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What is Your Opinion on Marionette Fold Excision?
asked 6 months ago by NoMoreFolds in Kelowna, BC
Latest answer by Sam Naficy, MD
Question viewed 318 times
Tags: marionette lines, excision, opinion, scarring
I have recently had a partial facelift that unfortunately did not correct my marionette folds. I have had filler in the past which also did not adequately reduce/correct these. I am considering having these folds excised. I realize that there is much controversy surrounding this procedure due to the issue of scarring. In my mind I would trade a small likely imperceptible scar for obvious and glaring marionette folds. I would appreciate any input. Thanks so much.
22 answers to What is Your Opinion on Marionette Fold Excision?
+5
Marionette Fold Excision
Well, the issue is how imperceptible the scar will be, something that we cannot predict. We always hope for that, but if you end up not getting a fine thin line, it will be very hard to hide it on a permanent basis.
+1
Marionette line treatment
If you are looking for a permanent solution to this your best bet wold be a permanent filler such as on the link below. Surgical excision would result in a scar in a place that may not be so easy to hide.
+1
Marionette Fold Excision scar is too obvious, try fillers, fat and Botox to DAO
I do not excise the Marionette line of fold. The scar is just too obvious no matter how carefully if is done.
A lower Facelift with Platysmaplasty (neck lift) done properly should help the Marionette Lines. Improvement in Jowls, Jaw Line and Marionette lines is an integral part of a Facelift.
If Marionette Lines reappear after a Facelift there are several ancillary techniques which can help.
Fillers like Juvederm, Restylane, Pearlane and Sculptra can be used to plump the...
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+1
Marionnette Lines and the Partial Facelift
The socalled Marionette lines are an integral result of facial aging. Their presense usually indicates that aging has progressed to the point that surgical intervention is necessary. I'm not quite sure what a "partial" facelift is but it must provide a "partial" result. All facelifts regardless of variety make an attempt to improve both nasolabial and Marionnette lines. Fillers give additional improvement. Resorting to direct excision of these lines is to admit...
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Paul S. Howard, MD
Birmingham Plastic Surgeon
Birmingham Plastic Surgeon
+1
Scarring Risk in Marionette Lines
Very simple- in my experience, I would not excise the marionette lines, either directly or with a lateral corner lift lip, due to the risk of scarring.
+1
Marionette fold excision
Direct excision of marionette fold is probably not the best idea since it will result in a prominent visible scar. A total and comprehensive face/neck lift should lift the marionette folds quite well. Any residual marionette lines can be augmented with injectable fillers. In 20 years of private practice, we have never excised marionette folds.
+1
Marionettes
Excision of the marionettes lines or nasolabial folds is a good option for very deep lines. The incision line is usually preferable to the deep fold. This procedure is reserved for patients who are unhappy with results from other procedures.
Jacob Freiman, MD
Miami Beach Plastic Surgeon
Miami Beach Plastic Surgeon
+1
Facelift - Marionette Fold Excision?
Right - and that's the problem. A "small likely imperceptible scar" would almost always be a good trade for a "problem" area but it is a huge risk to take in the even that a more significant scar would be problematic. Which I suspect it would be on that part of your face.
Procedures such as these (excision of facial folds) are more likely to be appropriate for people who are on stage or who are visible mostly from a distance and can wear make-up to...
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+1
Marionette fold excision
Do not do this.
Even an optimal scar will still be noticeable in this location, and will likely require make-up to disguise it.
Instead, consider fillers to the area, or a further SMAS and skin tightening along the jawline. A good facelift is very effective for treating this problem.
+1
Marionette Folds: options and scars
Greetings, Marionette folds can be difficult to treat and may require more than just a lift. I would recommend giving the fillers a try again and even moving on to fat grafting as a means to add more volume and longevity. In addition, I would utilize fractional laser techniques to help tighten the skin in this area. Finally, I would consider excision only as a last option for as you already appreciate, may lead to visual scarring.
James Wire, MD
Minneapolis Plastic Surgeon
Minneapolis Plastic Surgeon
+1
What is Your Opinion on Marionette Fold Excision?
