Don’t Worry, Look Happy

Down in the Mouth

image1Have you heard the expression, “Down in the Mouth?” Do people ever come up to you and ask, “Why do you look sad?” Even though you may have felt perfectly content, when people keep asking if you’re sad or angry, it could leave you feeling… well, sad or angry.

For many people, they can’t help projecting a sad or angry appearance, even when they’re not feeling this way. It’s a matter of DNA. Some people inherit stronger muscles, called the depressor angularis oris, which turn the corners of the mouth downward. You can reverse this expression by smiling continuously, which isn’t practical, and may even border on inappropriate in the wrong context. Remember the notorious Joker from Batman? So, while smiling is wonderful thing, you can’t do it all the time to rectify this issue.


Fillers such as Restylane, Juvederm or Sculptra can help turn the corners of the mouth upward. Note that I said help, but not correct entirely. If fillers can’t adequately address the problem, you may need minor surgery to elevate the corners of the mouth. This involves removing a small triangle of skin just above the corners of the lips, and this elevates the area permanently. The procedure is performed under local anesthesia and leaves a faint scar. The choice then becomes whether you want to trade a chronic “Down in the mouth” look for a small scar above the lip. Weighing these options is an expected part of what each patient should factor during the decision-making process for any type of surgery.

Sad or Angry Eyes

Other anatomical features that makes us look unhappy, angry or sad are the frown lines between the brows. This expression is caused by the corrugator muscles, which become stronger as we grow older and caused by frowning and squinting. We all have a reason to scowl at times, but too much frowning strengthens the muscle and deepens the lines to the point that they contract even when we are happy. As with any muscle—when you exercise it, it becomes stronger.


There’s a simple solution for treating frown lines. Botox or Dysport. If you keep up with these products, the muscle becomes weaker, as the lines become less pronounced and you can do it less frequently. Using filler is also an option to help elevate the wrinkles as well. This must be done very carefully. For truly deep wrinkles, the muscle can be surgically removed. For a saggy outer brow causing a sad look, a brow lift can be performed along with removing the muscles that makes you frown.

So, if you’re outward appearance doesn’t match your feelings on the inside, your solution may be easier than you think. And that’s something to smile about.