Lower Face Lift Q&A

92%

WORTH IT RATING

27 Reviews

Ask a Question

View Before and Afters

Average Lower Face Lift Cost: $9,379

Learn about Lower Face Lift

120 people and 176 doctors are talking about Lower Face Lift

Get Free Email Updates

Improving Marionette Lines with Lower Facelift?

asked 2 years ago by BrookeinCO in Colorado
Latest answer by Larry S. Nichter, MD, MS
Question viewed 3,272 times
Tags: face, lines, marionette lines

How much improvement can I expect from a Lower facelift with fairly significant marionette lines?

When I hold my face where approximately I think it will look after surgery, I still see the lines. They become less severe, but somewhat horizontal. How often are some type of fillers needed with the surgery? Thank you.

20 answers to Improving Marionette Lines with Lower Facelift?

Improving Marionette Lines - surgery, fillers or both

Lower face lifts or mini-lifts re-drape the redundant skin in this region smoothing them out to a degree. The assessment however is key to determining if additional procedures are required: for example: if there is redundant fat in the jowl region this should be reduced (liposuction or direct reduction), if there is pre-jowl ("thumbprint depression between chin and jowl) depression then it would indicate that a filler is probably needed. Fillers... more

Larry S. Nichter, MD, MS
Orange County Plastic Surgeon

Marionette Lines

A lower facelift will address most marionette lines if they are not too deep. Pre-operative evaluation is important in determining whether or not additional filling may be needed. This would include the use of fat grafting or dermal-fat grafting at the time of the facelift. If it is borderline, then I usually error on the side of not doing any grafting and evaluate after surgery. I feel that an "overdone" look is worse than having to use fillers judiciously post operatively. I hope... more

Douglas L. Gervais, MD
Minneapolis Plastic Surgeon

Marionette lines

Marionette lines may respond to fillers like Juvederm or Restylane, or more permanently to fat transfers. The lower facelift should help redrape and tighten the skin of the jowl area, and depending on the vector of pull, may help correct the marionette lines well. These procedures are often combined to optimize results. A consultation with a board-certified plastic surgeon can help you in your decision process.

Tim Abou-Sayed, MD
Palm Beach Plastic Surgeon

Benefits of the Lower Face Lift

A lower facelift, or necklift, is a procedure to improve the neck and jawline, minimize the appearance of the jowls, and treat the marionette lines (the lines below the corners of the mouth). There are many different variations in this surgery regarding incision placement and treatment of the SMAS and skin, depending on the surgeon's training and preferences. In many patients the marionette lines are eliminated through a lower facelift. However in patients with deeper lines or less... more

Umang Mehta, MD
Bay Area Facial Plastic Surgeon

www.mehtaplasticsurgery.com

Define the problem then match the correct procedure.

The current theories of facial aging provide that facial fat melts away in some areas and accumulates in others. The corners of the mouth exemplify a zone where soft tissue "melts" away, leaving a trench, starting from the corner of the mouths and extending inferiorly towards the jaw; the so-called "marionette's lines". A lower facelift assists in repositioning the mandibular jowls and redefining the neck and jaw. If a surgeon exerts adequate pull on the overlying... more

Lavinia Chong, MD
Orange County Plastic Surgeon

Marionette lines and a lower face lift

Thanks for the great question - A lower facelift is designed to address the neck and submental (beneath the chin) excess skin as well as the jowling which can contribute to the marionette lines. You should see a significant improvement but sometimes there can be some residual lines. Have a careful conversation with a board certified plastic surgeon about what to expect and how to proceed in a manner that best addresses your concerns. I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon

Marionette lines and lower facelift

The marionette lines should be much improved after a lower facelift. In some cases it may be necessary to either resurface the skin in this area or fill the lines with fillers. The vast majority of patients will not require any fillers in this area however.

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon

www.bolithomd.com

Marionette lines

The depth of the lines is important. A lower facelift may alleviate the lines a bit but I would also recommend filler around the lips for this condition. The procedures can be combined for an optimal result. Fillers and surgery are performed together when both are appropriate; I have never thought of it in percentile terms.

