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CosmeticSurg Blog

Dr. Rodriguez discusses Plastic Surgery, Medicine, and Stem Cell Research

Smile Surgery to Help Permanent Frowns

A recent article in the Wall Street Journal highlighted a Korean Plastic Surgeon who is popularizing the so called Smile Surgery. MSN News also recently featured an article about smile surgery, called a “smile lipt,” – a combination of the words “lip” and “lift.” While this procedure may sound odd, there are definitely some patients who are good candidates for this procedure. I have performed this procedure, also known as the Corner Lip Lift in my practice in Baltimore.


Some people have a distinct permanent frown type expression and Smile Surgery can help them because it lifts the corners of the mouth.  The procedure is performed by Plastic Surgeons and it helps change the permanent sad or angry look to a more pleasant expression. This technique is different than a traditional lip lift procedure, as that technique focuses solely on the long space between the upper lip and the base of your nose. A Lip Lift does not address the corners of your mouth. The Smile Surgery focuses exclusively on lifting the corners of your mouth.

Since I do lip lifts and mouth rejuvenation quite often, I’d like to point out a few technical details for the procedure that addresses only the corner of your mouth and helps improve your smile.


botox logoBotox is a great option for those too timid to commit to a permanent procedure.  This non surgical option is fairly popular. We inject Botox to the outer corner of the lower lip, where the Depressor Anguli Oris (DAO) is located. This muscle pulls the corners of your mouth down and out. When you weaken the muscle with Botox, the corner of the lip comes up naturally from the pull of the lip elevator muscles. You lose the ability to turn the corner of the mouth down for 3-6 months. It is not unusual for patients to have this procedure when they come in for Botox to the frown lines of the forehead.


DAO Release

facial muscles surrounding lipsThis procedure divides  and cuts the DAO muscle. It is more like a permanent Botox.  I performed my first DAO release in 2008 and was pretty excited about it at the time. However, I no longer perform this technique as I think cutting the muscle introduces unnecessary risk.  I think the Corner Lip Lift is a much better alternative . As with the upper lip lift, I prefer not to cut muscle, so I have moved away from this technique.

Corner Lip Lift

smile surgery illustrationThis is my procedure of choice to lift the corners of the lip. The objective is to re-position, upwards, the lateral commissure (where upper and lower lips meet) as seen on the illustration marked as an upward arrow.  On the left side of the picture we see the outline of the incision made to elevate the corner of the mouth. The arrow shows the direction that the corners are moved up.  This is a very subtle and tiny movement.

It is important to keep two things in mind. First, you do not want to extend the lateral commissure out unless you have a short mouth. Otherwise, you can come out looking a little bit like the Joker. Secondly, the incision line on the corner of the mouth should not be too long because you want to keep the white roll of the vermilion border as long as possible.

I prefer the corner lip lift because it does not affect lip movement, which is very important for expressing a full range of emotions. In my practice we use it less often than the lip lift, but some patients find that after a successful lip lift they still want a more “uplifted” look, more of a smile. In those instances, the corner lip lift can be the perfect solution.


Yes, as stated above, some patients not only have long spaces above their upper lips, but the corners of their mouths droop downward. When desired from the outset, I can perform both the lip lift and the corner lip lift during the same surgical session.

Beautiful lips are often identified by a nice cupid’s bow and the perfect amount of space between the upper lift and the base of the nose. In this video I talk about lip lifts, lip augmentations, and avoiding the dreaded duck lips. Check it out and, as always, feel free to ask questions about smile surgeries and corner lip lifts in the comments.

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  • wrote
    November 19, 2015 at 10:45 am

    I’ll put you in touch with Kelly and she will be happy to help you.
    She can be reached at kelly@cosmeticsurg.net

  • wrote
    November 19, 2015 at 10:42 am

    Yes there are 2 specific things you can do with Botox.
    The injection of Botox between the eyebrows and at the top of your nose between the brows will take care of your frown.
    The injection at the corners of the lower lip will help your smile. We do this quite a bit.

