54, what would be the best procedure in my case for marionette lines & nasolabial folds? (Photos)

Before I answer how to fill in static lines like nasolabial folds and marionette lines, let's discuss how they come about. For most people, it starts with volume loss from the temple area amd under the eyes where we start to lose our fat pads as we age. I've long advocated for lifting the skin and correcting for deflation and volume loss from the top and that means starting with temple ands tear trough filters. After that, we can fill in the NSL and Marinette lines if still needed.
Please let us know if you find this helpful and what other this you'd like us to cover.

Hello! I’m Lauren, the aesthetic injector here at Colorado Plastic Surgery Center. Since your skin is already in good condition, but you’re noticing volume-related lines, filler may give you the result you’re really looking for. Filler is often the most direct and immediate way to soften deeper lines like nasolabial folds and marionette lines. It works by restoring volume that’s been lost with age, which helps "lift" and smooth out those areas.

When considering treatments for marionette lines and nasolabial folds, it's important to evaluate both your personal goals and the characteristics of your skin. Here are some options you might consider discussing with a dermatologist or cosmetic professional:

Dermal Fillers (e.g., Juvéderm): Fillers are a popular choice for addressing nasolabial folds and marionette lines. They work by adding volume to the areas, smoothing out the lines and providing a more youthful appearance. Juvéderm is a hyaluronic acid-based filler that is commonly used for this purpose and can provide immediate results with minimal downtime.

Morpheus8: This is a minimally invasive skin tightening treatment that combines microneedling with radiofrequency energy. It can help improve skin texture and firmness, which might be beneficial if you are looking for overall skin tightening along with addressing specific lines.

Combination Approach: Sometimes, a combination of treatments can yield the best results. For instance, starting with fillers to address volume loss and following up with skin tightening treatments like Morpheus8 can enhance the overall effect.

Other Options: Depending on your skin type and goals, you might also consider treatments like laser resurfacing or other radiofrequency devices that can help stimulate collagen production and improve skin texture.

It's crucial to have a detailed consultation with a qualified dermatologist or cosmetic surgeon who can assess your skin and recommend the most appropriate treatment plan based on your specific needs and expectations. They can also discuss potential side effects and recovery times associated with each option.

You will likely have the best result from a combination of treatments. Fillers can give you additional volume which we lose as we age. Morpheus8 combines RF technology with microneedling and can improve overall skin tone and texture. The two are often combined to give a more complete result. You can learn more by visiting my website or a provider near you.

At least from the photos provided, there appears to be volume deficit in the cheeks that is contributing to the under-eye tear troughs and bags and to the deepening smile lines, and additionally to the marionette sagging around the sides of the mouth. If this is indeed so, then the use of an appropriately robust HA volumizing filler for the cheeks would help to not only improve the under-eyes, but create a more desirable Ogee Curve to the cheeks and to diminishing the smile folds (likely without the need for even directly treating them with filler) and to some extent also improving the marionette lines. The latter will likely additionally benefit from the use of a robust HA lifting filler to help to further lift and straighten the angles of the mouth. Plain Juvederm, much like ordinary Restylane, would not be appropriately robust fillers to accomplish these tasks, nor would the results of treating these issues with either of them lead to long-lasting results.
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert and best of luck.