Can Botox Get Rid of Marionette Lines, Mouth and Chin Lines, and Wrinkles?

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

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

While Botox is not generally considered the best treatment for lines around the mouth, marionette lines are affected by a specific muscle that pulls down the sides of the lips so Botox can be helpful with expert injection. In addition, these lines are usually caused by volume loss, and are also improved with the use of dermal fillers such as Restylane, Juvederm or Radiesse. An in-person consultation with a board-certified dermatologist would be needed to evaluate your concerns and come up with a custom treatment plan.

Thank you for your question. Fillers are typically a better choice to get around the mouth.  You can use Botox to raise the corner of the mouth or reduce the dimpling on the chin.

Thank you for submitting your question. Botox can help alleviate some of the dynamic lines in the lower lip, and chin. It will may also help lift the corner of the mouth. MArioette lines are best treated with a filler. Make an appointment with an expert injector to discuss perioral rejuvenation and discuss the best treatment plan. Best Wishes

For these areas, you probably would need fillers rather than Botox. Fillers will smooth away these creases 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.

Based on your photo, we would not be using any Botox for you.  The only time we use Botox for the lower face is when we think it would benefit a patient for smoker's lines.  We often use a combination of Restylane and a few units of Botox in the upper lip to get rid of smoker's lines, but it does not appear these are an issue for you.

It does appear that you have lost a little volume in the nasolabial (smile or laugh) lines on the sides of the nose and mouth and that the volume loss continues down below the mouth as you have pointed out (marionette lines).  We would most likely use 2 syringes of Restylane to add volume to these areas.  Good luck.

Botox works well by paralyzing the muscle of facial expression like the muscles that cause the lines in the forehead, the glabella (area between the eyebrows) and the lines around the eyes (crowsfeet).
Fillers like restylane and other HA work by filling in the area around the folds and filling in the furrows. These products work well in the nasolabial fold, the marionette and the jowl area.
Hope that helps.

Botox is most effective for the forehead and smile lines around the eyes. Botox works by weakening the muscles that cause those lines. For example, it can lessen your ability to scowl or frown. It can also make it when you smile that the crow's feet are less obvious. For the lower face, it can soften a marionette line by weakening the muscles that pull the lip downward. It can do the same for the chin lines. However, generally speaking the actual wrinkles are still there and usually require a filler to correct those areas like hyaluronic acids.