  • wrote
    November 19, 2015 at 10:39 am

    Many University Medical Centers have clinics where residents perform surgery under the supervision of their faculty. I suggest you enquire at one of these Medical centers.
    Florida has many surgical centers with Plastic Surgery training programs so I know you will find something if you try hard.

  • wrote
    November 10, 2015 at 3:52 pm

    I am a 53 year old white women who has a severe case of turned down lip corners. They are long deep and the same on both sides. I never use to have this. Maybe clenching did it? Had a few offel years of stress. Can you use me as a case subject for start to finish photos, study? I can not afford the procedure. Please help me or ask your collegues in Florida to help me. Thank you, Cathryn

  • wrote
    November 9, 2015 at 8:08 pm

    I have a natural frown when my face is at rest. Is there a procedure using botox which would allow me to smile lifting my lips into more pleasing look and then be injected which would then prevent me from frowning? Thank you.

  • wrote
    November 4, 2015 at 3:35 pm

    I’d like to find out more? I’d care to find out more

  • wrote
    July 19, 2015 at 10:03 am

    All questions regarding price are handled by Kelly at kelly@cosmeticsurg.net.
    I will forward her your request. BTW, we do separate the muscle from the corner of the lip to allow it to “turn the corner”, but the bulk of the muscle stays intact.
    Thanks for your interest!

  • wrote
    June 12, 2015 at 6:10 pm

    Dear Doctor Rodriguez:
    What is your ballpark price to have both the smile and lip lift surgery? I like your ideas of it being like permanent botox and not cutting muscle.
    Thank you and regards!

  • wrote
    June 6, 2015 at 2:20 pm

    First of all, everybody has a degree of asymmetry (unevenness) in every single aspect of their face and body.
    As far as your case is concerned, I think I would need to know a lot more about your history and see your lip in motion before I could make any recommendations.
    For something reversible, you could try botox on the right corner of the mouth to deactivate the depressor muscle on that side.
    Contact Kelly at kelly@cosmeticsurg.net if you are interested in a virtual consult.

  • wrote
    May 11, 2015 at 7:58 pm

    Hello! I have always had a problem with the sides of my mouth being uneven. Whether I’m smiling, talking, or not moving my lips at all, the left side has always had a nice, slightly-upward curve while the right side points directly down (people tend to think I’m smirking when I’m smiling!). I’ve tried to look in the mirror and contort my facial muscles to make my lips look even, but no matter what I do, it never looks right. Would the lip lift and/or the corner lip lift help me? Like, could I get it just on the right side of my lips or something? If not, is there any procedure you could suggest for me, or will I just have to deal with it? Thanks!

  • wrote
    April 21, 2015 at 11:23 am

    Not many people do this procedure. I myself, very experienced at lip lift waited a while before starting to do corner lip lifts routinely.
    We do get lots of patients from out of town. Since the procedure is done under local anesthesia a lot of patients come the day before surgery and leave the day of surgery or the day after. It is a very simple process.
    Contact Kelly if interested kelly@cosmeticsurg.net

  • wrote
    April 5, 2015 at 3:51 am

    Hi from Texas!
    I am hoping that you know of another qualified Plastic Surgeon in the Houston area who is doing the Corner Lip Lift Proceedure. I have called a few, but, they were not familiar with the actual Corner Technique.
    My entire life, people constantly ask me, ‘Are you mad at me’, or ‘Come on, smile! Things can’t be that bad!’. I am always in a great mood, thanking The Lord for all His blessings, especially since I was not suppose to be alive right now!! I really want the outside world to see how wonderful life really is, no matter what problems you face (I’d like to do it smiling more).
    If you know anyone in the Houston area, even if they can only give me a place to start, that would be wonderful!
    Thank you!

  • wrote
    April 2, 2015 at 10:44 am

    From what you are describing it seems like you are a perfect candidate for Lip Lift and corner lift. The Lip Lift will ensure you show the upper teeth, the corner lift will turn up the corners just barely so you have a relaxed appearance.
    Contact Kelly at kelly@cosmeticsurg.net and she will be able to answer a lot of your questions and set up a virtual consultation so aI can make more specific recommendations.

