Turn that frown upside down! How to get rid of resting B!@#H face

Hi my beauties! Let’s talk about something that I get asked about in clinic a lot - how to treat resting B!@#H face!

So what exactly does this mean? Resting B face is often observed when someone has downturning of the DAO muscles (depressor anguli orris). This is the muscle that connects the corner of your mouth with the mandible, and as we age and things start to go a little south, this muscle can start to pull downward which gives the appearance of being upset, sad, or angry.

Lucky for us, the treatment for this is relatively simple! You have 2 options, filler and botox. Filler can help keep that area turned upward, full, and happy looking while also helping to prevent irritant dermatitis from forming in the corner of the mouth due to saliva accumulation.

Botox, however, is my favorite treatment for a downward pulling DAO muscle. It’s a little quicker and a little easier, however, if you need to make sure you go see an injector that is highly skilled because this area of the face can be tricky to inject due to the fact that there are a lot of small muscles in this area that are all really important to how the lower half of our face looks and functions.

When I’m injecting someone I ask them to show me their bottom teeth because this allows me to see exactly where their DAO muscles are, and helps me get a very precise injection. Because not everyone’s anatomy is exactly the same! So I assess every patient individually.

However, I don’t recommend doing filler and botox in this area in the same treatment. This is because when you inject filler you get microscopic swelling, and if you inject botox directly after this it can lead to migration of the neuromodulator into other muscles and create undesirable results.

So I always start with 1 procedure, usually botox first, and then if there needs to be a little more augmentation we can add filler later.

The same is true for chin botox! I don’t recommend getting too much botox in the chin/peri-oral area at the same time because of the delicate group of muscles in the area. Best to do these treatments separately if needed.

Check out my YouTube video below for a more deep dive into this area of the face, and don’t forget to subscribe while you’re there to join our derm family!

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