NO, IMHO that's just plain silly. Why would you have incisions leading to scars in one of the most visible parts of your face. See other plastic and cosmetic surgeons until you find a reasonable and logical solution because this isn't it IMHO.
+1
Excision of Marionette Lines
Excision of marionette folds is an option. However, I would be very cautious. The scar could be wore than the folds themselves. The marionette folds can be a very challenging problem. A full facelift can soften the folds but I would not expect them to be eliminated. If you are considering excision I would look around for a surgeon who has performed this procedure and look closely at his before and after pictures to get a realistic idea of what you could expect.
+1
Marionette Fold excision
I think at this point you should take "a step back".
Discuss your concern and wishes with your surgeon and ask him/her how he/she can address your concern before embarking on another procedure. If you are not satisfied what you hear you may want to seek another opinion.
A "regular" facelift should improve your Marionette lines considerably. Maybe your "partial" facelift should be changed to a "regular" facelift. Fat...
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Guido P. Gutter MD
Evansville Plastic Surgeon
Evansville Plastic Surgeon
+1
Peristent marionette lines
I highly discourage excision of these. Sounds like what you needed was a full facelift instead of a 'partial' one. Please consider a full facelift before attempting excision. Best wishes, Dr. H
+1
Marionette (Doll, Nose to Corner of Mouth) Fold Excision
A (permanent) scar is the result of every full-thickness incision through skin. While surgeons can occasionally limit the length of the scar, they can never ethically guarantee the scar would be "imperceptible". The location, orientation, mobility, tension on the scar and your ethnicity will affect the ultimate scar as much as the skill of the surgeon. The best way to guarantee an imperceptible scar is to NOT cut the skin.
While nasolabial fold excision (and excisional brow...
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+1
Excision of Marionette Folds -- Treatment worse than the problem?
I personally would advocate against doing a direct excision of a marionette fold. Fillers, volumizers (sculptra, fat), and/or a more extended facelift would all be better options in my opinion. Although it's possible to have a scar that is imperceptible, that is not always the case. If by "glaring marionette folds" you mean long length and great depth, then an excision to treat this area would likely have to be long. The longer it is, the more noticeable it becomes.
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+1
Excision of Marionette Folds
Direct excision of marionette lines is not a great idea. Excising nasolabial folds is better in certain people, but also not a great idea. I would recommend filler, laser, chemical peel, or just living with it before I would recommend excision.
+1
Marionette Line Excision May Be Acceptable In Older Patients
Of the two central facial folds due to aging, nasolabial and marionette lines, excision is a viable treatment option. While excision of either of these folds can be tremendously effective, there is the trade-off of a scar. That scar is a lot better accepted in the nasolabial fold region than in the marionette lines and does not really look very good in younger patients. For patients over 65 or 70, it is an option if one really wants to avoid a more major operation...
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+1
Marionette Fold Excision
A facelift rarely improves significant marionette folds and fillers tend to offer partial improvement also. An excision is uncommon but depending on your skin type, may be a reasonable option if you can accept teh tradeoff of a scar.
Karol A. Gutowski, MD
Chicago Plastic Surgeon
Chicago Plastic Surgeon
+1
Excision of facial creases of aging
The "extended corner lift" you refer to is a good option when performed for the correct indications in carefully selected patients. If the creases and sad look bother you and you believe your surgeon can manage the scar, go for it.
+1
Marionette excision
If your facelift was a mini lift, you would be better off (and should have from the start) have a full facelift. This will usually get at least 50% improvement of the folds. The direct excision is ok if you are older but the scar in a younger patient could be very bad.
+1
Facelift and Marionette Fold Excision
You are correct, one option for treating severe marionette folds, that were not improved fully with a facelift, may be to directly excise the skin in the fold. You are also correct that the controversy surrouding this procedure is the resultant scar. In older patients with thin, fair skin, the scar from this procedure may be acceptible; in a younger patient, with more exuberant scar formation, it may not. Have your surgeon access the scar formation you had with your...
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