Botox blocks muscle movement. It is primarily used on the upper face- forehead, the 11 between the eyes, crows feet around the eyes, bunny lines on the nose. It can also be used on the lower face in very targeted areas: the neck platysmal bands, the fine lines around the mouth, the wrinkling of the chin, and the depressor of the mouth.
This is a journal article that looked at the anatomy of the depressor anguli oris, which forms the line that pulls the corner of the mouth down. Yes, the muscle that makes you look grumpy. The downturn to the mouth. The frown. You need to be careful when injecting here, as you don’t want to hit the other muscles in the area. Just the depressor anguli oris.
What was this study? This was in the August 2024 issue of the Aesthetic Surgery Journal. “Deciphering Depressor Anguli Oris for Lower Face Rejuvenation: A Prospective Ultrasound based investigation.”
In this they look for the DAO anatomy. They looked at it using ultrasound on 41 patients. They looked at how to identify the muscle during exam, using the labiomandibular fold (LMF). They then injected Botox.
Findings:
- They measured the DAO at 3 points: near the mouth- zone 1, midway- zone 2, and near the jawline-zone 3.
- DAO was at a depth on average of 5.26 near the mouth, 5.61 at midpoint, and 8.42 near the jaw.
- The muscle gets thinner and wider as you go from zone 1 to zone 3.
- Botox injections should only be done in zone 2 and zone 3.
- Improvements were 88% when the mouth is neutral, 32% when smiling and 15% when downturning the mouth
- They injected Botox (Allergan) 4 units on each side- 2 at each injection point.
- Patients were 73% extremely satisfied at 1 week. At 3 months 97.5% were extremely satisfied. No patients complained
My thoughts?
Love it! Meghan Douglass RN and I are both trained in how to inject here. If you have a downturn to the lateral corners of your mouth, or the fold from the mouth to the jawline (the labiomandibular fold) is getting more pronounced, this for sure is a thing to try.