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Practicing Safe Aesthetic Medicine

Treatment for Marionette Lines
Downturned / Sad Mouth- Marionette Lines

Medical Prescription Icon- Prescription Only | Doctor Consultation Required Botox Injection

Treatment Summary

  • Anaesthetic Icon



  • Treatment Results

    Results | Duration

    2-3 Weeks | 4-6Months

  • Treatment Procedure Time

    Procedure Time

    20 Minutes

  • Treatment Risk and Complications

    Risk & Complications

    Allergic Reactions, Bruises, Swelling, Eyebrow/eyelid dropping asymmetry

  • Full recovery from treatment

    Full Recovery

    No Downtime

  • Back to Work from Treatment

    Back To Work


Some individuals, particularly women, possess persistent downturned mouths. At the corners of the mouth, furrows (marionette lines) appear from the oral commissures and express sentiments of sadness and melancholy. This inverted smile is the result of depressor muscles pulling the corners of the mouth inferiorly. Small, carefully injected doses of botox can weaken this pull and enable the levator (lifting) muscles to raise the corners, softening the depression from the angle of the mouth.

Although botox can successfully uplift the mouth, dermal fillers may be required for deep lines extending from the corners of the mouth and can be used in conjunction with botox.

Indication: Down-turned corners of the mouth or marionette lines.

Muscle Targeted: The depressor anguli oris muscle; a triangular shaped muscle that originates at the jawline and inserts into the corner of the mouth.

Muscle Action: When contracted the muscle pulls down and depresses the corners of the mouth which can give the appearance of a 'sad mouth'.

Marionette Lines Treatment: The muscle is identified on ??grimacing?? and a small injection of botulinum toxin is placed at the origin of the muscle on either side of the jawline. When this muscle has relaxed it allows the levator muscles of the of the mouth to help lift the corners.

Adjacent muscle movement: Some individuals have related excessive movement or dimpling of the chin.

Possible Side Effects:

  • Smile asymmetry
  • Very rare: Difficulty with certain oral functions â?? elocution, eating, drinking


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