by using fillers after the Botox has taken effect.

If you have more questions about Botox for the lower face, Dr. Lawton offers free consultations and can answer all of your questions and concerns. Call us at 714-846-5950 for an appointment of email us through our website at

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