BITTERNESS FOLDS
What is the bitterness fold ?
The bitterness fold is a wrinkle on either side of the face that runs down from the corner of the mouth to the oval of the face.
The name derives from the sad, tired look this crease creates.
Aesthetic medicine techniques are effective in removing bitterness lines.
Treatment of bitterness folds in video
What causes bitterness lines ?
The appearance of bitterness lines is linked to ageing.
Several changes to the face are responsible for them:
♦ The fall (ptosis) of malar fat: the fat found at cheekbone level descends to the oval.
♦ Loss of support in the central and lateral part of the cheekbone: the fat in the cheekbone melts away, the bone resorbs and their supporting role is lost.
♦ Loss of support in the chin area: fat and bone melting at this level are responsible, the corner of the mouth is no longer supported and descends.
♦ The action of the lowering muscles of the labial commissure, particularly the DAO (depressor anguli ori) muscle: they pull the corner of the mouth downwards.
♦ Reduced skin thickness.
A poor lifestyle aggravates the development of these folds. The factors responsible are smoking, lack of sleep and hydration, sun exposure…
→ Find out more about wrinkle filling
Stages of facial ageing
The Metz laboratory has created a severity scale for bitterness folds based on the presence, length and depth of the fold. This classification guides therapeutic management, with the most severe stages often requiring surgery.
♦ Stage 0: no visible fold, continuous skin line.
♦ Stage 1: shallow but visible folds with slight hollowing.
♦ Stage 2: moderately deep folds, skin break visible only on the face without expressions.
♦ Stage 3: very long and deep folds, prominent skin break.
♦ Stage 4: extremely long and deep folds, very visible.
How can I get rid of bitterness lines naturally ?
Some women like to dedicate a few minutes of their day to facial gymnastics.
The muscular component plays a small role in the appearance of bitterness lines.
The exercise involves smiling and pulling up the corner of the mouth with two fingers.
How can bitterness lines be removed ?
How can a drooping mouth be corrected ?
Aesthetic medicine techniques can be used to reduce and sometimes erase bitterness lines. Advanced stages usually require surgical treatment.
The type of treatment proposed is decided following a clinical examination, and the protocol is adapted to the anatomy of each patient.
Botox injections to treat bitterness lines
Botox injections are only useful in cases of hyperactivity of the depressor muscle of the corner of the mouth. This muscle pulls the corner of the lips downwards. In some patients, this muscle is very active and blocking it with an injection of botox causes the corners of the mouth to move upwards.
Some doctors systematically carry out this injection. In my opinion, this only makes sense if it is the right indication.
This injection must be carried out by an experienced practitioner, as a botched procedure will cause deformation of the mouth with salivary incontinence and force the patient to eat through a straw.
→ Find out more about botox injections
→ Find out more about the medical lift technique
Hyaluronic acid injections to lift the face without surgery
The main cause of the appearance of bitterness lines is the loss of superficial malar fat.
The most physiological treatment, i.e. to give the patient a rejuvenated face without creating plumpness and volume, is to lift this fallen fat.
This therapeutic approach must precede any direct injection of the wrinkle so as not to weigh down the oval and puff up the face.
This is the medical lift technique invented by Dr Mauricio di Maio. This technique gives immediate results and aims to restore the face’s youthful triangle.
Filling bitterness lines with injections of hyaluronic acid
Hyaluronic acid can be injected directly into the wrinkle. In the treatment protocol, the wrinkle is filled after the lift technique.
The injection is often carried out with a cannula to avoid the appearance of haematomas. The result is immediate.
Depending on the indication, I will use a volumising acid if the fat that has melted away needs to be replaced, or a skin booster if there is a break in the skin.
→ Find out more about skinbooster
→ Find out more about hyaluronic acid
Hyaluronic acid injections to treat loss of support
A volumising hyaluronic acid with a firm consistency is injected into the chin, para-chin and cheekbone area in cases of bone and fat reabsorption.
The aim is to replace the structures that support the face and that have disappeared over time.
The injection is often carried out using a cannula.
Reducing bitterness lines with Sculptra injections
Sculptra stimulates skin synthesis. Its results are progressive, visible three months after the injection.
This treatment should be combined with hyaluronic acid injections, and is strongly recommended for people in their thirties and over. Sculptra injections alone cannot treat or prevent the appearance of bitterness lines.
The aim is to treat or prevent skin thinning and the resulting sagging.
→ Find out more about Sculptra
Results and side-effects
The result is immediate and improves within three weeks of treatment. It lasts approximately one year.
The lift technique restores the youthful triangle and refines the oval of the face.
The face appears rested, and wrinkles are reduced physiologically or completely erased, depending on the patient’s requirements and anatomy.
The immediate after-effects are marked by slight swelling and the appearance of small haematomas, which are rare and last no more than a few days. Normal activities can be resumed immediately after the injections.
Prices
Type of consultation
Tarifs généralement pratiqués
Hyaluronic acid
600 CHF per syringe
Botox
250 CHF
Sculptra
800 CHF per bottle