One of the most frustrating facial concerns men bring to aesthetic providers is the 'sad face' — mouth corners that pull downward at rest, creating an expression that reads as unhappy, stern, or unapproachable even when you feel neutral or relaxed. The cause is almost always the depressor anguli oris (DAO), a small triangular muscle that pulls the corners of the mouth toward the jaw. As men age, the DAO becomes more dominant relative to the muscles that pull the corners upward, and the result is a resting expression that doesn't match how you actually feel. A small amount of Botox — typically 3-6 units per side — can neutralize the DAO and restore a neutral or slightly positive resting expression.
What the DAO Muscle Actually Does
The depressor anguli oris is one of several muscles that control the corners of the mouth. Its job is to pull the mouth corners downward — useful for expressions of sadness, disgust, or disapproval, but a liability when it's overactive at rest. In younger men, the opposing zygomaticus muscles (which lift the corners) and the fat pads that support the lower face keep the corners in a neutral or slightly upturned position. As men age through their 30s, 40s, and 50s, lower face volume loss and increased DAO activity shift the balance, and the corners begin pointing south even in neutral expression. Deep marionette lines — the grooves that run from the mouth corners toward the jaw — are a related sign of the same imbalance.
The DAO Botox Procedure — What to Expect
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Search by Zip Code →DAO Botox is a precise, targeted treatment: 2-4 units per side, injected directly into the body of the DAO muscle, typically located about 1-1.5 cm below and lateral to the mouth corner. The injections take 2-3 minutes. There's no downtime, and the mild needle marks at injection sites resolve within an hour. Results begin appearing in 5-7 days and reach full effect at 2 weeks. The result is subtle but significant: the mouth corners rest at a neutral or slightly elevated angle instead of pointing downward. You still have full range of expression — you can frown, show displeasure, and express negative emotions normally. What changes is the resting default.
DAO Botox is one of the most satisfying treatments in male aesthetics because the before-and-after is immediately visible in a resting expression photo — the sad or stern face becomes neutral — yet no one can identify that anything was done. The change reads as a personality shift: 'he seems more approachable' rather than 'he had something done.'
Who Is a Good Candidate?
The ideal DAO Botox candidate is a man who: (1) notices his mouth corners pull noticeably downward at rest, (2) gets comments that he 'looks unhappy' or 'seems stern' when he's actually neutral, (3) has relatively good lower face volume (severe marionette lines with significant volume loss may need filler to address the structural component alongside or before DAO Botox). Men with naturally flat or neutral mouth corners aren't good candidates — DAO Botox works by reducing the downward pull; if there's no significant downward pull to begin with, the treatment won't produce a meaningful change. A consultation with a board-certified provider includes assessment of your specific DAO anatomy and whether treatment is likely to produce the result you're after.
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Search by Zip Code →DAO Botox vs. Mouth Corner Filler — Which Do You Need?
Many men with downturned mouth corners actually need a combination of DAO Botox and filler for optimal results. The DAO creates the downward pull; but in men with deep marionette lines and significant volume loss in the lower face, the structural deficit also needs to be addressed. The typical approach: DAO Botox first (3-4 units per side), evaluate at 2 weeks, then add a small amount of hyaluronic acid filler to fill the marionette groove if residual depth remains. Some men are satisfied with DAO Botox alone; others need the filler component to address what Botox can't. The distinction: DAO Botox fixes the active muscle pull; filler fills the static groove that has formed over years.
How DAO Botox Fits with Other Treatments
Most men who get DAO Botox are also getting upper face treatment — frown lines and forehead are the most common concurrent areas. The combination produces a comprehensive resting expression improvement: the stern brow from frown lines is relaxed, and the downturned corners from the DAO are lifted. Together, these two treatment areas address the most common sources of the 'resting unhappy face' in men. Many providers include a DAO assessment as part of a standard consultation even if it's not the man's primary concern — because men often aren't aware of how significantly their mouth corners affect their resting expression. Find providers who treat this area at /find-botox-near-me.
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Search by Zip Code →Cost, Duration, and Maintenance
DAO Botox uses a small number of units (6-10 total across both sides in most cases), so the cost is lower than full upper-face treatment. Expect to pay $80-200 for DAO treatment as a standalone, or a small add-on charge (often $50-100) when combined with upper face treatment. Duration is similar to other facial Botox: 2.5-4 months depending on metabolism and muscle strength. Because the DAO area uses fewer units, some men find it wears off slightly faster than their forehead treatment and schedule touch-ups at the 3-month mark. Consistent treatment every 3-4 months is the standard approach.