Correction of a drooping or downward corner of the mouth can be done by both surgical and non-surgical methods. While Botox and injectable fillers can help lift the mouth corner, the only permanent method is surgical. The corner of the mouth lift has been around for decades of which my modification, the pennant technique, alleviates most of the scar concerns of the previous methods.
By definition moving the mouth corner up or even just outward (mouth widening procedure) runs into the orbicularis oris muscle. This is a complex of muscles that surrounds the mouth that enables it to act like a sphincter or to pucker the lips. While often perceived as a single encircling muscle, it is actually a confluence of different muscles. At the corner of the mouth the levator anguli oris and depressor anguli oris muscles come in at an angle to merge with the orbicularis muscle (modiolus) to create the ability to raise or lower the mouth corner.
Once the skin and superficial fat are removed in a corner lift these muscle fibers are exposed. The most medial portion of these fibers is then excised in a wedge fashion which creates a deeper defect.
The lower slip of the muscle fibers are lifted and sutured up to the superior slip to create a muscular support for the lift. The vermilion edges of the mouth corner can then be successfully inserted into the excised skin segment area wkto complete the lift.
This muscle modification works well in the corner of the mouth lift where it is done for the traditional horizontal leveling of the mouth corners or in an extended mouth lift technique. (lip curls)
Dr. Barry Eppley