Robert L. Kraft, MD
New York Plastic Surgeon

Marrionette Lines and Lower Facelift

Marrionette lines improve with traditional lower facelifts to some degree. However, certain facial muscles create these lines and they are not directly corrected by the facelift muscle repair. I advise most of my patients that they will probably need filler to the area approximately once a year to get more of a result. Fillers alone, however, cannot solve the entire problem. This problem frustrates patients and doctors alike.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

Marionette lines are treated through both tightening and filling

You are very perceptive - with deep marionette lines or folds, a lift alone is inadequate, and can make the remaining marionette fold travel in an unnatural direction. I find that filling - either with fat or injectible fillers - is a necessary adjunctive treatment for deep marionette folds even with an excellent surgical facelift.

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon

Mrrionette Lines

Brooke: The procedure that will help add volume at the same time as the Facelift would be a fat transfer. You can read more about this in various sections on this website. Basically, the fat is harvested from one site of your body that has enough donor fat. It is then separated and injected into the desired areas. These areas can be discussed with your Plastic Surgeon prior to your procedure. This is very common practice to do in combination. The body will not reabsorb all of the... more

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

Face lift

It is very possible that you still need some kind of filler after your face lift but also is important to evaluate the quality of your skin. Sun exposure and dry skin will cause lines and can be also be treated and will help your results.

Alejandro J. Quiroz, M.D.
Mexico Plastic Surgeon

Marionette lines improved with facelift?

The marionette lines are usually improved some with facelift but usually some sort of filler is needed for optimal result. If the face were pulled really tight, the marionette lines might be completely gone but you would be too tight, one of those catagory 3 hurricane face lifts. Not a good look especially if you tend to be thin. Lisa Lynn Sowder, M.D.

Lisa L. Sowder, MD
Seattle Plastic Surgeon

Options to fix marionette lines

Patients today have many options for facial rejuvenation of the lower face. Dermal fillers are extremely popular in patients that want to correct the nasolabial folds and marionette lines (otherwise known as the smile lines). Dermal fillers also work extremely well around the commissures of the mouth. If this is your main concern, a dermal filler may do the trick. To redrape the skin of your jawline and neck, a lower facelift will be more appropriate. Your best bet is to work with a... more

B. Pat Pazmino, MD
Miami Plastic Surgeon

Marionette line treatment with Lower Facelift

Marionette lines occur where the deeper tissues connect to the skin causing the loose skin, muscle, and fat to overhang and long term folding that creates wrinkles in the skin itself. A facelift will reduce the looseness that overhangs, but I like to place your own natural fat in the space between the skin and muscle to reduce the pull. Additional injectables, such as Juviderm, may be needed to fill the skin crease itself.

Randy J. Buckspan, MD
Austin Plastic Surgeon

Hard to tell without seeing the photos.

A facelift by an experienced surgeon should use your own tissue as a filler along with the face lift. Fillers alone can improve temporarily the problem.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Ask your Surgeon specifically how they will address your marionette lines

Hi Brooke, As always you have already received some excellent advice here. I would like to add some more thoughts that you can utilize during your actual consultation. As you have read, facelifts can certainly address marionette lines - the degree they will do so depends heavily on two things: 1. How deep and large the marionette lines are 2. What type of facelift technique is being done (they are not all the same & they do not all have equal impact on the marionette lines) Ask your... more

Kamran Jafri, MD
New York Facial Plastic Surgeon

Marionette lines and facelifts

The marionette lines will improve from a facelift. They will not be totally irradicated and some patients may desire further treatment with filliers after surgery. Most patients are well satisfied just with the improvement from surgery.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Marionette lines will improve with facelift surgery

Marionette lines will improve, but not necessarily totally go away. Most of the modern Facelift techniques lift the SMAS muscle which is one of the main culprits causing these lines. Also releasing the mandibular ligament as part of a Facelift will also help. However, lines "etched" into the skin may still need filler and as mentioned in the previous answer, for a narrow jaw this can also be helped by Mittleman implants.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Treatment of marionette lines during a Facelift procedure

Dear Brooke, An advanced facelift that addresses the SMAS layer will have a significant impact on the marionette lines. In some cases where there are pre-jowl depressions that create deep marionette lines, a Mittleman implant can be a useful adjunct. If you are referring to very superficial lines, perioral resurfacing can address these, but you have to be careful regarding your skin type. If resurfacing is not a good idea for you, then HA fillers can be used, but these have a temporary... more