Medical Minute: Resting Bitchy Face

February 19, 2018



When I first heard this condition mentioned, I had to laugh, because some of my female patients have commented about their older, “bitchy” face. What causes a face to look bitchy, and what can be done to help it?

Botox for Resting Bitchy Face

As humans, we’re hardwired to evaluate each other, and our subconscious brain immediately decodes facial expressions. This influences how we feel about the people we meet. When the corners of the mouth start to turn down, either through a genetic facial predisposition or through the aging process, it can make us appear mad, sad, or … bitchy. This isn’t necessarily fair, but life isn’t always fair, and we can’t control how our subconscious brain naturally interprets the world and influences us.

This condition can be helped in younger patients: a small amount of Botox injected into the correct part of the lower face will relax the muscles, pulling the corners of the mouth downward. In my more mature patients, resting bitchy face is due to volume loss that occurs with age around the mouth. Adding that volume back can dramatically turn that area around (and turn that frown upside down.)

While some people with resting bitchy face aren’t bothered by these issues, for those that are, there are safe office-based treatments that can help.