Is your facial expression sending the right message?

I was prompted to write this post after my older daughter kept asking me if I was mad. For the life of me, I couldn’t figure out why she kept asking me that. Then one day I happened to see my reflection in my phone and did a double take. I was scowling and didn’t even realize it!

Are you giving the wrong impression just by natural aging? Besides wrinkles and changes in our skin texture, the aging process can unconsciously change our facial expressions, making us appear angry or sad without even realizing it. Since communication is a major function of the face, distortions in our expression can be rather off putting.



Frown lines are probably the most common reason people initially seek treatment. Vertical lines that appear between your eyebrows portray anger. These lines develop due to overactivity of the two muscle groups above your eyebrows. Frown lines are easily softened with a neuromodulator like Xeomin® or Botox®.


The Omega Sign was first described by Charles Darwin as “grief muscles”. This appears as two vertical slits between the eyebrows, joined at the top by a horizontal crease, resembling the greek letter Ω. It can be associated with sense of grief, sadness or depression.

Veraguth’s fold is a similarly important visible sign initially reported by Otto Veraguth around 1911, who observed diagonal eyelid folds on the outward edges of the upper eyelids.


As we age, volume loss and skin laxity results in lowering of the eyebrow. They go from being nicely arched to having a flattened appearance. This can give a sense of concern. Eyebrow shape can be corrected by several methods: neuromodulators like Botox® or Xeomin®, fillers, or fibroblast therapy, depending upon age, degree of volume loss and other factors present.


The tear trough area is gaining more popularity of late. More and more people are seeking advice for concerns about their eyes. Whether it be puffiness, dark circles, or lines, changes in this area can make you not only look tired but the dark circles due to volume loss, thinning skin, or genetics can give an angry appearance.


Nasolabial folds, also called laugh lines or smile lines are creases in your skin extending from both sides of your nose to the corners of your mouth. They can become more prominent and permanent as you age. Smile lines become more noticeable over time due to a loss of volume in the cheeks along with decreasing collagen and elastin. The deepening wrinkle casts a shadow on the face giving an expression of disgust or anger. By adding volume to the midface (cheeks) and if needed to the fold itself, a more youthful and positive emotion is restored.


A downturn mouth not only is a sign of aging but makes one look sad or grumpy. The loss of volume along with the downward pull of the depressor causes a deep line and also casts a shadow. This can be corrected by adding filler to restore volume and also injecting a neuromodulator to relax the overactive muscle. Other options include RF/Microneedling or fibroblast therapy.


Loss of volume and increased tone of the muscle around the mouth can cause the lips to be pursed resulting in an angry appearance. This is corrected by relaxing the muscle and/or adding small amount of filler to correct the volume loss.


A line under the lower lip and above your chin is known as the mental crease. The appearance of a deep mental crease may be caused naturally by genetics, a result of the natural shape of your chin or due to jaw or teeth malalignment.

After age 40, the mental crease can deepen as a result of collagen and elastin loss, repeated expression, and the mentalis muscle pulling up. An exaggerated chin crease conveys a grumpy emotion of grumpiness.


Last but certainly not least is the dreaded jowl. Yes, that lump of sagging skin that droops below the jawline and is a telltale sign of aging. Its appearance is due to loss of volume and decreased collagen and elastin. The presence of jowls can convey sulking or heaviness. Fortunately, there are many ways to correct the jowls. This is an area that I have had great success with Profound® RF/Microneedling. I will also relax the muscle that pulls down on the jaw line. Fibroblast therapy and discretely placed filler can also help to improve the appearance.

If aging is causing you to give off a negative vibe, there are many non-surgical options that can have you looking positive and feeling great!

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