How do I get rid of marionette lines down each side of mouth, and prevent a double chin?

Liposuction or kybella can be used for your double chin, although you look like a neck/face lift candidate.  Marionette lines can be improved with fillers and/or fat.  I suggest you see an expert for an evaluation to go over all your options.  Best, Dr. Emer.

In my opinion, based on the pictures you posted, your best option is a face and neck lift. Any procedure short of that will leave much to be desired as your "marionette lines" are actually deep folds due to significant laxity of cheek tissue and the best way to correct them is to lift the cheek, not inject filler in the fold.

The best fillers for the marionette lines are Juvderm and Restylane and the double chin can be treated with Kybella or the coo-mini by Coolsculpting.  Best, Dr. Green

Hi, based upon the attached photos your cheeks are very flat anteriroly (in the front), there is excess fat in front and below the cheeks as well as across the neck.  The nasolabial folds and marrionette lines are an indication of sagging facial tissues as well as excess fat.  Using a dermal filler to fill up these folds will "add" volume making the face larger, not smaller and more shapely.  If you have "jowls" this is sagging
facial tissues and an indication for some form of a facelift, not Cheek
Augmentation. I have performed many Cheek Augmentations over the past 30
years and the notion that Cheek Implants or dermal fillers to the cheeks will
lift tissues is an urban myth. Filler to the cheeks or cheek implants
will not lift up the jowls. The underlying SMAS layer, of the face, must
be dissected, lifted, trimmed and re-sutured. The excess skin is then
removed and the facelift incisions closed.



My most popular facelift is the minimally
invasive, short incision facelift that has all the benefits of more invasive
facelifts (traditional, mid-face and subperiosteal facelifts) but with these
added benefits:



•very small incisions

•minimal tissue dissection = less bruising and
swelling = rapid recovery

•can be performed in 90 minutes or less, with or
without general anesthesia

•no incisions within the hair = no hair loss

•excess fat can be removed

•excess skin removed

•cheeks, chin and jaw line can be augmented with
dermal fillers (I prefer Perlane) or facial implants

•most patients fly back home to parts all over
the world in as little as 3 days post-op

Hope this helps.