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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?

Asked 39 months ago by monarchbutterfly in Edmonton, Canada

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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... more

David Mabrie, MD

Bay Area Facial Plastic Surgeon

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... more

Scott Sattler, MD

Bellevue Plastic Surgeon

ASPS

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

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

Marionette line fillers

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!

Thomas T. Le, MD

Baltimore Facial Plastic Surgeon

Gaunt in the Cheeks

Cheek lines such as yours can be treated with any of the fillers mentioned above. The challenge is in filling the lines without it looking bumpy or uneven and for the filler to not make your lower face appear square. Finding a good provider with excellent skill in achieving a natural appearance, I believe, is just as important, if not, more important, than which filler he/she selects. When choosing a provider for the first time, go with a short-term filler first... more

Amir Moradi, MD

San Diego Facial Plastic Surgeon

Combination of Restylane and Radiesse Works Well

Looking at your photos I would use a combination of two products, Restylane (or other hyaluronic acid product), and Radiesse. Restylane works great as a dermal (skin) injection expanding wrinkles and supporting the skin during facial movement. For hollowness a deep tissue filler like Radiesse has much better longevity and a great ability to round out the shape of your face. Restylane can do the same, however, I think you will find that Radiesse lasts considerably longer... more

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Louis W. Apostolakis, MD

Austin Facial Plastic Surgeon

Marionette lines

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.

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Ronald Shelton, MD

Manhattan Dermatologist

Is Perlane the Best Filler for Cheeks?

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... more

Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

Marionette line filler

I find that for deeper lines usually in the "marionette" area, that Perlane is a better option or layering Perlane deep and Restylane on top of that. However, the picture that you show here, one needs to balance expectations, as if the lines you are shooting for are really tied into your natural facial musculature, i.e. dynamic, thus really created when you smile, then your results will be minimal and your expectations should be managed appropriately.

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Steven Hacker, MD

West Palm Beach Dermatologic Surgeon

Restylane Good Choice

I prefer Retylane in this area since it is a little "stiffer" and will give you more support. Some might argue for a deeper filler such as Perlane 9deeper version of Restylane) or Juvederm Ultra Plus, but I think you would do fine with Restylane. Good luck.

Arnold R. Oppenheim, MD

Virginia Beach Dermatologist

Yes, for you.

Hello, monarchbutterfly, again, You have a nice lower face, and I think well placed fillers will help your lines a lot. Going by your picture, I think Restylane is the best choice for you. It is quite long lasting (up to 6 months), and it is also forgiving. This is important for you, because you need fairly superficial injections, which means it is possible to get a little bump. This risk increases with thicker, longer lasting fillers. I use a lot of Juvederm, but for you, I would use... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Filler alone may not be enough

Restylane, Juvederm, Radiesse, etc., can all be used to fill in nasolabial folds and marionette lines. Your picture shows lines on the inside of the cheeks. These are technically not marionette lines. As Dr. Sattler said, it would be good to see your picture when you are not smiling. Folds and lines that are present when someone is not smiling are best treated with fillers. Which filler you use is up to you and your doctor. Lines that appear only when you smile are very hard to treat with a... more

Sirish Maddali, MD

Portland Plastic Surgeon

Restylane is a great option

We have found Restylane to work great for patients with similar situation. It helps to provide both volume and needed structural support for skin. Your doctor will assess your particular case further, including your facial anatomy, smile pattern, skin texture, and general health. Restylane treatment will be a great option for you, provided it is done by an experienced physician.