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

Doctor Answers 20

Fillers are meant for the marionette lines

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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.

Yes but think carefully!

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 love going fillers as much as I love putting on my make up, because it is an art!

Chances are you need a combo of Botox and fillers. Botox should be placed carefully because it can cause a "joker smile" if you are not a candidate for it! Therefore, I always have patients smile really big to see what the effect of the botox will be on their smile before we even discuss this as an option.

Fillers are great because they support the angles back up! Most people think that they need to put fillers just in the area of the sagging! Not true! There are "vectors" to sagging. IF you find the area of the vector and place fillers there, you create a bigger lift to pull up the parts of the face sagging. Then once you lift from there you also add fillers to the M-lines to enhance them.

You NEVER want to have too much fillers on the lower face- it causes an aged appearance because young faces are like a nice triangle and older faces are an inverted triangle. So, simply put, enhance the upper face can help make a natural restoration to the sagging angles of the mouth.

I always determine which combo of fillers to use based on the consolation: as my patients are talking I watch them animate their faces. The answer comes to me based on their unique anatomy! It really is so satisfying to see their happy faces after!

Best of luck!

Tanya Kormeili, MD
Los Angeles Dermatologist

Botox can be helpful with expert injection

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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.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 26 reviews

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Botox vs fillers for marionette region

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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.

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

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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


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Hi Laura.  Thank you for your question. The general algorithm is that Botox is effective in the “upper ⅓” of the face: forehead lines, crow’s feet, and lines between the eyebrows. These lines are “dynamic” lines, caused by underlying muscle contractions. By relaxing the associated muscles, Botox smoothens the upper ⅓ of the face. “Static” lines in the lower face, such as the nasolabial folds, are amenable to facial filler.
Hope this is helpful. Best wishes. Dr. Shah

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon

Fillers, not Botox

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

Nonsurgical 3D Vectoring, Volumizing, Filling, & Botox Work To Decrease Sagging, Wrinkling & Improve Facial Contour & Definition

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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

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Probably not what you want...

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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 should consider fillers like juvederm as the preferred option...

Ken Landow, MD
Las Vegas Dermatologist

Botox for Marionette, Mouth, and Chin Lines and Wrinkles?

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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.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 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.