Age: 23 - How to fix marionette/nasolabial folds on a YOUNG patient? (Photos)

Question

Hi— I am 23 and I have intense marionette/nasolabial lines that connect to each other when I talk. I think they are mostly generic as my parents both have deep lines in the same areas as well as heavy jowling. However, I also had my lower jaw pulled forward by an orthodontist as a child which significantly altered the appearance of my face and I believe that could be a factor. My understanding is that the best way to correct these lines is a lower facelift, however I am of course going to be incredibly hard pressed to find any reputable doctor willing to perform that on me for way least 10-15 years. I know fillers are an option but I fear they are only a very temporary fix and may migrate. I have a hard time finding other people my age with this issue as it seems to be more of a problem with my actually skeletal structure than with aging, however I know it will worsen as I age. Is there anything I am not considering in treating these? In the past I used to wonder if pallete widening or jaw augmentation would be beneficial to my appearance. Could either of those help? In general how is a problem like this approached? I worry it is unfixable without a face lift, which is not accessible to me at this age. You can see in the photos that the lines are mostly visible when I talk, and in some lighting are less apparent.

Ali Riza Öreroglu, MD · Answer

Based on what I can see from the photos, the prominence of your marionette and nasolabial lines appears to be related more to structural and soft tissue factors than simply age. It’s important to understand that facelift surgery is not solely about age—it is primarily about the condition of your skin elasticity and facial muscles.
In your case, I would recommend starting with less invasive options such as fat grafting (fat transfer) to restore volume and soften the appearance of these lines. This approach helps to balance facial contours and provides a more youthful, natural look.
If, over time, skin laxity and tissue sagging become more pronounced, then a lower facelift can be considered to achieve more permanent and comprehensive improvement.
In summary, your concern is definitely manageable at your age and typically approached in stages. A thorough in-person examination is essential to tailor the best treatment plan specifically for you.

Gary M. Horndeski, MD · Answer

You should consider an eccentric lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Michelle Zweifler, MD · Answer

There are treatment options for marionette lines and nasolabial folds.  Most people would start with filler either in the area to camouflage the depressions or in the cheeks for "lifting"; similarly, this can be done with fat grafting to the face.  Sofwave nonsurgical skin tightening stimulates your own collagen and helps to help the chin, jawline, eyebrows and often the cheeks.

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Age: 23 - How to fix marionette/nasolabial folds on a YOUNG patient? (Photos)

Answers (3)

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