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Is a Facelift the Only Answer for Marionette Lines and Jowls?
asked 2 years ago by 2114anon in Philadelphia area
Latest answer by Michael Law, MD
Question viewed 4,878 times
Tags: age 65-74, face, jaw, jowls, marionette lines
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
34 answers to Is a Facelift the Only Answer for Marionette Lines and Jowls?
+1
Fillers can help marionette lines.
Facelifts with fillers work the best, but you can improve your looks with fillers in the meantime. See an experienced facelift surgeon and let him tell you what to expect from fillers alone.
+2
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,...
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+2
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,...
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Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon
Freehold Facial Plastic Surgeon
+2
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...
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+2
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...
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Robert T. Buchanan, MD
Highlands Plastic Surgeon
Highlands Plastic Surgeon
+2
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.
David Shuter, MD
Jupiter Plastic Surgeon
Jupiter Plastic Surgeon
+2
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...
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Steven Schuster, MD
Boca Raton Plastic Surgeon
Boca Raton Plastic Surgeon
+2
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.
+2
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
Chicago Plastic Surgeon
Chicago Plastic Surgeon
+2
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...
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+1
See the forest not trees
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
don't get fixated on lines. realize the goal is to look better. at 66 my...
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Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
Boca Raton Plastic Surgeon
+1
Is a facelift the only answer?
Certainly, at your age should be beneficial. However, if you a little "knife shy" there are and slay procedures that may just work and satisfy your desire for correction. The reason popularization of restoring volume to the face is particularly helpful with the marionette lines and mid face area. Injections of Restylane and other fillers transient. A longer correction more meaningful correction can be obtained using your own fat. This is a simple procedure, but does take time....
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+1
Marionette Lines and Facelifts
Marionette lines, by in large, are not really corrected by any type of facelift surgery because these lines are caused by many different factors including muscle and fat atrophy, animation of the deep muscles, and from motion around the corners of the mouth. The optimal management of this is multimodal. Specifically, the use of fat or filler injections which are done at the same time as a facelift. If there are deep wrinkles one can use of a laser or chemical peel as well to help correct...
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+1
Facelift vs fillers?
Many women see facial aging in the central lower third of the face, in the form of mandibular jowls (fatty pouches, which sag from the outer corner of the lip downward over the jaw) or marionette's lines (trenches, which radiate obliquely from the outer corner of the lip and contribute to a "sad" appearance). Please be aware that my comments are "generic", without benefit of seeing your photos.
Mandibular jowls and jaw structure are well addressed by any...
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+1
Filler for marionette lines
In my opinion, your best nonsurgical option would be to have a filling material with hyaluronic acid (Juvéderm Ultra Plus being one of the better ones) placed in this area. It will serve to decrease the depth of the marionette lines. Both marionette lines and the nasolabial folds typically respond pretty well to filling materials.
This nonsurgical procedure can usually be done within 15 to 30 minutes by a qualified surgeon, with minimal downtime to you (though you can expect some...
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Deason Dunagan, MD
Huntsville Plastic Surgeon
Huntsville Plastic Surgeon
+1
Alternative treatments for the marionette lines
Although a lower facelift will be your best solution for the marionette lines and jowling you can disguise the aging process by using dermal fillers (Restylane, Radiesse or Sculptra) and some Neurotoxins (Botox or Dysport). Well placed fillers can restore volume back to the upper face and along the jaw thus resuspending the tissues that start to sag with age.
Also using a small amount of Botox to decrease the downward pull of the corners of the mouth will create the allusion of an upward...
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Michael L. Workman, MD
Portland Plastic Surgeon
Portland Plastic Surgeon
+1
Treatment of Jowls and Marionette Lines
A facelift will improve your jowls, but have little effect on the marionette lines. Fillers are usually the best treatment for those marionette grooves. If you do not want a facelift, a pre-jowl implant or fillers in the pre-jowl region may be beneficial.
+1
Treating jowls and marionette lines
Marionette lines are the grooves that appear with time running from the corners of the mouth to the jawline by the chin. Jowls are loose skin, fat and muscle that accumulate just outside the marionette lines as the skin thins, the fat and muscle atrophies and the ligaments holding them relax with age.
Treatment should be based on the severity of the problem and the anticipated result on the part of the patient. A traditional facelift will most likely always be the best bet as it...
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Barry Stuart Handler, MD
San Diego Plastic Surgeon
San Diego Plastic Surgeon
+1
Aging face
The easy part is the "jowls" you describe- the fat pockets along the jaw line. This and many other signs of aging are nicely handled with face lift. A lower face lift also will rejuvenate your neck.
Though the marionette lines are difficult to completely remove, they are usually improved greatly. This can be supplemented with filler injections. In some cases, a "direct excision" can performed which eliminates the lines, but leaves fine scars.
Or you can always use...
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Scott E. Kasden, MD
Dallas Plastic Surgeon
Dallas Plastic Surgeon
+1
Facelift alternatives
You may potentially benefit from facial fillers such as Juvederm or Restylane. But I would really need to see photos and/or examine you in person to give you the best advice. Please send any photos you have and I would be happy to evaluate them for you. My contact info is listed in my profile. Thank you and best of luck to you.
Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
Beverly Hills Facial Plastic Surgeon
+1
Answer for marionette lines and jowls
Again a photo would really help us determine your appearance. But at age 66, I assume you have significant folds. If you used a filler or collagen stimulator injections they would round your face out and give a fuller appearance. It may be just what you need. Vs a facelift - lifts away those folds. Or do a combination of both filler and surgery lifting.
From MIAMI
+1
Facelift is not the only answer unless.........
Hello,
A facelift provides significant improvement. It reall comes down to what your expectations are, budget and then the relationship you develop with our doctor
Michael Kulick, MD
San Francisco Plastic Surgeon
San Francisco Plastic Surgeon
+1
Combination treatments for marionette lines
Typically, jowls on the lower ace are best treated with a lifting type of procedure often with some minimal liposuction. Minimally invasive neck and lower face lifts can be done to improve those areas. However, these procedures typically do not improve the marionette lines. Fillers, are the best options for marionette lines and often both procedures can be done simultaneously or fillers can be done first and if the jowls still bother you, then you can have those treated later.
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Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
Jacksonville Facial Plastic Surgeon
+1
The answer is there is more than one answer
There is usually no "only answer" in plastic surgery. This is a fact that makes us very unique among the medical specialties. We have many tools in our armamentarium to solve problems in various ways. A visit to a board certified plastic surgeon for a consultation will better identify the procedures that you might be a candidate for. Good luck!
+1
Lower Face Rejuvenation
Basically there are three ways to treat jowlng. I will approach it with the least invasive. The first would be through a radiofrequency non-invasive procedure such as Thermage. The problem at least up until now is there is no way to determine what your response will be do it. The second would be fillers to help camoflauge the jowling. The last would be a lower face lift to help pull the SMAS tighter and get rid of the redundent skin.
Sharon Theresa McLaughlin MD
Long Island City Plastic Surgeon
Long Island City Plastic Surgeon
+1
Is a facelift the right procedure
Without a picture, it is hard to give you specific advice. However, facelift is the gold standard in rejuvenating an aging face. If you have minimal lines, then dermal fillers or fat grafting may be helpful. However, if you loose skin or significant folds, then facelift may be the best option for you. Good luck with your procedure.
+1
Facelift is the solution to marionette lines
You needn't fear a facelift ane this is the solution to marionette lines at the corner of the mouth. There is nothing as effective at correcting the jowl and the fold which occurs with facial aging. I don't like suctioning fat from the face as the thinned subcutaneous tissue (fat) is part of the aging process. Suctioning is likely to produce more skin laxity. Facelift is an opportunity to lift and fix the jowl higher in the cheek from where it has descended to correct cheek hollows, and to...
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Peter E. Johnson, MD
Chicago Plastic Surgeon
Chicago Plastic Surgeon
+1
Juvederm, Sculptra, and Botox Can Help, Eventually You May Want Some Lifting
The aging process involves deflation and sagging. Deflation can be addressed via fillers such as Juvederm to the nasloabial folds, marionette lines, and corner of the mouth. The angle of the mouth depressor muscle can be injected with small amounts of Botox to help lift the sad downward effect this muscle gives.
Sculptra injected ino the midface and hollow areas of the face can re-volumize and give some lift. Eventually skin will need to be resected to help correct the skin laxity via a...
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Keith Denkler, MD
Marin Plastic Surgeon
Marin Plastic Surgeon
+1
Addressing marionette lines and jowls
A face/neck lift will certainly address facial jowls, but will do little for marionette lines. A suitable option would be injectable dermal fillers to soften and minimize the severity of these lines.
+1
You can start with fillers and Botox to treat marionette lines
I am not sure why you are afraid of a facelift, but I know that some patients are, and for different reasons. Some are afraid of the overdone or wind-tunnel look, some are afraid of the surgical procedure and long recovery time, and some are afraid that it might be extremely expensive. It these are your concerns, I would certainly recommend a consultation with one or perhaps several Facial Plastic Surgeons or Plastic Surgeons to discuss these in details.
On the other hand, the facelift, or...
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Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
Seattle Facial Plastic Surgeon
+1
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.
+1
Fillers are an option
I have many Los Angeles patients who see the horrible facelift results that abound here and are understandably frightened by the prospect of a facelift.
First know that many, many board certified general plastic surgeons out there performing facelifts received minimal formal facelift training in their general plastic surgeon residencies. Here in Southern California with a number of excellent plastic surgery residencies, residents are lucky to be the primary surgeon on a single facelift. ...
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+1
Facelift Fear
Truthfully, a Facelift is the best answer for jowls and will also help but not eliminate marionette lines. Fillers will help the pre-jowl area, but will not create an equivalent result to Facelift.
The dilemna you present is not uncommon among patients I see in consultation, a phenomenon I describe as "Facelift fear". The usual reason for this concern is that a bad or overdone Facelift screams at you from across the room. What many patients don't realize is that many of the...
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+1
Marionette lines and jowls
There are many anatomical factors that influence the appearance of so-called marionette lines and jowls. Because of this, there is no one solution and often there are many parts of the solution. Skin laxity, loss of volume, small chin, overbite malocclusion all contribute to varying degrees. This means that skin resurfacing to restore elasticity, lifting both as a face and mid-face lift, chin implants or jaw surgery, and fillers using fat or other temporary injectables each has a role.
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