A downturned mouth, where the corners of the lips point downwards at rest, is caused by genetics, the pull of the muscle that depresses the mouth corners, and age-related volume loss and skin laxity. It can make people look sad or tired even when they are not. Options include filler and anti-wrinkle injections to soften the downturn, and a corner lip lift, a small surgical procedure that removes skin above each corner to lift it.
What causes a downturned mouth?
- Genetics: some people are born with corners that sit slightly lower than the centre of the lips.
- Muscle pull: the depressor anguli oris muscle draws the corners downwards; when it is strong, the downturn is more obvious.
- Volume loss: fat and bone around the mouth reduce with age, removing support from the corners.
- Skin laxity and jowls: descent of the cheeks and early jowling can drag the corners down and deepen marionette lines.
- Dental changes: tooth loss, wear or changes in the bite reduce support to the lips.
Often several of these factors act together, which is why assessment of the whole lower face is important.
Marionette lines and the mouth corners
Marionette lines run downwards from the corners of the mouth towards the chin. They are often linked to a downturned mouth and develop as the cheek and jowl tissues descend. If significant jowling is the main cause, treating the mouth corners alone may not be enough, and lifting the lower face with a facelift may be more effective. A corner lip lift addresses the position of the corners themselves rather than the jowl.
Non-surgical options
Small doses of anti-wrinkle injections can weaken the depressor muscle so the corners sit a little higher, while dermal filler can support the corners and soften marionette lines. These treatments are temporary, usually lasting a few months, and need to be repeated. Excess injection can affect smiling or speech, and filler carries risks including lumps and, rarely, blockage of a blood vessel, so treatment should be given by a trained medical practitioner. At CLNQ, these injectables are provided by the clinic’s non-surgical doctors, not by Mr Nassab.
What is a corner lip lift?
A corner lip lift is a small procedure, usually carried out under local anaesthetic, in which a precise triangle or crescent of skin is removed just above each corner of the mouth. The skin is then closed so that the corner is lifted into a more neutral or gently upturned position. It can be performed on its own or combined with a subnasal lip lift, which shortens the central upper lip. The aim is a softer, more relaxed expression at rest rather than a fixed smile.
Scars and trade-offs
The main trade-off with a corner lip lift is the scar. Unlike a subnasal lip lift, where the scar hides in the crease under the nose, corner lift scars sit on the skin at the edge of the lip and can be more visible, particularly in the first months. They usually fade over 12 to 18 months and can be concealed with make-up once healed, and in men a beard may cover them. People who form thick or raised scars may not be good candidates. Mr Nassab will discuss scar risk honestly at consultation.
Recovery and risks
Swelling and mild bruising settle over one to two weeks, and stitches are usually removed after about a week. The lips may feel tight or stiff initially, and eating and talking can feel slightly awkward for a few days. Risks include visible or widened scars, asymmetry, over- or under-correction, infection, bleeding and temporary numbness. Contact the team the same day if you develop a fever or spreading redness.
Is it right for you?
A corner lip lift may suit adults whose corners droop at rest despite good support from the cheeks, who are non-smokers and accept a small visible scar. If jowling or volume loss is the main cause, other treatments may be better. Corner lip lift surgery is quoted at consultation, and the consultation costs £150. Cosmetic surgery is for adults aged 18 and over.
Frequently Asked Questions
Why does my mouth look sad at rest?
Downturned corners are often genetic or caused by a strong depressor muscle, volume loss and skin laxity with age.
Is a corner lip lift permanent?
It is long-lasting, but the face continues to age, so gradual change over time is expected.
Will a corner lip lift leave scars?
Yes. Small scars sit above the corners of the mouth; they usually fade over 12 to 18 months but may remain visible up close.
Can anti-wrinkle injections lift the mouth corners?
Small doses can relax the muscle that pulls the corners down, giving a subtle, temporary lift.
Can a corner lift be combined with a subnasal lip lift?
Yes. The two are sometimes combined to lift both the centre of the upper lip and the corners.
