What is the longest lasting treatment for marionette lines? Juvederm, or is there something more recent? (Photo)

Fillers, implants and fat can all be used to sculpt the face. Fillers like Radiesse, Voluma, Perlane work great for cheek volumization which helps improve nasolabial and marionette lines as well indirectly. Fat can also be used which is something I do frequently in my practice. I suggest consulting with a facial contouring expert. Best, Dr. Emer

Hello disappointed2064,Thanks for your question. For the marionette's lines I am a big fan of Radiesse (calcium hydroxyapatite) filler.  It is a biological volumizer that, once injected, triggers your body to produce long lasting collagen to fill the deflated areas around the lower corner of your mouth.  Patients typically need 1-2 sessions of injections separated by 3-6 months.  Results can last for several years. My next favorite option is fat grafting to the area.  This procedure allows for the use of your own fat as a natural filler.  Roughly 50% of the fat survives to naturally fill the area.Other options include Sculptra and prejowl silicone implants.  Hyaluronic acid fillers like Voluma and Restylane Lyft are great as well, but reabsorb completely over time.  They work well but do not leave behind any long lasting volume like the other 4 treatments I've mentioned.I recommend that you consult with a facial enhancement specialist for a more in-depth discussion about your options.Good luck,Dr. Shah

There are many fillers that can be used for this area.  Your lines are deep so you would want the thicker, longer lasting fillers such as Juvederm ultra plus or Restylane Lyft.  Could also use Radiesse here.    

Longer lasting fillers such as Voluma or Restylane Lyft can be used bu in my experience fat grafts provide the longest result. In your case I would also suggest that you have fat injections in your nasolabial grooves.