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Is Restylane Best for Marionette Lines?

I'm 35 years old, and I have several medium marionette lines on the sides of my mouth. It almost looks like my face is gaunt (especially in the cheek area), and it doesn't help that I have a narrow face. I have been looking into fillers--namely Restylane. Is this treatment best for someone like me, or should I go for other fillers?

Doctor Answers (20)

Restylane for marionette (smile) lines


Great photograph!  You've got a beautiful smile.  I can see the area you wish to improve.  While a personal consultation is always best, it appears that you can benefit from a Restyalne treatment to the area.  Other dermal-fillers, such as Perlane, Juvederm, or Radiesse can also be used to treat the smile-lines.  If you are pleased with the results of the temporary dermal-fillers, you may want to consider using Artefill (a semi-permanent filler) for your next treatment.  Artefill can last upward to 12 months!

Restylane, Perlane, Juvederm, and Artefill are all FDA-approved treatments for the marionette lines.  They are safe, effective ways to rejuvenate your appearance.  Ultimately, the depth of your lines, coupled with your skin thickness will determine which filler will work best for you.

I suggest finding a physician with the credentials, experience, and viewing actual patient before/after photographs to achieve the best results.

Best of luck!

David C. Mabrie, M.D., FACS

Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 56 reviews

Quit smiling!


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

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 36 reviews

Injector skill matters more than specific filler.


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.

Joseph J. Castellano, MD
Tampa General Surgeon
4.5 out of 5 stars 7 reviews

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Restylane for Marionette Lines


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!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Restylane is the ideal filler for age 35-44 to treat marionette lines


Restylane is a lovely filler, particularly for your age group. It will fill in the hollows and the marionnette lines in a cosmetically elegant wasy.  If you have deeper hollows then you might require a little Juvederm or Perlane.  The key is to find an experienced injector who will give you the best cosmetic results.  Please let me know how it turns out!

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 27 reviews

What is best for the marionette lines


Well, this is difficult to answer. The simple reason being is that no one product is best for everyone. Treatment decisions must be made for an individual and, in the case, one size does not fit all.

For the most part, Belotero, Juvederm Ultra, and Restylane are great for mild marionette lines. For moderate lines Perlane, Juvederm Ultra Plus, and Radiesse are often good options. For deeper lines, facelift may be best, but Radiesse or Perlane may help.

The bottom line...

Just as a handyman does not only have only one tool in his/her toolbox, cosmetic surgeons must have more than one product at their disposal.

Robert S. Bader, MD
Miami Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Is Restylane Best for Marionette Lines


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

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 38 reviews

Marionette Lines


Juvederm, Restylane, and Radiesse can all provide good results. The choice you should make is the one to find an experienced and expert injector. He/she can then guide you on which product to use.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 16 reviews

Restylane is great for marionette lines


Restylane is a great choice for marionette lines. It fills in the area very well and looks very natural , without looking  lumpy or bumpy. Other choices include Perlane, Juvederm Ultra Plus, and Radiesse. Dr. Behnam.  

Ben Behnam, MD
Santa Monica Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Marionette Line Treatment


Judgment of Marionette Line significance is best performed without smiling.  At 35, yours are probably such early changes that virtually any filler will do the trick.  I tend to use Radiesse because it is more cost-effective over time, particularly when the sole issue is volume.  Hope this helps.  

Brian M. Braithwaite, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.