Fillers like Juvederm and Restylane are best for the marionette lines. These are hyaluronic acid fillers that can make the smile lines or lines of the mouth look much better. They "fill in" these lines so that the wrinkles and lines are smoother and much less pronounced. Botox is not meant for the marionette lines and would cause your face to droop.
Can Botox Get Rid of Marionette Lines, Mouth and Chin Lines, and Wrinkles?
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Doctor Answers 19
Botox can be helpful with expert injection
Botox vs fillers for marionette region
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Can Botox Get Rid of Marionette Lines, Mouth and Chin Lines, and Wrinkles
Hope this is helpful. Best wishes. Dr. Shah
Fillers, not Botox
Nonsurgical 3D Vectoring, Volumizing, Filling, & Botox Work To Decrease Sagging, Wrinkling & Improve Facial Contour & Definition
Unfortunately, smiling photographs are not very helpful for tailoring a treatment plan for any individual. In general terms, however, my first choice for most cases of marionette ("Howdy Doody" or "sad") lines would be The Nonsurgical 3D Vectoring Facelift, with particular concentration on the marionette area. This non-invasive procedure, which employs volumizers, such as Radiesse, can be found described in detail elsewhere in the RealSelf Q&A archives.
The Nonsurgical 3D Vectoring Facelift not only softens the marionette lines, but, if necessary, (via appropriate placement of the injectable volumizing materials) can also improve the smile lines on the sides of the nose and the jowls along the jawline as well as give greater, more youthful definition to the cheeks.
For treating the "lipstick bleeding" (aka "smoker's) lines around the mouth, fillers, such as Restylane L or Belotero Balance are quite effective. For dimpled, pebbly chins, chin augmentation, using Radiesse combined with Perlane L (in my Upper East Side practice) and Radiesse plus Restylane SQ (In my Israel office) can be extremely helpful, especially when combined with microdroplets of a neuromodulator, such as Botox, Dysport, or Xeomin for smoothing the chin and providing greater projection and definition.
Naturally, consultation with a board certified aesthetic physician with experience with all current facial rejuvenation techniques and injectable agents is advisable to ensure that the treatment plan that is created is tailored to the specific needs of the individual
Probably not what you want...
for the the mouth, chin and marionette lines botox is not what you really need...the role of botox seems limited to some improvement in the creases radiating from the lips and maybe a little bit at the jawline just to either side of your chin where it may slightly raise the corners of your lip...botox certainly helps calm active movement in the chin and of course reduces wrinkling there...for the rest...you should consider fillers like juvederm as the preferred option...
Botox for Marionette, Mouth, and Chin Lines and Wrinkles?
Botox placed in this area is an "off label" use. Having said some injectors will place Botox in these areas. Most often, patients may benefit from Botox placed in the DAO muscle. Usually we will use a filler in the areas that you are talking about. Please seek out an experienced and well trained injector.
Fillers are better for lower facial lines or wrinkles
Rule of thumb, any lines on the lower portion of the face should be filled with fillers such as Restylane, Juvederm, Radiesse, etc. Tiny doses of Botox can be used in those areas as well, but a filler will really give you the look you want. Botox relaxes the muscle, so is much more utilized for the upper portion of the face.
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