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Turn That Frown Upside Down! Botox for Sad Smiles, and Other Lesser Known Injectable Treatments

Botox for Sad Smiles

Turn that frown upside down. A sad smile, or sad mouth, is where the corners of the lips are constantly pointing downward, looking almost as if they are being pulled down towards the chin. This gives the appearance of someone continually looking as if they are frowning, angry or sad. This effect is caused by certain muscles in the mouth being stronger than the muscles that oppose them. A Botox injection into the depressor muscle in the mouth area (anguli oris), causes it to relax, allowing the corners of the mouth to be gently lifted and upturned. The effect is instant happiness! OK, well maybe not, but within a few days of injection, the corners of the mouth will relax and the overall effect will be a happier looking smile with more upturned lips.

Tear Troughs

I have had dark circles under my eyes even since I was a child. In fact, one day in high school when I didn’t wear make-up, my counselor called me into her office and asked if I was on drugs. Seriously? By the way, an awesome message to send to young girls: make-up is good, no make-up: you like you’re on drugs.

Oooooo, I remember her well.

Anyway! I’ve always wanted to do something to fix it, but never would have imagined something was possible. Dermal fillers can be used to change the appearance of the under-eye area, not just for dark circles but other issues as well. So the area where we see dark circles under the eye is called the tear trough. The tear trough is a semicircular area under the eye from the inner corner to the outer corner. A deep tear trough can create a shadow that is perceived as a dark circle below the eye. It also creates a division between the lower eyelid and cheek and this becomes more noticeable as we age. Because aging leads to volume loss and tissue laxity in the lower eyelid, the tear trough becomes more prominent. Also, the appearance of lower eyelid bags can accentuate the tear trough, making the shadow more visible.

Dark circles under the eyes can be due to skin discoloration, the shadow caused by a protruding lower eyelid, or the bony orbital structure of the eye. Also, a lack of soft tissue support in the under eye area can accentuate blood vessels in the area, which looks like brown pigmentation….this also makes you looked tired. Using a hyaluronic acid dermal filler, such as Restylane, can provide a cushion between the skin of the under eye area and the bone, decreasing the appearance of the dark circles. The filler can also even out the groove that is sometimes visible between the cheekbone and eye socket, and in general, leaves the under eye area smoother, with a more even surface, allowing reduction in shadows and darker pigmentation.

Nose Tip Lift

When some people smile, a muscle in their upper lip pulls their nose tip down. This muscle is called the depressor nasii septi, and can be fairly pronounced in some people. A Botox injection in the upper lip (at the junction between the nasal septum and upper lip) can slightly elevate the tip of your nose. How is that possible? Like with most other Botox procedures, by injecting one muscle with Botox, other muscles untreated with Botox can work unopposed. So by weakening that depressor muscle which pulls down on the nose when the face animates, the nose tip remains stationary, giving you the appearance of a lifted nose.

Gummy Smiles

What is a gummy smile? It refers to excessive visible gum tissue when smiling. It can be caused by several issues: small teeth, short upper lip, hyperactive upper lip, or overgrowth of gum tissues. The treatment for this is theoretically much like the nose tip lift: an injection of Botox in the upper lip reduces the lifting action of lip muscles (“elevator muscles”), which reduces the amount of gums visible when you smile. Voila! More perfect starlet smile.

Brow Lift

I have always wondered how so many women I see on television or in print have such gorgeous eyebrows. That perfect curve in just the right place and the lift that places emphasis on the eye. This can also be accomplished with Botox, OR filler. With Botox, the injection relaxes the muscles that pull the eyebrow down (the corrugator, procerus and orbicularis oculi muscles). That allows the muscles that pull the brow up, (like the frontalis) to function unopposed. Are you seeing a trend here yet? Botox injections are like effectively ending a tug-o-war: weaken one side and the other side can work without opposing force. With filler, a small amount is injected near the top of the orbital rim, under the eyebrow, which gives support to the brow and also creates a lifted appearance for the eye and brow.

Ear Lobe Rejuvenation

If you’ve worn big earrings in your pierced ears most of your life, you will definitely relate to this. Or, if like me, you got your ears pierced by a 17-year -old in the mall in 1984, and one hole is lower than the other, you may be interested in fixing this issue. Ear lobes also become stretched out and elongated just due to the effects of gravity, age and time, but mostly it is caused from the constant pull of earrings. And elongated or uneven holes make earrings hang somewhat crooked. It never would have occurred to be that this it is possible to remedy the appearance of thinned ear lobes or crooked and elongated pierced-ear holes. But using a dermal filler in the ear lobe can create a plumping effect and can be used to make the uneven or stretched out ear-piercing hole look more even.

The filler adds volume to the ear lobe and helps expand and stretch the ear lobe out to a more youthful appearance, filling out any small wrinkles or creases. Fillers in the ear lobe can last longer than in any other area of the face, probably due to the lack of any muscle movement on the treated area.

Chin Augmentation

My mother had a chin implant back in 1979 in Houston. It’s not a procedure I hear people talk about very much. She also had a nose job at the same time. Doing the two together completely changed the shape of her face. Most people who want a chin implant are probably doing it to bring more balance to their face or profile, which my mother definitely achieved with her plastic surgery. But if you’re not ready to go under the knife or don’t want a permanent implant, dermal fillers can be used for a non-surgical chin augmentation. Injectable fillers can be sculpted to give the desired shape, projection, width and length to the chin. The dermal filler can last up to one year and the results rival that of permanent implants. And unlike the downside of surgical chin implants, injectable fillers are less invasive and allow more precision over the shape and size of the chin.

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