DAO release – Lifting the corner of the mouth

A collage of photos of a patient before and after lifting the corner of the mouth.
DAO release: Before and After (courtesy Dr. Le Louarn, Aesthetic Surgery Journal Vol 26, No 5)

“DAO” (Depressor anguli oris) release to lift the corner of the mouth.

I have always been a fan of the Lip lift procedure. There are many reasons why it’s preferable to fillers, but the most important one is that it looks so good and natural. The effect is best in the central part of the lip. The Lip lift raises the upper lift so that your teeth are slightly exposed, creating a youthful and fresh appearance.

So what about the corner of the mouth? As you age the corner of your mouth can turn down. In the corner of the mouth, the only surgical option until recently was an incision on the lip margin. I never liked this option. For one, unlike the Lip lift procedure, where the scar is hidden under the nose, the scar is right on the lip margin. This never looks natural because the border between the red part of the lip and the skin is impossible to duplicate.

Several years ago, some physicians started injecting Botox into the muscle that turns down the corner of the mouth. The effect is striking. The corner of the mouth comes up to a normal level, and loses that scowling downward turn of the mouth. The patient looks happier. Since it’s Botox, it has to be repeated every few months.

A couple of weeks ago, a patient asked if I did the “DAO” release. Frankly, I didn’t know much about it. Luckily, the plastic surgery National meeting (ASPS) was coming up and I went on a mission to find out more about it. When I attended the ASPS meeting earlier this week I spoke to many doctors, saw presentations by surgeons who did the procedure, and read up a lot on the anatomy and physiology.

The verdict? The DAO release procedure is a winner. The reasons are as follows:

The results look great, and not just pictures, but videos showing the lips in motion. Technically, it is within the scope of any competent board certified plastic surgeon with proper knowledge of the facial anatomy. Finally, it is not a time consuming or technically complicated procedure.

I can’t wait to start offering this procedure to my patients. The procedure is as effective in men as it is in women. It is a perfect compliment to the Lip lift. To make a lip look truly younger and attractive, there is nothing like a Lip lift combined with a DAO release.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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22 thoughts on “DAO release – Lifting the corner of the mouth”

  • Laurent Chaumy says:

    This is a mail four Dr Rodriguez please. Sorry for m'y bad english but I live in Paris( France). I have a DAO problèm on my mouth. What is better please: a myectomie? Or bottox injections un thé DAO?Thank you. Kindly yours.Laurent
    • Dr. Ricardo L Rodriguez says:

      Laurent: Botox injections are effective but temporary. Myomectomy is also effective but permanent. I would recommend to do first the Botox to see if you like the result. If you do like the result, then get the myomectomy.
  • chris arehart says:

    Hat is approx. cost of the botox treatment fo downturned smiles? Ty for any info you can share. I libmve in S.C. and asked several plastic surgeons around here and none of them even did this procedure
    • Dr. Ricardo L Rodriguez says:

      Chris: We do quite a bit of DAO release both with Botox and surgically. Contact Kelly at kelly@cosmeticsurg for more info on pricing. Thanks!
  • Marta says:

    Hi. The corners of my mouth have almost always turned slightly downward. When relaxed I look sad or grumpy. I've been self conscious about this since my teen years. I'm in my forties. I can't say it has gotten much worse with age, but it certainly hasn't gotten any better. Question- You write the Botox will help bring the corners up to their "normal" level. If my norm is already a downward turn, would Botox help me at all or is a procedure more invasive in order, such as surgery? Thank you.
    • Dr. Ricardo L Rodriguez says:

      Marta: The Botox does bring the corners up because there is no opposing action from the lip depressor muscles. Perhaps you may need a "corner lip lift" that just lifts the corner of the mouth a tiny bit...but makes a big difference.
  • Colleen says:

    Is the DOA release a surgical procedure or is it using Botox? Is there a way to permanently release the DOA?
    • Dr. Ricardo L Rodriguez says:

      The DOA release is a surgical procedure. I do not do It, nor do I know anyone who is currently doing it othe Other than Dr. William Little in DC. I do it with Botox, which lasts 3-6 months. It is a great option as it allows You to see its effects and decide wether you want a permanent effect. I have several patients that get it regularly.
  • Kathy says:

    Dr. Rodriguez, 9 years ago I had a corner lip lift. Sadly the corners of my lips are turned down again. I intially had a great outcome, no visable scars, no keloids. However, I do not want to have another corner lip lift since the chance of scarring would be greater this time. My question is am I able to have Botox injections with having the previos surgery? Your time is greatly appreciated. Kathy
    • Dr. Ricardo L Rodriguez says:

      Kathy: Yes, the Botox works great. One of my staff members does the DAO with Botox every few months, and she loves it.
  • dental implants vancouver says:

    Lifting the corner of the mouth!! It seems very impossible but it is true. DAO Release is great, it definitely change and transform the face of that example.
  • family dentist in Vancouver says:

    Depressor anguli oris procedure is amazing, though in the first place is a little bit unbelievable. I will definitely recommend this DAO to my aunt. Great in information.
  • caty says:

    hi, i was wondering if you could do a video or further blog post on the procedure, as you did the lip lift, or give us some information regarding, cost, the actual procedure, the aftercare and optimal age, thanks
    • Dr. Ricardo L Rodriguez says:

      I have a few subjects on the burner, but thanks for the suggestion, we will get on it as soon as we can! Thanks for your interest
  • Noelle says:

    Dear Dr. Rodriguez, About a year ago I had a bullhorn lip lift done. Thusfar I'm very happy with the results, however, since I now have a bit of a 'downwards slope' in my upper lip, the corners of the mouth seem to be positioned a bit low. It gives me a bit of a 'disappointed look'. I was wondering if a DAO-release (the release of the depressor anguli oris) could offer a solution and, if so, if this procedure could be done under local anesthesia; if there would be any 'restraints' post-operative (for example, the chewing of hard foods); and if it would be possible to receive a 'ballpoint figure' for this procedure. Thank you very much in advance for your time! Kind regards
    • admin says:

      There is a procedure for the DAO release, which can be done under local anesthesia, but I don't recommend local anesthesia. It is very hard to keep the mouth open and steady unless you use a bite block, and that can get uncomfortable. You might want to try Botox to the DAO muscle to see if it gives you the effect you want. If you like the effect, then you can get the permanent procedure (DAO release)
  • carmen chunga says:

    i am interested in the DAO procedure ... do you know when it will be available.. thank you very much
    • Dr. Ricardo L Rodriguez says:

      The DAO procedure is available, you may want to try Botox to the area before you do the procedure to see if you like the result. The procedure is great by itself, it can also be a great complement to facelift or in combination with a lip lift.