Is a Facelift the Only Answer for Marionette Lines and Jowls?

I'm 66 and a happy person. But I look sad because of the lines going down from the corners of my mouth to each side of my chin. I also have little pockets of fat on each side along my jaw line. Guess this is all normal, but I'm tired of hiding behind my long hair. I'm afraid of a face lift, and have read that a lower face lift does not take care of the Marionette lines anyway. What to do? Thank you

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35 Doctor Answers | Asked by 2114anon in Philadelphia area

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Jowls and Marinette Lines

Hi, You can tighten you jowls with a minifacelift but this will have little effect on your marionette lines. Marionette lines are difficult to treat but they can be somewhat eliminated using injectable fillers. A more extensive facelift will have a small effect on the marionette lines butyou may want to consider a minilift and injectable fillers. Best, Dr.S.

Jowls

Lower Face (Jowl Area) Lift Loss of skin elasticity with age (and sun exposure) allows the lateral and lower cheeks, which aren't tightly attached to facial bones, to 'sag'. On either side of the chin are ligaments which hold the skin more tightly against the jawbone (mandible). This is where, and why, 'jowls' develop. I have also observed that many people develop both atrophy of soft tissues and slight recession of the mandible between the chin and the jowl area,... more

Michael Law, MD

17 reviews

Raleigh-Durham Plastic Surgeon

michaellawmd.com

Facelift only answer for marionette lines and jowls

A well performed facelift is the best procedure to treat sagging and puffy jowls as well as the associated sagging skin and soft tissues of the neck. At your age,most people have, to a greater or lesser degree, the findings of laxity of the skinand soft tissues of the face and neck. These findings are amenable to a facelift that will provide redraping with significantly improved contours. Unfortunately, surgery to treat the marionette lines is often far from successful. In some cases,... more

Marionette line solutions

The simplest answer is for injections of filler, either hyaluronic acid products like restylane or juvederm, or calcium based products like radiesse. these are temporary though, so some patients then consider fat transfer as a more permanent solution. But in many cases that just leaves patients with a full, jowly chipmunk appearance. So that is why a facelift of some type is a better solution. Facelifts have lots of names, and mean different things in different offices. So whether its... more

Alternative to a facelift

There is no real alternative to a Facelift, particularly for marionette lines and jowls. However, one can do a relatively good job of mimicking the effects of a facelift with fillers. I prefer Radiesse for this area. It is quite long lasting and allows the body to build some of its own collagen, the support substance of the skin. The problem is that to disguise the jowl, you are forced to make the chin look wider. In spite of this, this really is an excellent alternative until you build up... more

Combination treatment is best

The very best solution is usually a combination of a surgical lift and some type of filler. Lift alone or filler alone will give improvement, but not the maximum possible. At age 66 a complete "erasure" of all lines is unrealistic and would look unnatural. I prefer to use the term "soften" and this can be obtained by the above methods.

Treating the marionette lines

Isn't it great the way we plastic surgeons can make such wonderful names for all the signs of aging! The marionette lines or Charlie McCarthy lines are a result a fixed point in the face and the face aging around it. If they are severe then only a facelift will give you adequate result often combined with adding your own fat or tissue. If they are mild you can use fillers like restylane, juvaderm or radiesse to give you temporary relief. If you are willing to accept some improvement you... more

Treatment of marionette lines

In a young peson when these lines begin to form they can be disguised with fillers. At 66, you will need a facelift but even that will only eface them 50%. If that isn't enough, some fillers on top of the surgery will help.

Options for jowls and marionette lines.

A lower face lift with either a chin implant or fat injections and perhaps precise jowl liposuction are a reasonable and relatively low risk approach to managing jowls and marionette lines. Your other options are fillers. I generally am not impressed by the results of skin tightening lasers and believe they achieve only a subtle change.

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Solution for Marionette (Puppet or Drool) lines and Jowls

A successful solution and treatment are always based on proper diagnosis. For this reason, a picture would have made answering your question much easier and applicable to your situation. Young people do NOT have nose to mouth (Nasolabial) lines or corner of mouth to jaw (Marionette, Puppet or Drool) lines, these come on with age. As we age, our facial bones become smaller resulting in the scenario of the same table cloth (IE skin) covering an ever shrinking table - as a result, less of the... more