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Which Filler for Marionette Lines and is One Syringe Sufficient? Can a Nurse Inject?

asked 10 months ago by HMiller in Texas
Latest answer by Mitchel Goldman, MD
Question viewed 460 times
Tags: marionette lines, gaunt, quantity

My face is gaunt with loss of volume and several marionette lines when I smile. Would juvederm work for this area? I've had restylane in past and it made my skin appear blue and didn't work that well. I'm hoping Juvederm will give a better result. Is one syringe enough (hat is all I can afford at this time.) When I made the appt, I was informed my PS has a nurse do the injections. I trust my PS, but is this ok? Would one syringe be enough for marionette and a little in my lips?

12 answers to Which Filler for Marionette Lines and is One Syringe Sufficient? Can a Nurse Inject?

+3

Physician filler injector is best

At rest your lower face has no depression to fill. A filler like Juvéderm can be used very carefully to soften the etched lines you have, but only very carefully. I do not recommend having a nurse injector do this for you. An experienced physician who understands how to place filler skillfully and artfully is best. Done incorrectly you can look overfilled or blue lines or hue can occur from improper superficial placement. You situation requires finesse! More importantly, I... more
Kimberly Finder, MD

San Antonio Dermatologic Surgeon

www.theliposurgeryclinic.com

+1

Sculptra is best

I would suggest Sculptra as it seems you have lost a lot of fat in your cheeks, which is the underlying cause of the smile lines. I would suggest only letting an MD do your injections, especially if you move to a filler like Sculptra.
Mitchel Goldman, MD

San Diego Dermatologic Surgeon
+1

I generally recommend staying away from nurse injectors

I generally recommend staying away from nurse injectors unless the nurse has tremendous injecting experience. You also want somebody who can inject all the different products, not just Juvederm. In this case, it doesn’t look like the marionette lines are so much an issue as the fact that you need more lifting. Sculptra will thicken the skin and minimize the lines. I think it’s very important to go to someone who can do injections for all products such as... more
Joseph A. Eviatar, MD

Bronx Oculoplastic Surgeon
+1

Marionette lines are different from cheek lines

It depends on the injector's skill and some nurses are better than the doctor, and, vice versa. You don't really have marionette lines. You have nasolabial lines and cheek lines and they are noticable when you animate your face. Fillers will only 'help' because you have a strong dynamic smile which causes these lines. I'd suggest Sculptura for the cheek and Juvederm ultra plus or Voluma or Radiesse for the nasolabial lines. You may need 2 syringes for the nasolabial... more
Harlow Hollis, MD

Victoria Plastic Surgeon
+1

Filler might help some

A filler like restylane or juvederm might help soften the marionette lines but I'm not sure that that will make you happy. It will improve what you see when you are still, not smiling. It will not improve the lines lateral to that that occur with motion. Sculptra or Radiesse would be better to add volume. If you are on a budget and want to take the edge off things and add some volume to lips I would choose Restylane as one syringe will get you started well. You should see no blue... more
Jo Herzog, MD

Birmingham Dermatologist
+1

The Best Fillers for marionette Lines and Cheeks

Your photos clearly demonstrate that these are not "marionette lines" but are caused by "deflation of the cheeks" due to volume loss. Juvederm is used to treat superficial wrinkles and is not effective for volume loss so I believe you will be disappointed if you rely on Juvederm for your treatment. Volume correction can best be done using either Radiesse or Sculptra. Neither of these should be injected by the nurse instead of the doctor. In fact, Sculptra is restricted... more
Mitchell Schwartz, MD

South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

+1

Injections of marioneet lines

Personally, I like to inject my patients myself. Although I am sure there are many nurses qualified to do it. The marioneet lines can certainly be filled out with hyaluronic acid. The depressions behind your marionette lines can be treated as well.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Which Filler for Marionette Lines and is One Syringe Sufficient? Can a Nurse Inject?

Great posted photos, thanks. Either of these HA's will accomplish the "job". I recommend being prepared to have 2 cc's injected, but start slowly to see if one or one and a half or all of two cc's is needed. As far as a nurse injector, I have no issues with nurse injectors but than you should be paying them. Oh right they can not purchase HA's it has to be a licensed M.D. Well than I want the responsible person, the doctor, to inject then. It is the old "what... more
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Fillers

Your lines at rest and those that are superficial, may be helped with fillers. They dynamic lines which are increased with animation can only be softened with fillers. My suggestion would be to start with one syringe and see how you like the result. It is always easier to add more filler then to try and remove it. Also, I would suggest starting with an HA like Juvederm or Restylane since these can be melted away with another injection. Who injects you would have... more
David Shafer, MD

New York Plastic Surgeon

www.ShaferPlasticSurgery.com

+1

Which is the best filler for Marionette Lines? Can a nurse inject?

I find that Juvederm and Restylane are more alike than they are dissimilar and both will work well for the Marionette lines you show. Personally, I do not delegate filler injections to my R.N. and although many R.N.s will do a fine job, my patients prefer me to do this for them and it is a service that I am happy to provide. After viewing your photos, it looks like you may benefit more from 2 syringes of these fillers than trying to get by with just one. In... more
Lawrence Kass, MD

Saint Petersburg Oculoplastic Surgeon
+1

Fillers

Many nurses under a doctors oversight are excellent injectors. Stay away for medical spas nd Botox/filer parties. If you want a lip fill that must be done first in order to have enough to make sure they are equal. The remainder goes into marionette lines. One syringe should do it but, be prepared for two.
David A. Bray, Sr., MD

Los Angeles Facial Plastic Surgeon
+1

Fillers

The best solution to loss of volume in the face is fat transfer. You can use juvederm, if it is well placed it will not have a blue hue. Although there are good injectors, I believe if your plastic surgeon does not have the time for you to inject your FACE with fillers, I would not allow any nurse injector. Find a plastic surgeon that can give you the time you deserve.
Samir Shureih, MD

Baltimore Plastic Surgeon

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