  • wrote
    March 28, 2015 at 7:14 pm

    I have a smile that seems like a frown and not very friendly! When I open my mouth and my jaw drops my bottom teeth show. I am unhappy with it because it makes me feel like I have an ugly smile and an old one at that! Can you advice me what I need because I am like to change my self up, I feel tired and need some kind of help with my smile! Thank you for your help! I would appreciate any help!

  • wrote
    March 26, 2015 at 4:30 pm

    You are probably swollen.
    At three days after a lip lift most patients are still very swollen and stiff.
    Talk to your surgeon because depending on what surgical technique he used you may take anywhere from a couple of weeks to a month for all the swelling to go down.

  • wrote
    March 19, 2015 at 8:32 pm

    Hello Dr. Ricardo L Rodriguez,

    I just had a lip lift AND corner lip lift done 3 days ago to allow for more teeth to show. That was my goal going in. Now when I smile none of my upper teeth show at all because my upper lip turned out super thick and won’t raise all the way up. Is this normal? Is it due to the swelling? Will it change once the swelling go down? I am so upset because now when I smile trying to show teeth my upper lip just covers them completely.

    Thank you for your time,


  • wrote
    March 11, 2015 at 12:11 pm

    Not many surgeons do the Lip Lift. Indeed, most of the patients I get are from out of town, including some from Europe.
    I will let Kelly at kelly@cosmeticsurg.net know of your interest, and she can talk to you about pricing.
    Thanks for your interest!

  • wrote
    March 7, 2015 at 12:26 am

    Just approximately (or a range) how much would a lip lift run? And is this a technique used commonly or a procedure unique to the Dr.?
    Thank you

  • wrote
    March 1, 2015 at 6:02 pm

    I do not know any surgeons in Australia.
    We do have a major international clientele here and have operated on several Australian, Singapore, etc. patients.
    You may start by trying out Botox in the corners of the mouth.

  • wrote
    March 1, 2015 at 5:58 pm

    I will let Kelly know of your interest so she can answer more questions and if you want you can send pictures for us to evaluate.

  • wrote
    March 1, 2015 at 3:42 pm

    Happy Birthday!!!!
    There’s a range of things we could to from a lip lift, to a corner lift, etc. but to really get a good idea we would need to see pictures.
    Contact Kelly at kelly@cosmeticsurg and she can give you details so we can set up a Skype or phone conversation.
    We’re looking forward to hearing from you, and envious of the fact that you are in Florida! God bless the sun!

  • wrote
    February 21, 2015 at 1:44 am

    Hi Dr. Rodriguez, Plastic surgery is something I have never considered before, but now at the age of 48 I am almost suicidal over my non-existent smile. Not that it bothers me, it’s my face and I’m used to it, but every day I get people telling me to smile and stop being so grumpy, and it has finally broken my spirit. After doing some internet research on the different forms of ‘smile-lift’ available I like your solution the best. However I live in Australia and would never be able to come to you. Hence this email.do you have colleagues over here, or would you know how I could find a reputable surgeon who could do this surgery for me here in Melbourne, Australia. Your help would be greatly appreciated.

  • wrote
    February 19, 2015 at 12:27 am

    I want to change frown lip into a smiley lip heart shape.

  • wrote
    February 9, 2015 at 5:29 am

    I will be 65 on march 2 2015 and have a frowning face.
    13 years ago Dr Edward Trupman of MiamI did the refresher
    surgery on my face and when a teen I had nose reconstructive
    surgery thanks to a breathing problem by Dr Ralph Millard of Miami.
    I now live in Ft. Pierce, Florida as a retired Kindergarten/First Grade
    teacher of the Gifted/ESL Can you help me smile, again, when I awaken
    and can it be there throughout the days of my life until I am called home? That would be awesome!

