Does Botox work for marionette lines?

Question

Would Botox work for my marionette lines? How about for golf ball chin? Isn’t there a danger that if the marionette lines get too relaxed with Botox, it could have an adverse effect on the jowls and make them sag even more?

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Unfortunately Botox does not work on marionette lines, you would need to consider filler for these.

Jonathan Kulbersh, MD · Answer

Thank you for your good question. Marionette lines, the lines that form from the corners of the mouth to the chin, are caused by collagen depletion, which is a natural part of the aging process. The best way to treat wrinkles caused by collagen loss is with injectable dermal fillers, not Botox. Botox is a neuromodulator that works by relaxing facial muscles that lead to the formation of some wrinkles. It is most commonly used in lines of the upper face, such as forehead wrinkles and crow's feet. Make sure you work with an experienced, qualified injector to ensure the best possible results from your procedure.

Alan Gonzalez, MD, FACS · Answer

Hello @MeUCantSee thank you for your question. Sometimes when we frown really hard there is a line and if it is very deep is a fold. Botox is used to avoid the contraction of the muscle that forms the expressions lines and that those lines don't become folds. The marionette lines can not be treated with botox but it can be fill with hyaluronic acid because the filler that can elevate volume and the line does not show. Best wishes!

Jason Emer, MD · Answer

botox doesnt work for marionette lines these need skin tightening like threads, morpheus and fillers.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant or moxi regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8/pixel8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Amelia Damse, DO · Answer

Botox cannot be used to treat marionette lines, since these lines are caused by drooping of the skin due to volume loss. This problem is addressed by injecting dermal fillers into the mid face (cheekbones) or directly into to marionette lines to soften their appearance. However, golf ball chin, or dimpling of the chin, can be treated by injecting a few units of botulinum toxin to relax the muscles causing these dimples.

Benjamin Barankin, MD, FRCPC · Answer

Botox can be helpful for those with downturned corners of the mouth. However, for most people fillers (usually hyaluronic acid) placed in the Marionette lines and/or into the cheeks can help soften or even greatly reduce Marionette lines depending on how deep they area. Skin tightening, e.g. Morpheus8, Thermal, etc, can also be considered and provide some benefit. If these lines are too deep, then facelift surgery will be most beneficial.

RAS Medical Aesthetics · Answer

Yes Botox works well on the marionette lines. Botox will reduce the movement of the muscle around the mouth that creates those lines. Also will help with the muscle that pulls your mouth corner downward. If injected correctly there shouldn’t be any adverse effect. Injector should inject 1 cm above the angle of the jaw. In the line with the Depressor Anguli Oris muscle. Using Botox on the chin will temporarily relax the movement of the muscle underneath the skin. This will help smooth the appearance of wrinkles on your chin.

Curated Medical - Scottsdale · Answer

Botox can sometimes help with marionette lines. There is a muscle called the depressor anguli oris (DAO) that pulls down the corners of your mouth and makes you frown. This muscle can be treated with Botox, although you may also need filler. Botox can also easily treat golf ball chin.

Camille Cash, MD · Answer

Botox is not the correct product to treat marionette lines.  Fillers are commonly used to improve this area.  Other treatments like Morpheus8 can improve skin tone and texture.  See an expert injector to learn more.

Dmitriy Schwarzburg, MD · Answer

Marionette lines are best treated with a face lift, or fillers. Since Botox works to paralyze a muscle to treat wrinkle, this will not be good for marionette lines where there are lots of muscle activity. Always consult with a board certified medical practitioner for best results.