I am a 45 year old woman with awful marionette lines. Can a filler be used? (photo)

I've always had a very plump face and now it's sagging around my mouth. Can this be treated with a filler, and what type would you suggest? How much would I need if so, because I'm looking for a ballpark estimate of the cost for testing my sagging. It's really aging me! Thank you!

Doctor Answers 4

You would benefit from dermal fillers and a skin tightening procedure

Thank you for your question and photo. Based on the photo you provided, it appears as though your marionette lines are quite pronounced due to sagging of the middle and upper face. Doing a volumizing filler such as Voluma in the mid-face to create contour and accentuate your cheek bones will actually create improvement in your nasolabial folds and marionette lines. If the marionette lines are still prominent after this, I will use a filler like Juvederm or Restylane to fill in the line directly. In addition to fillers, you may consider a skin tightening procedure such as Ultherapy. Ultherapy uses non-invasive ultrasound-heating to tighten the skin and subcutaneous tissues, creating a lifting effect which would also benefit you. 

If considering any of these treatments, I recommended scheduling a consultation with a board-certified plastic surgeon or dermatologist familiar with these treatments who can help you find a treatment plan that works best for you!

I hope this answer is helpful! Best of luck.


San Diego Dermatologic Surgeon
4.8 out of 5 stars 6 reviews

Solution for marionette lines.

A patient with your facial features can be treated successfully with dermal fillers.  When the mid face is "plump" or full, Voluma can be used along the lateral cheek lines to lift and improve the shape and proportions of the face. Care must be taken not to add to the fullness of the mid face.  In my patients who have deep marionette lines like yours, I also use Voluma along the chin (an off label area for this filler) followed by Juvederm below the mouth corners to complete the correction and turn those corners back up.  This treatment looks very natural and can really give your face a refreshed appearance.

The number of syringes needed and other specific plans for your treatment would be determined during the examination by your doctor.  Best of luck, Dr. Gill


Marlin Gill, MD
Decatur Family Physician

Filler for Marionette lines

Thanks for the question and picture.  From the picture you would greatly benefit from filler.  You could have Vlouma or Juvederm placed over the jaw line which would even it up all the way to the chin and then place regular Juvederm in the fold and under the edge of the mouth.  This would greatly fill in the defect and give you a more smooth and youthful look. You may want to consider some filler to the nasolabial fold also as this can add to the lift of your lower face.  Hope this helps.

Dr. ODell

Filler for marionette lines

Hello, and thanks for your question and photos. You appear to be an excellent candidate for facial rejuvenation with hyaluronic acid (HA) fillers. In particular, I think you would benefit from Voluma, which is a thicker HA filler, meant to be placed deep so as to provide structure and lift, thus softening the lines in the lower face as well. You may then also require placement of a softer filler directly into your marionettes to further soften them. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Best of luck, Dr. Frucht. 

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

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.