  • wrote
    February 8, 2015 at 8:38 am

    How long have you had this problem? Is it relatively recent? Is it the result of an accident?
    In any case your condition would need to be carefully evaluated before we knew what the best solution is.
    If you are interested, we could set up a virtual consult so I can evaluate pictures or do Skype so I can see.
    Contact Kelly at kelly@cosmeticsurg.net if you are interested

  • wrote
    January 22, 2015 at 8:56 am

    I have the left side of my mouth goes up when I smile but my right side don’t move I would like to know if you could help me to smile right please let me know something I would like to smile pretty before I leave this earth

  • wrote
    January 21, 2015 at 12:55 pm

    There are several factors here including the “ortho work”. Is it jaw bone work or tooth work? BTW, both can affect the smile.
    To give you an educated opinion I would need a lot more information. In any case, if you are interested, contact Kelly at kelly@cosmeticsurg.net and she can tell you what you would need to set up a virtual consult.

  • wrote
    January 21, 2015 at 1:19 am

    I am male 27 yrs old and I am doing ortho work (yeah late in the game) I am now concerned with the way I smile. My smile as much as I try always looks like a frown. I was told by ortho that it was due to my upper jaw being further out than most people. What I dont understand is what that has to do with lips. Can an ugly smile really be turned into a great smile?

    Los Angeles CA.

  • wrote
    December 11, 2014 at 4:29 pm

    You live in a beautiful part of the world. I went once to Vancouver once and was utterly charmed by the city. I am waiting for the next plastic surgery meeting scheduled there to go again.
    We do a lot of lip lifting and corner lip lift is a subtle thing that people are usually very happy with because the scar is almost invisible and the effect is very pleasant and nobody will think you had anything done.
    I will have Kelly at kelly@cosmeticsurg.net contact you for more details.

  • wrote
    December 11, 2014 at 4:03 pm

    I think the corner lift helps a lot of people, and possibly also you of course. To get a better idea of what we could possibly do with you, I think we need photographs to evaluate what the fat grafts did.
    Anyways, I’ll let Kelly at kelly@cosmeticsurg.net know so she can give you more info.
    Thanks for contacting us!

  • wrote
    December 4, 2014 at 3:48 am

    I am having a lower facelift on Dec. 16 2014. After that, maybe within 6 mos. I intend to have a lip lift done in your office…..at least that’s the plan now.
    I live in Victoria B.C. on Vancouver Island, above Washington State.
    Over 10 years ago, CBC TV said we were the most physically fit city in Canada. I used to hike all over our beautiful island. I want to do it again. Too much botox or say, lip surgery is eschewed here by the people with whom I associate.
    The ’70′s icon Katharine Ross has the subtle corner lip lift that looks so natural that if I did the same it would be accepted by my people………
    Could you achieve that same natural look? The corners of her mouth look extended into a slight, very slight elevation…so in my imagination I don’t see the width of her mouth shortened to make the little sort of curve…..but I really don’t know what I am talking about when it comes to surgery….
    Thanks for any reply

    sincerely, Linda

  • wrote
    November 21, 2014 at 10:35 am

    Dr Rodriguez,

    I had fat injections to the folds running from the nose down to my mouth and some around the mouth and now my mouth has this permanent frown with lines coming from both corners of my mouth. Would the corner lift take care of these lines? I look older now than before the fat injections. I’m very self concious about it
    Thank you for your help

  • wrote
    September 17, 2014 at 8:36 am

    I cannot say for sure if the downturned lips are from Botox to the masseter. The masseter muscle is not related to the muscles of expression and is in the back of the jaw right in front of the lobule of the ear. Something else may have happened or what was injected was not the masseter.
    The cause of down turned lips is complex. Of course aging is the biggest factor, but fat atrophy in the area around the lip is also a factor.
    In any case, it seems you are a good candidate for “corner lip lift”. The corner lip lift will not rejuvenate your entire face, it only affects the corner of the mouth but it’s effect is noticeable. I have not seen you in pictures, and you may want a virtual consult, but a lip lift may also help and that has a more general effect, especially when combined with the corner lip lift. I’ll have Kelly at kelly@cosmeticsurg.net contact you for any more questions you might have.

