Is Restylane Best for Marionette Lines?

Injectable fillers are an excellent option for treating
marionette lines. When utilizing this approach a large variety of injectable
fillers are currently available. These include Restylane, Juvederm, Sculptra, Artefill
and Radiesse to name a few. The filler chosen is dependent on the patients’
anatomic findings, aesthetic goals and the surgeons’ comfort level.In the
vast majority of cases we prefer either Juvederm or Restylane when treating
these lines. Although there are differences between these products, they are
both associated with excellent clinical results. Both fillers last about 6 to 9
months and are associated with high satisfaction rates.If
patients are satisfied with the results of these injections we occasionally
switch to a longer lasting injectable. In most cases we prefer Radiesse which
can last 2 to 3 years.If
you’re considering injectable fillers for marionette lines, consultation with a
board certified specialist is appropriate.This specialist should be able to formulate an appropriate treatment
plan for this problem.

I am excited share that with the advancement of dermal filler technology, plastic surgeons are able to offer a more extensive arsenal for patients who are looking for nonsurgical treatment options for facial rejuvenation.  The marionette lines, or the lines that extend from the corners of the mouth, can be treated with Restylane, Restylane Lyft, Juvederm Ultra Plus, and even new product Resytlane Defyne. I would recommend scheduling a consult with a board certified plastic surgeon or highly skilled and experienced injector who can assess your degree of volume loss to the area and make the most appropriate recommendation for you.

Restylane®
is a hyaluronic acid-based filler very similar to JUVÉDERM®, Perlane® and other
HA fillers. They all work in the same way, are formulated similarly and deliver
equivalent results for roughly the same length of time (give or take). That
being said, it’s absolutely the case that some patients see a better result
with one HA filler over another, and many surgeons see more positive results
working with one product instead of a different product. For the best results,
focus on finding an experienced injector who knows exactly how to address
marionette lines and who has plenty of experience. Try some options and see
which one you prefer. Once you find what works best for you, then you can
commit to brand loyalty.

Thank you for the question and the great picture. Restylane is a great option for marionette lines, as well as other folds or hollow areas of the face (such as nasolabial folds, the under-eye area, etc.). This product is made from hyaluronic acid (HA), just like Juvederm, Perlane, and Belotero.  The differences between these have to do with crosslinking and viscosity (thickness and flow). This type of filler can last between 6 and 9 months in most patients. Radiesse is a different material (calcium hydroxyapatite) and lasts a little longer (9 to 12 months). The key to getting the best treatment for you is having a positive relationship with a provider you trust -- that was you can work together to achieve the aesthetic results you want. Best of luck moving forward!

Restylane works well on marionette lines but I prefer Juvederm Ultra Plus because it has thicker particles and I like the result.

Restylane is an excellent choice for Marionette lines.  However other fillers give the same results but with potentially more longevity for the same or slighter higher cost (e.g. Radiesse).  Each filler has its own properties which might make it a better choice for you.  A thorough evaluation by an experienced practitioner is necessary, and I would be happy to discuss the options with you.  Have a nice day!

you could have Radiesse, Perlane or Juvederm Ultraplus injected into the deeper lines, and Restylane, Juvederm Ultra injected into the finer lines. When you smile, though, you will still see your creases form.

We agree with some of the other practitioners that you do not have an issue with marionette lines, but rather a loss of volume in the cheeks. For this area, we prefer Perlane. This is only a preference for us based on experience, duration and the ease of use in this area. There are many fillers that can be used.
One of the reasons we use Perlane is that it is easily reversed with Hyaluronidase (an enzyme that breaks down Restylane, Perlane and Juvederm). Because longer lasting fillers like Radiesse cannot be reversed easily, we would not use them in your situation (multiple creases very close together).

It would be interesting to see your face in repose- with no facial expression- to get a sense of the depth of your Marionette lines, and to see if you have a pre-jowl sulcus.
A fine marionette line can be filled with virtually any filler. I'm favoring Evolence for this application because of its ease of injection and longevity.
If you do have a pre-jowl sulcus- this tends to deepen the appearance of a marionette line, in my opinion. In patients with both problems- I will treat the pre-jowl sulcus with Juvederm or Evolence (about the same price, roughly), and then treat the marionette line with whatever product the patient is interested in. I think the sulcus needs to be treated with something more substantial than just Restylane.
Most Kindly,
Scott Sattler MD FACS

Botox and fillers can be used to even out your face. You may ask for botox, fillers, and PDO. A combination of all may be attempted to contour your facial features. Please contact a qualified provider with extensive experience in these procedures.