HomeAnswersCosmetologysmile designCould Botox improve awkward half-smile in social settings?

In social situations, I give an awkward half-smile. Will Botox help?


The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At July 8, 2017
Reviewed AtJanuary 30, 2024

Patient's Query

Hello doctor,

I wanted to get your opinion on my situation to see if you guys might be able to help. For several years now, I have had trouble with smiling fully in certain situations. Generally, in social situations, it is almost like I give an awkward half-smile. It is hard for me to smile fully. This does not really occur when I am alone, only when I am in a social setting around people. Needless to say, I also suffer from OCD, which seems to have gotten worse over the years. But it really just involves me checking things several times. The smile issue is affecting my life way more. However, I want to know if it is more of a physical thing or a mental thing. What leads me to believe it is physical, is that I have tried exercises like smile practice, in which I hold a smile in the mirror for about five minutes. About three minutes in of holding the smile, I feel a tightness in the cheeks area, and then right after that my smile feels normal, almost as if I have released tension in a muscle or something. This does work, but constantly having to do this multiple times a week is super annoying. This led me to look into Botox, specifically the DAO procedure, which essentially freezes up the depressor angularis oris muscle in the face, which prevents frowning, and allows people to smile a lot easier. I went to two local cosmetic surgeons, but they said they were not too familiar with this procedure, and that they felt that it might work or might not, but did not feel comfortable doing it. This problem is really ruining my life and has been for years. Being able to only give a half smile in social situations is embarrassing and something that everyone notices. This often leads me to take MDMA in social situations, which makes me really happy, and not care about my smile. However, I know that I ca not keep doing this. It is not a sustainable way to cope with this issue. I wanted to get your thoughts on my situation. Thanks.


Welcome to icliniq.com.

DAO (depressor angularis oris) procedure, where the muscle is cut off is really not advisable. It is not performed commonly either. If not done correctly, it can lead to side effects and incorrect smile. Botox is done to elevate angle of mouth incase there is a depression like with aging. Instead of all these procedures which would not guarantee a perfect smile, I would suggest you continue the smiling exercise. From your description, I would say there is nothing wrong with your muscles. In your case, there is no such problem and it is a psychological thing. But if you still wish to take an opinion, then you should consult a plastic surgeon along with clinical photographs. One image without a smile and one with a smile.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Thakare Sampada Avinash
Dr. Thakare Sampada Avinash


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