  • wrote
    September 16, 2014 at 7:31 pm

    Hello Dr. Rodriguez,

    I have downturned lip corners. I never noticed this until I turned 40, after a Botox injection of the masetter muscle about a year ago. I have not gotten any more botox since then as I did not like my lip corners turned downward. I thought I have downturned lip corners because of skin laxity in the buccal area. Is corner lip lift also a good option for facial rejuvenation? I wasn’t born with downturned lips. Thank you!

  • wrote
    September 7, 2014 at 3:58 am

    I really like your way of expressing the opinion and sharing the information.

  • wrote
    July 21, 2014 at 3:48 pm

    Thank you Dr. Rodriguez. That makes sense (lower lip looks fine after upper lip lifted). I will contact Kelly for more questions or appointment.
    Thank you for your comment. Look forward to seeing you soon.

  • wrote
    July 13, 2014 at 2:43 pm

    Although practically every patient that has a lip lift asks for something to be done to a lower lip, I find that once the upper lip is lifted the lower lip looks fine. I offer patients to do a corner lift or something for the lower lip later, but the truth is only a few ask for a corner lip lift after the upper lip lift has been done and nobody to date has asked for something to the lower lip.
    I will let Kelly at kelly@cosmeticsurg.net so she can give you more info.

  • wrote
    June 6, 2014 at 11:50 pm

    Hi Dr. Rodriguez,
    I am thinking about getting a lip lift (along with corner lift and botox for DOA release). I also would like to improve my lower lip. I am wondering if you perform a V-Y plasty on lower lip? I know the filler is the option but I’m looking for something permanent without putting anything foreign to my lips.

    Thank you,

  • wrote
    May 18, 2014 at 1:54 pm

    Ms. E
    Everybody gives names to their procedures as a way to make them easier to remember by patients.
    I do anguloplasties frequently. The most important thing is not to extend the length of the lip which is what I think a lot of surgeons do when they do a corner lift. I think that creates too much of “smile” and looks unnatural. I agree with you, the only objective is to eliminate the downward turn. Contact Kelly at kelly@cosmeticsurg if you are interested in more info.

  • wrote
    May 18, 2014 at 1:54 pm

    Ms. E
    Everybody gives names to their procedures as a way to make them easier to remember by patients.
    I do anguloplasties frequently. The most important thing is not to extend the length of the lip which is what I think a lot of surgeons do when they do a corner lift. I think that creates too much of “smile” and looks unnatural. I agree with you, the only objective is to eliminate the downward turn.

  • wrote
    May 18, 2014 at 1:49 pm

    We get a lot of patients from out of town. We have several from Europe, including patients who knew about me but decided to stay nearer to home and get the procedure done but were not satisfied with the results.
    As far as the corner of the mouth it may be the way you move your muscles when you speak. Try to adjust the way you speak while standing in front of a mirror. You will be surprised at you much you can accomplish. Actors train themselves to imitate facial mannerisms and facial quirks, so you can do it too.
    If you are interested, we can set up a virtual consult.

  • wrote
    May 6, 2014 at 6:32 pm

    I would love to see actual photos of your corner lip lift.
    Have you done a Valentine anguloplasty perfected by Dr.Flowers, & currently done by Dr. Cedeli? I equate the smile lipt popular with Asians, which I don’t want. I just want to rid my frown. Thank you.

  • wrote
    May 4, 2014 at 10:07 am

    Hi Dr. Rodriguez,
    I have been researching lip lifts for quite a while now as I am very interested in having one done and in all my searching it seems that all arrows point to you when it comes to the best surgeon for the job! I would love an upper lip lift to help with a long upper lip and no tooth show or natural parting of the lips when mouth is at rest. My question however is regarding the corner lip. One side of my mouth pulls downward when I smile and speak and it really bothers me! It’s not noticeable when my mouth is at rest however. What would you recommend for this? I so wish I was closer to your location!!

