Some people visit us because they are told they look angry even when they are not making any particular expression.
This is a condition where the area below the corners of the mouth appears prominent, and the lines around the mouth point downwards.
Even if the impression is the same, the cause can be divided into two, and the approach varies accordingly.
Take just one minute to read this.
Where the Impression is Formed
There is a muscle that pulls down the corners of the mouth. If this muscle is overused, the corners of the mouth may appear fixed in a downward position even in normal expressions.
In addition, if the tissue in the cheek area sags downwards, weight accumulates around the mouth. This can create a prominent, lumpy appearance.
How to Check if the Cause is Muscular
Compare your expression when you relax and make a neutral face in front of a mirror, with when you intentionally pull down the corners of your mouth.
If it is less noticeable with a neutral face but becomes clear when you exert force, the muscle plays a significant role. Conversely, if it remains the same even with a neutral face, sagging is a greater factor.
This is merely a way to estimate, and in reality, most cases involve a combination of both.
Approach When the Cause is Muscular
The approach is to reduce muscle movement. However, if the dosage and location are not set correctly, the movement of the mouth may become unnatural or pronunciation may become uncomfortable in this area.
It is connected to surrounding muscles, requiring delicate adjustment, and there are individual differences in how long the effects last.
Approach When the Cause is Sagging
An approach that reaches the weighted layer is necessary. Procedures that address the surface skin texture may not be able to change the position of already sagged tissue.
Since the layer to be treated varies depending on the depth at which weight has accumulated, there is a process of confirming the layer before proceeding.
Summarizing the Two Branches
| Observation | Main Cause | Approach Direction |
|---|---|---|
| Less noticeable with neutral face, clear when exerting force | Muscle tension | Muscle movement control |
| Remains the same even with neutral face | Tissue sagging | Lifting that reaches the corresponding depth |
| Both apply | Mixed | Divide the proportion and proceed in order |
Mixed cases are common, and in such instances, it is best to determine which factor has a greater proportion first and then set the order.
Why There's an Order When Proceeding Together
Sometimes both approaches are performed on the same day, but not always.
If sagging is the main cause but only the muscle is treated, the change may feel minor, and vice versa. It is easier to see results by determining what plays a larger role and then setting the order.
We also consider the schedule together due to overlapping recovery periods.
Recovery and Precautions
Swelling, bruising, and a feeling of pressure may occur, and the degree and duration vary among individuals.
The mouth area is frequently used for expressions, so for a few days after the procedure, changes may feel unnatural. It is too early to judge the results during that period.
It is safer to consult with medical staff before proceeding to confirm if the method is suitable for your condition.
If you are curious about the perceived timing of Lifting & Tightening, you can also refer to the article When Titanium Lifting Actually Shows.
Frequently Asked Questions
Will treating only the muscle area resolve it?
If the cause is predominantly muscular, you may see a change. However, if the tissue has already sagged, that part will remain.
Will increasing the dosage make it more certain?
The mouth area is involved in expressions and pronunciation, so increasing the dosage does not necessarily lead to better results. It is important to precisely determine the location and amount.
Can I receive both on the same day?
It may be possible depending on your condition, but it is better to determine which factor has a greater proportion and then set the order. We also consider whether recovery periods overlap.
Can I determine my own case?
You can get an estimate by comparing your neutral face with when you exert force. However, since cases are usually mixed, it is more accurate to confirm the proportions during a consultation.
How long do the effects last?
This varies depending on the approach, individual muscle usage habits, and tissue condition. It is difficult to state a uniform duration of effect.
Visit and Consultation Information
O.N Clinic is conveniently located near Gangnam Station, making it easily accessible by subway.
It is more accurate to confirm whether muscle or sagging has a greater proportion by observing your expressions together. For any questions, you can easily inquire via Chat Now for Consultation.
Author: Dr. Oh Seung-Min (Chief Director of O.N Clinic, graduated from Seoul National University College of Medicine, Academic Chairman of the Korean Laser Dermatology and Hair Society). More details about his career can be found in Medical Staff Introduction. First published 2026-08-20 / Last reviewed 2026-08-25
This article is for general information purposes only, and appropriate treatment and results may vary depending on individual conditions.
