DAO Botox in Newport Beach
The corners of the mouth say a great deal about how a face reads — even at rest. When they turn downward, the face can project sadness, fatigue, or displeasure that the person doesn’t feel. A small amount of neurotoxin in exactly the right place changes that.
DAO Botox targets the depressor anguli oris — the muscle responsible for pulling the corners of the mouth downward. By relaxing this muscle, the mouth corners lift subtly to a more neutral or slightly upturned position at rest, softening the appearance of marionette lines and eliminating the perpetually downturned expression that many patients find frustrating.
At Plump Medical Spa in Newport Beach, Dr. Amir Mortazavi, MD assesses each patient’s perioral anatomy before treating the DAO — evaluating the balance between the depressor muscles pulling down and the levator muscles lifting up, and considering whether adjacent perioral muscles should be addressed alongside the DAO for a fully balanced result. The treatment is customized to what he finds, not applied as a fixed protocol.
DAO Botox does not lift the mouth the way filler does. It relaxes the muscle that is actively pulling the corners down — allowing the natural resting position of the mouth to be more neutral. Patients looking for significant volume or structural lift in the lower face may benefit from filler in addition to or instead of DAO Botox. Dr. Mortazavi discusses this distinction clearly at consultation.
Two concerns, one muscle
Downturned mouth corners
When the depressor anguli oris is overactive or stronger than the muscles that lift the mouth corners, the corners rest in a downward position — creating an expression that reads as sad, stern, or disapproving even when the face is relaxed. DAO Botox relaxes the downward pull, allowing the corners to settle in a more neutral or slightly lifted position.
Marionette lines
The lines that run from the mouth corners down toward the chin — named for the lines on a marionette puppet — are deepened by repeated DAO contraction over time, as well as by volume loss in the lower face. DAO Botox reduces the muscular component of these lines. For deeper marionette lines with a significant volume component, filler may be recommended alongside.
Dr. Mortazavi’s approach
The DAO is a relatively small muscle but it sits in a complex perioral environment where multiple muscles interact. Treating it in isolation without assessing the surrounding anatomy can produce a result that is unbalanced — the corners may lift but adjacent muscles compensate in ways that look unnatural.
Muscle balance assessment
Dr. Mortazavi evaluates the balance between the DAO and the levator anguli oris — the muscle that lifts the mouth corners. If the levator is weak or the DAO is unusually strong, the dose and placement are adjusted to produce the most natural correction without overcorrecting.
Perioral context evaluation
The DAO treatment is evaluated in the context of the full perioral area — lip position, mentalis activity, platysmal pull, and any existing filler. Adjacent muscles that may be contributing to the downturned appearance or marionette line depth are identified and included in the treatment plan where appropriate.
Volume assessment
For patients with deep marionette lines, Dr. Mortazavi evaluates how much of the line depth is muscular versus volume-related. When volume loss is a significant contributor, filler at the marionette line or prejowl area may be recommended alongside DAO Botox for a more complete correction.
Left-right symmetry
DAO strength is commonly asymmetric — one side pulling down more than the other. Dr. Mortazavi assesses and doses each side individually rather than applying the same units bilaterally, correcting asymmetry rather than preserving it.
What to expect
Treatment
One to two injections on each side, placed precisely into the depressor anguli oris below and lateral to the mouth corners. The treatment takes under 5 minutes. Most patients find it very comfortable — the dose is small and the needle is fine. No numbing is typically required.
Onset and duration
Results begin to appear within 3 to 5 days as the DAO relaxes. The full effect is visible at 2 weeks. Duration is typically 3 to 4 months, consistent with other small facial neurotoxin areas. Patients who treat the DAO alongside their regular Botox appointments find it integrates naturally into their overall facial maintenance schedule.
What the result looks like
At its best, DAO Botox produces a result that is noticed but not identified — people remark that the patient looks well-rested, happy, or more relaxed, without being able to point to what changed. The mouth corners settle in a more neutral position and the face reads as more approachable at rest. This is the goal: a correction that looks like you, not a correction that looks like something was done.
The perioral area is one of the most nuanced regions to treat with neurotoxin. Small errors in placement or dosing show clearly — the mouth is one of the most expressive parts of the face and patients notice when it doesn’t move the way it should. Dr. Mortazavi assesses the full perioral environment before treating the DAO and customizes the approach based on what he finds. All injections performed personally.
Frequently asked questions
What is the DAO muscle?
The depressor anguli oris — DAO for short — is a small triangular muscle that runs from the jaw up to the corners of the mouth. Its function is to pull the mouth corners downward during facial expressions. When it is overactive or stronger than the muscles that lift the corners, it keeps the mouth corners in a downturned position even at rest, creating an expression that reads as sad or stern.
What does DAO Botox do?
DAO Botox relaxes the depressor anguli oris, reducing its downward pull on the mouth corners. This allows the corners to settle in a more neutral or slightly upturned resting position. The result is a more relaxed, approachable facial expression at rest — without looking like anything was done.
Will DAO Botox lift my mouth corners significantly?
DAO Botox produces a subtle, natural correction — not a dramatic lift. It removes the active downward pull on the corners, allowing them to rest in a more neutral position. Patients looking for significant structural lift or volume in the lower face may benefit from filler in addition to or instead of DAO Botox. Dr. Mortazavi discusses realistic expectations clearly at consultation.
Can DAO Botox help with marionette lines?
Yes — partially. DAO Botox reduces the muscular component of marionette lines by relaxing the muscle that pulls the skin down repeatedly. For marionette lines that have a significant volume-loss component — which is common in patients with more advanced aging changes — filler may be recommended alongside the Botox to address both the muscular and structural contributors to the lines.
Is DAO Botox safe near the mouth?
Yes, when placed correctly. The risk with DAO treatment is injecting too close to the modiolus — the complex muscular node at the corner of the mouth — which can cause temporary asymmetry or weakness in the mouth corner with smiling. This is a placement issue, not an inherent risk of the treatment. Dr. Mortazavi’s assessment of the perioral anatomy before injecting is specifically designed to avoid this.
Can the DAO be treated at the same appointment as other facial Botox?
Yes. DAO Botox is commonly added to appointments that include forehead, glabella, lip flip, or bunny line treatment. It is priced at $150 regardless of whether it is performed alone or alongside other areas.
How much does DAO Botox cost at Plump?
DAO Botox at Plump Medical Spa in Newport Beach is $150, whether performed as a standalone treatment or combined with other areas in the same appointment.
Related treatments
DAO Botox is often combined with these treatments for a complete lower face result.
Schedule a consultation
DAO Botox for downturned mouth corners and marionette lines is available at Plump Medical Spa in Newport Beach, serving patients throughout Orange County and Southern California.
4667 MacArthur Blvd, Suite 310 — Newport Beach, CA 92660
(949) 568-7544 — info@plumpmedicalspa.com
Tuesday – Saturday, 10am – 6pm — By Appointment Only