  • wrote
    January 29, 2014 at 10:53 am

    Ça va?
    We get many patients from Canada (y compris beaucoup de francophones!)
    Kelly, at kelly@cosmeticsurg.net will be happy to help you arrange a virtual consult. We can use Skype or FaceTime, and I’d be delighted to speak to you.
    À Bientôt!

  • wrote
    January 28, 2014 at 6:44 pm

    Hi Dr. Rodriguez,

    I live in Montreal and I am interested in having a lip augmentation volume and lifting. Could you please tell me how we can arrange a consultation?

    Thank you!

  • wrote
    January 12, 2014 at 6:38 pm

    Is this a Persian name?
    I have forwarded your email to Kelly, she will be able to help you out.
    Looking forward to hearing from you.

  • wrote
    January 8, 2014 at 3:08 pm

    my name is chehrazed, i am from Montreal,i want to now the price of Mouth corner lift/
    thank you

  • wrote
    November 3, 2013 at 1:01 pm

    Sorry for the delay, I have been in a medical mission trip to Armenia and just got back.
    We do get lots of out of town patients. Some see me the day before, some the day of surgery.
    We’d love to chat with you, contact Kelly at kelly@cosmeticsurg.net and she will give you details about pricing, travel, etc.
    Ideally, we could Skype or FaceTime (if you have iPhone or Mac) to get a better idea of your goals.
    Looking forward to hearing from you!

  • wrote
    November 3, 2013 at 12:56 pm

    Hello Laura!
    Sorry I did not get to this before, I was in a medical mission trip to Armenia and just got back.
    This procedure achieves precisely what you are looking for.
    I would look at my previous posts on this one on technique, and others that you can find here
    Contact Kelly at kelly@cosmeticsurg.net and she’ll be more than glad to send you info and set up a Skype session if you are interested.

  • wrote
    October 18, 2013 at 11:50 am

    While doing self portrait drawings in an art class we were learning about facial proportions and shapes of facial features. My art teacher pointed out in class that student XYZ always looks like he is smiling because the corners of his mouth naturally turn up, while if you’ll look at Rebecca’s mouth, it looks like she is frowning because the corners of her mouth naturally turn down. That statement and realization has haunted me ever since and I was very interested in this article as there may be hope to correct my infinite frown, which has never been a true reflection of my feelings or mood.

  • wrote
    October 14, 2013 at 2:59 pm

    I would like to do the corner lip lift, I don’t live in Baltimore but will trave there to do it, can you tell me more or lest the price of this procedure.
    Thanks in advance, and please let me know what are the times available to see the doctor perhaps next week, and can I see the dr and have the procedure the same day?

  • wrote
    October 7, 2013 at 9:05 pm

    Hi, I am happy with the shape of my lips but would like to shorten the distance between the nose and top lip, would this procedure work well for that? Would it change th shape of the lip dramatically?

  • wrote
    October 7, 2013 at 2:12 am

    Thank u so much for replying! I honestly can’t wait to get them done. Ill be seeing you soon i guess :)

  • wrote
    October 3, 2013 at 11:08 am

    The scarring under the nose for the main lip lift is almost invisible and on some patients you literally have to get up inches away from the face and stretch the skin to see the scar. On practically every single patient that comes for a 4 month post op visit, if I have not seen the chart I cannot tell I did a lip lift unless I look at the pre op photos.
    The corner lift is a subtle scar because it is at the corner of the lip. A trained eye can see it but I doubt anybody else will. I am doing the corner lift more and more, but it is definitely less common than the conventional lip lift.
    The short answer to your question is that people close to you will know you look different but will not be able to pinpoint what it is.
    Call Kelly! She’ll be happy to help you at kelly@cosmeticsurg.net

  • wrote
    September 27, 2013 at 5:12 pm

    i’m really interested in getting the corner lip lift done along with the upper lip lift Dr Rodriguez. Can you tell me if either of them leave any obvious scarring? Will anyone be able to tell i had these surgeries done?

    Thank you