Can Botox Be Used to Correct Marionette Lines? Is That Possible?

Hi Rosie.  We do at times use Botox in the chin area, but not specifically for marionette lines.  We use Botox to relax the mentalis, which is the chin muscle that can cause a condition called "pebble chin".  This constant flexing of the chin muscle can cause the chin to look mottled or bumpy almost as if acne scars are present when they are not.  But I digress....

We use Restylane, Juvederm, Perlane or Radiesse in the lower face.  We do not use Botox for marionette lines. Most often Restylane, Perlane or Juvederm in the marionette lines and Radiesse for the jowls at the outer edge of these lines.  Take a look at the link below for more information on the facial areas we treat and how we treat them.

  I have heard Botox used for this and have tried it in a handful of patients.  I have not seen much improvement.  Fillers are better here.

Marionette lines are formed by a combination of a loss of facial volume, normal skin aging, and the presence of deep retaining ligaments attached to the skin.  There are surgical and non-surgical methods of treatment.  In regards to non-surgical methods, they are best treated with dermal fillers which can restore volume and also elevate deep folds.  Botox Cosmetic can be useful when the corners of the mouth are downturned secondary to overactive depressor muscles.  On some occasions, optimal results are obtained with a combination of the two treatments.  

I would suggest a filler material for correction of marionette lines.  These lines are "static" wrinkles, meaning they are caused by gravity and volume loss.  "Static Wrinkles" require volume enhancement with a filler substance such as an artificial hyaluronic acid filler like Restylane or Juvederm, or a more permanent filler like fat.  "Dynamic Wrinkles" those that are caused by muscle motion, such as the crow's feet or 11 lines between the brow, can be treated with Botox.  Botox will paralyze the muscle which is causing the wrinkle to form.  Good Luck...Dr. Corrado

Fillers are used to replace volume and help improve the marionette lines between the corners of the mouth and chin. Botox doesn't help these lines, but does help lift up the corner of the mouth if it has started to droop. The Botox is injected in the vicinity of the depressor anguli oris (DAO) muscle near the jaw for that purpose. Injecting Botox near the marionette lines may give you a distortion of the mouth temporarily.

In some patients, Botox can reduce the appearance of marionette lines.  Fillers like Restylane, Perlane, or Juvederm can be used as well.  Often times I will use Botox in combination with a filler to get the best result.  Injecting Botox is this area is tricky and you can have complications which can be temporarily disfiguring so be sure to go to dermatologist or plastic surgeon that has a lot of experience with injectables.  Take care, Dr. Groff

You usually need fillers for marionette lines.  Radiesse for $630/ syr or Restylane/juvederm $550/ syr is the usual choice.  Don't waste your money on botox in this area.

You may have learned by now that the Marionette lines is the lay term for the line or groove that goes from the mouth corner down to the jaw border. This is caused by thinning of the tissue layers, loss of tissue tone and deflation of the tissue thickness. the result is sinking and sagging of the lower cheek tissues that slide along this crease. Fillers and skin tightening with or without surgery is recommended.
Botox temporarily relaxes muscles and would be a primary treatment for these lines.
Dr. Mosher

Since Botox works by locally paralyzing your muscles that make a particular wrinkle, this would not be a good idea for your marionette lines that are not due to excessive muscular activity. Injectable fillers work well for improving the appearance of many wrinkles around your mouth. My personal preference is to use Silikon-1000, an off-label filler, for permanent results.

All the best from NJ.

Marionette (labiomandibular) lines are best treated with fillers or a a facelift. Occasionally, botulinum toxin can be used in the Depressor annguli oris to limit downturning of the corner of the mouth which can make the marionette lines appear more prominent.