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Much of one’s facial expression has to do with the mouth or perioral area. While there are over 10,000 different facial expressions, most can be lumped into six major categories. One of these categories of major facial expressions is smiling of which the mouth plays a major role. Everyone knows that an upturned smile line conveys happiness and a downturned frowning one is unhappiness.

The lip line at rest is usually seen as a straight horizontal line with the corners of the mouth being level. Whether it is by aging or one’s natural mouth development, some people develop a downturning of the corners of the mouth creating a constant frown and an undesired mouth appearance. While many perceive that a facelift can lift up the corners of the mouth, this is not true as the point of the tissue pull is just too far away. Injectable fillers can create some uplifting of the corners of the mouth but the effect is not sustained and usually only of a minor improvement.

The one proven procedure to uplift or level out a frown is the corner of the mouth lift. This very simple procedure works because it removes tissue directly at the corner of the mouth and changes the position of the lateral commissure. It was described many decades ago and has been called the Valentine Anguloplasty procedure based on the shape of the skin cutout. It works so well that the plastic surgeon must be careful to not overdo it (which is very easy to do) lest the patient is left with a permanent joker’s smile.

A recent internet report out of Asia talks about the growing trend of the ‘mouth corner lift surgery’. They describe a procedure that is identical to the well known corner of the mouth lift. They give it the name ‘Smile Lipt’ because it not only lifts up downturned mouth corners but leaves one with upturned curls for a permanent smile effect. They provided the following before and after pictures to illustrate the effect of the ‘Smile Lipt.’

While some question whether these pictures are for real, they most definitely are. One of the telltale signs of a corner of the mouth lift are small scars on the skin outside of the vermilion or red part of the corner of the mouth. These scars are difficult to hide particularly in thicker Asian skin. Careful inspection of the skin outside of the corners of the mouth in the pictures shows the scars.

Such upturned mouth curls may be a desired fashion trend in Asia, but in America this is exactly the result one wants to avoid from a corner of the mouth lift. They may be cute mouth curls in one part of the world but a undesired joker’s smile in another.

Dr. Barry Eppley

Indianapolis, Indiana

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