I have marionette lines, lip lines, and wrinkles all at once! What's the best wrinkle fillers to get rid of these lines?

When we graduated medical school, our professors told us "primum non nocere", first don't harm people. I interpret this as meaning that the treatments we give our patients should be safe.
I am proud now that the reports of granulomas with Artecoll and Radiance are surfacing that not one single patient of ours has ever been injected with that substance. Now that silicone horror stories are well-known, not one patient has ever been injected with silicone in our office.
While many patients will continue to be injected by the newest fillers with non-natural components such as methyl methacrylate beads, plastic spheres, liquid silicone, silicone gels, we will not inject them in our practice, because it simply does not make sense to put a permanent or semipermanent non-biologic material into the face in my opinion.
I am impressed with the safety and effectiveness of hyaluronic acid fillers. Prevelle is a lighter hyaluronic acid with a little lidocaine in it for sensitive patients or patients with little or no recovery time.
You can see by the posts that occasionally the heavier hyaluronic acids such as the Juvederm series and Restylane or Perlane, wonderful fillers which we use daily, can cause swelling for several days, so this should be factored for patients who are on camera (i.e. newscasters) or have important social obligations immediately following their injections.
So while you can argue which is the best filler, please avoid the bad ones.

Thank you for your question. One of the most challenging aspects of pesky aging symptoms is they can seem to appear quite suddenly and often simultaneously. The good news is you can address all of these concerns in a single treatment session in most cases. Injectable fillers work very well to smooth away lines in the lower half of the face, including marionette lines. I might suggest Juvederm or Restylane for this area, although there are other options as well. Lip lines, also known as perioral lines, can be treated with a smooth injectable filler like Kysse. If lines are severe, laser resurfacing might be a better option. Finally neuromodulators are used to diminish lines that occur as a result of repetitive facial movement. All of these procedures could be performed together so you only need to schedule one appointment in most cases. I recommend scheduling a consultation with an experienced, board-certified injector who can examine you in person and create a customized treatment plan that meets your needs and goals best.

Wrinkles and lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like RF treatments, lasers, microneedling/PRP or sculptra to get increased collagen, tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Unfortunately, at some point, usually after 35 years old, we start noticing these lines after years of facial animation. I always believe that area needs to be addressed slowly and with the thicker fillers in the marionette lines and naso-labial lines, with the thinner fillers in lips and surrounding area. It really should be a process with gradual improvement as that lower face can look too full if injected with too much filler too quickly.  Progress not perfection is my motto.Best of luck,Dr. G

An in-person consultation would be needed to determine this but typically, a combination of different fillers would be needed.The foregoing information provided is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.

Hi there thanks for your question!
There are a lot of good products out there but above all I personally only use the Juvederm Vycross range of dermal fillers due to their smooth consistency providing natural looking and long lasting results. The products in the vycross range can all be used to improve the areas you have mentioned. 
I hope this helps! 
Best wishes, 
Dr Rupert 

As always, I recommend scheduling a consultation with an aesthetics professional first to determine the best treatment plan for you specifically. Also, this will give you a chance to evaluate the provider if you have never been to them before. That said, I believe Juvederm or Restylane would be the best filler options for what you're wanting. Tip: Look into Brilliant Distinctions if you haven't already! You can earn points and and apply them to future treatments at participating providers. 

There are many factors that go into choosing a filler:1) what are you trying to achieve?  A more robust filler will lift; a softer filler will smooth2) how thick is the patient's skin in the area to be treated?  Thicker skin needs a thicker filler; thinner skin may show bumps if you use a filler that is too robust3) is the filler going into an area of motion? If so, we want a filler that will move with the patient's skin and provide support during movement (eg restylane refyne)There is no one-size-fits-all answer to your question.

Great question! There are many different fillers and some that work best for specific areas. I find in my practice Juvederm Ultra, or if the marionette lines are fairly deep, Juvederm Ultra Plus work best. They both give a nice gentle inflation to the area without looking over filled. In some cases, I might layer the two.

For lip lines I prefer Vobella and for the body of the lip itself, Restylane Silk. Again, it’s about a gentle inflation and softening of the lines.

When injecting the lips I like my patients to be comfortable, so I do an intraoral block, like the dentist, and most patients find the procedure completely comfortable.

Best of luck!

Dr. Thomas Kaniff

Hello and thank you for your question. Currently we have a huge variety of different fillers on the market from Restylane and Juvederm family line of products. Restylane has 5 different fillers approved in the USA  ( Restylane, Silk, Lyft, Define, and Refine) and Juvederm has 4 different fillers (Ultra,Ultra Plus, Volbella, and Voluma). Each of these fillers differ in the ability to fill in the lines, lift, correct and smooth out. Some are thick and not easy to mold, others are very moldable and virtually invisible under the skin. You need to have an I person consultation to evaluate skin laxity and quality in order to determine which would be the appropriate option for you. You might also need skin tightening treatment to prevent your skin from getting looser and casing all those lines to appear. Please seek an expert consultation. It's your face at stake here. Hope this helps. Best, Dr.Avaliani

Juvederm is an excellent hyaluronic acid filler that is ideal for areas that see more muscle movement, such as the lips.  Restylane and Restylane Lyft are excellent hyaluronic acid fillers that are great for the nasolabial folds.  Depending on the patient's own metabolism, these fillers can last up to nine months.  Injections should be done by a board certified plastic surgeon or board certified dermatologist with expertise in the use of cosmetic fillers.