Improving Marionette Lines with Lower Facelift?

Thanks for the great question -
A lower facelift is designed to address the neck and submental (beneath the chin) excess skin as well as the jowling which can contribute to the marionette lines.
You should see a significant improvement but sometimes there can be some residual lines.
Have a careful conversation with a board certified plastic surgeon about what to expect and how to proceed in a manner that best addresses your concerns.
I hope this helps.

Please
understand that marionette lines can be seen even in children, but get deeper
as we age. The goal is to soften them so as to maintain a natural looking
appearance. A lower facelift should help soften the bottom third of the
lines. For more improvement, I find that fat transfer does an
excellent job, especially with deeper marionettes and horizontal creases in
that area. Sometimes, adding a CO2 fractional laser may be required to achieve
the desired result. I would caution you that if you are pulling your face
so as to make horizontal lines, you may be pulling too tight or possibly
in the wrong direction(s).
Be
sure to address these concerns with your chosen surgeon and ask him/her to help
you create a contingency plan for what you will do if the surgery doesn’t fully
correct this concern. That way you can rest easy and feel confident in your
decision.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

A lower facelift will help with marionette lines somewhat, but in most cases will not eliminate them. Keep in mind that some degree of fold in this area is natural and age-appropriate. Some attempts to over-tighten this area can end up looking strange and unnatural. If there is enough tissue available, I offer to transplant some of the patient's own tissue from under the skin into this fold to serve as a natural and semi-permanent filler. This works similarly to fat transfer, but is made up of the patient's own fibrous tissue as well, which allows it to last for many years. Again, this will often not completely eliminate this fold, but will help to soften it. Finally, injectable fillers might be an option for post-operative correction and additional improvement in this area.
Be sure to see a surgeon who specializes in facial aesthetic procedures in order to review all of the options in detail.
Best,

Hi,  if you have beautiful cheek bones, a lower face lift with midface lifting,  your jowls can be easily placed back to their proper position, that will give  fullness to your midface, improve "marionette  lines" and allow you a more youthful  look.
Best of luck to you

Most people age in 3 major ways:1) Skin inelasticity: the skin sags or stretches over time.  The best way to treat sag or excess skin is to remove it.  In milder cases, the skin can be tightened with CO2 laser or Ultherapy.2) Volume loss: we lose volume in the form of fat, collagen, muscle bulk, and bone.  As we age, we lose more.  If the skin is tightened without restoring volume support to the skin, you get an overpulled look.3) Decrease in skin quality: after a facelift, the excess skin is removed.  However, the skin that's left behind hasn't been rejuvenated.  The skin thins as we age and we lose collagen in the dermis.  Collagen can be replaced using a combination of Retin-A, Co2 laser, microneedling, etc. Marionette lines that persist after skin tightening occur as a result of poor skin quality or poor facial volume that needs to be added to address the other ways you may be aging.  

As we age, the cheek moves downward against the relatively fixed tissue around the mouth and this causes folds of skin that we call nasolabial folds and marionette lines. A lower facelift will significantly improve marionette folds. However, lines that are "etched" into the skin in these areas will not go away with a lift alone, but require some type of skin resurfacing.You may test this yourself by pulling the skin of the cheek up and away from the marionette region. Any lines that remain will also remain after a lift.

Lower facelift is a great way to go with marionette lines. Many plastic surgeons are now filling these types of wrinkles at the time of facelift. The best option is fat, as it is long-lasting, your own tissue. Dermabrasion may also provide some benefit. Your board-certified plastic surgeon is your best source for options that are best for you! You can find one close to you on plasticsurgery.org. Best of luck!

IMHO, Marionette lines are best treated with lower facelift surgery.  This does NOT mean that surgery will give you the same results as pulling your face backward AND it does not mean that surgery will "erase" or  make those lines "disappear."  The goal would be to significantly reduce the jowls and the depth of these lines.  fillers can be added later, if necessary.

Lower face lifts or mini-lifts re-drape the redundant skin in this region smoothing them out to a degree. The assessment however is key to determining if additional procedures are required: for example: if there is redundant fat in the jowl region this should be reduced (liposuction or direct reduction), if there is pre-jowl ("thumbprint depression between chin and jowl) depression then it would indicate that a filler is probably needed. Fillers  include fat transfer,  Perlane, Jeuvederm, Radiesse, Sculptra, and others to correct the jowl contour problem

Marrionette lines improve with traditional lower facelifts to some degree. However, certain facial muscles create these lines and they are not directly corrected by the facelift muscle repair. I advise most of my patients that they will probably need filler to the area approximately once a year to get more of a result. Fillers alone, however, cannot solve the entire problem. This problem frustrates patients and doctors alike.