Would a Lower Lift Help with Sagging in the Marionette Area? Doctor Answers, Tips
Lower Face Lift: Q&A
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Would a Lower Lift Help with Sagging in the Marionette Area?

Due to 30lb weight loss I have sagging in the marionette line area. Its not too bad but it bothers me that I look sad. I talked to a plastic surgeon about a lower lift. He said this would also help my jaw line. What would this entail. Is the recuperation difficult. I am 48. Would juvederm help to hold off the surgery for awhile? Can it help the neck? I have already had my eyes done and rhinoplasty so surgery isn't new to me.

14 Doctor Answers | Asked by Katt122 in florida
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Facelifting after weight loss

Your story is typical and a lower face lift or min-lift is designed to take care of the Marionette area, jowls and upper neck accentuated by weight loss. You may also need fillers (fillers do not work in the neck area) but I suspect loose skin needs also to be addressed. The aging process involves 3 things ; downward decent from facial soft tissue laxity, skin surface aging characterized by wrinkles and discoloration, and loss of volume especially in the cheek area. Failure to treat... more
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Lower facelift plus volume

Usually patients with your situation need volume (fat grafting or fillers) that are synergistic to lower face lift to improve the appearance of marionette lines. see video
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Filler Facelift Marionette Lines

You may need a combination of both. Don't be fixated on one or the other. there are a lot of complicated factors that go into these recommendations including the "strength" of the jaw and chin, skin consistency, volume loss, etc. If you feel comfortable with your surgeon then go with their recommendation. Good luck!

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Correcting Marionette Lines via Facelift

Facelifts help to some degree with correcting the oral commissure (marionette area) but often the area deepens or sags due to certain muscle action in the area. If the muscle is primarily responsible sometimes small doses of botulinum toxin (Botox and Dysport) can be helpful as can injectable fillers. But remember, fillers fill and Lifts lift. An experienced surgeon can show you how much of your problem can be corrected with each type of treatment.
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Neck lift and fillers

Ideally you would need a combination treatment of neck lift and fillers. However, dermal fillers can be used around the jowls and marionette lines with good results.
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Face lift

 You can discuss with your surgeon the possibility  for the use of fillers   and Botox to  help the down pull of the corner of you mouth .
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Marionette lines and sagging skin

At age 48 you probably have fairly good skin tone, although weight loss will affect that. Consideration for the fillers in the marionette lines can be entertained. The goal of the lower face/neck lift is to tighten up the jowls, but one needs to be very careful as to not stretch taller the wind tunnel of the face to try to pull out all of the marionette lines in that area. Nasolabial folds will not be stretched out with a facelift either.  
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Sagging in the marionette area

Combination treatment facelift plus filler is best answer for sagging marionette lines. The marionette area sometimes is reasonably simple to treat, but other times is more difficult. A simple answer is to utilize simple, safe and less expensive techniques such as Juvéderm or Restylane for the marionette line area. This can be a potential six to nine month or even one year successful therapy in many instances, but not all. More permanent answer entails Sculptra or lipo injection... more
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Fillers or Facelift for marionette lines

Both fillers like Juvederm and a facelift can help marionette lines and sagging or looking sad around the corners of the mouth.  You would probably get the most improvement in marionette lines doing both because they work by different but complementary mechanisms.   A facelift will tighten drooping skin, fat and muscle and fillers can help finish the job by filling in areas of skin with depleted collagen.   Fillers will not help the neck at all and only a facelift... more
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Marionette Lines Not Treated with Face Lift Surgery

While a face lift or neck lift may improve the nasolabial folds or marionette lines, face lift surgery won't always eliminate them. Facial fillers, such as Radiesse, Juverderm, fat, etc are better options to fill wrinkles and rejuvenate these areas. Facial fillers or injections will not improve the neck. Face lift and neck lift surgeries are more appropriate options to improve sagging neck and turkey-gobblers. With weight loss, fat transfer may be a better option for you at this... more
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