Help for people who feel happy when face indicates otherwise

By E. Ronald Finger CONTRIBUTOR

For many people, their outward appearance doesn’t seem to match their demeanor nor their feelings. Happy people sometimes look sad or angry because of natural lines and facial muscles.

A common complaint of patients is they can’t help projecting a sad or angry appearance, even when they are not feeling this way. It might be a matter of DNA.

Some people inherit stronger muscles, called the depressor angularis oris, which pull the corners of the mouth downward. One can reverse this expression by smiling continuously, which isn’t practical and even inappropriate in the wrong situation.

Remember Jack Nicholson as the notorious Joker from “Batman”? So, while smiling is a wonderful thing, doing it all the time may look a little strange.

An effective non-surgical, but temporary treatment is Botox, Dysport, or Daxy (which lasts twice as long) injected into the muscle below the corner of the mouth, allowing the corner to move upward. Fillers such as Restylane and Juvederm can also help turn the corners of the mouth upward slightly.

Alternatively, PDO threads might do a better job of both lifting and stimulating your own elastin, improving skin elasticity. Threads can be inserted in a few minutes during an office visit.

Ultimately, some patients may need minor surgery to elevate the corners of the mouth. This involves removing a small