Juvederm Injected in Nasolabial Folds, and Marionette Lines Appeared

I had Juvederm injected into my nasolabial folds, but now that area is more raised from being plumped up by the juverderm l find that the two shadows underneath (marionette lines) look deeper than before. I will be going back for a second treatment at the end of the summer, but if l have the marionette lines filled with my nasolabial lines then would that be over spreading the use of my two syringes? What can l do?

Doctor Answers 7

When plumping wrinkles you can't just address one area

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When wrinkles are injected, you might have certain ones that are your least favorites, but an expert injector should recommend other areas that might need treatment also, and its important to listen.  If enough product is available/affordable, then these areas should be treated.  Just chasing specific wrinkles will not necessarily give you the overall younger look that we all want, it may be that several areas need to be treated top produce the best result.  In your case, the marionette lines sound like they need to be treated, you probably didn't notice them when you were concerned with your nasolabial folds.  Now that they look better the marionettes seem more noticeable.

Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 217 reviews

Need to address both areas

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When one area is perfected you may notice other areas will stand out more.  I think the nasolabial folds are just as important as the marionette lines.  I would recommend if your on a budget, to use one syringe for your nasolabial folds and one for your marionette lines.  It will definitely look better and your working towards total correction.

David Stoker, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 62 reviews

Juvederm in marionette lines

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Juvederm is an excellnt choice to fill the marionette around the lower lips and chin region.  It should not be a problem and would complement the results taht you obtained in the nasolabial folds.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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Juvederm injected in nasolabial folds, and marionette lines appeared

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Interesting question. From your description I would recommend using another injector. I never try to spread out the amount to save $ or at the patient's request I use the amount I think is needed.


Marionette lines more obvious after smile folds injected with filler

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If there is a raised surface to the smile folds after your injections, then you may have more shadows in the marionette lines making them more visible. You may wish to start the next treatment with moderate improvement in the marionette lines first. Then use the rest of the product in the two syringes, for the smile folds and see if you like the results better. You might need to add a smaller third syringe to complete the look.

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Filling One Area With Juvederm May Cause an Adjacent Area to Become More Noticeable

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Two syringes of Juvederm should help your marionette lines and your nasolabial folds.  One of the common side effects of using fillers in an isolated area such as the nasolabial folds only is that once that area is corrected, other areas become more noticeable.  Have your injecting physician use enough filler to correct your concerns for best results.  Good luck and be well.

Dr P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
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Some times the filler is not the answer to the lines of the face . Fillers do not replace a face lift, in those cases it makes things look worse. That is why a Plastic surgeon should analyze the face the combination of wrinkles and be able to tell you whether fillers are appropriate or you should go for the face lift.

Many unqualified people like Gynecologists, emergeb=ncy room doctores , family physicians, internists ophthalmologists, are in the buisness of fillers and botox and cosmetic medicine without any training in the field.

They might be cheeper then the results are suboptimal.

Choose your DOCTOR carefully, for good results, and also will be less exppensive

Samir Shureih, MD
Baltimore Plastic Surgeon

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.