Can Botox be used to lessen severe marionette or nose to mouth lines?I look so miserable but I'm not!! (photos)

Hi Reetz.  There are two classes of injection products.  The first is neurotoxins and that includes Botox, Dysport and Xeomin.  All of these work by relaxing the muscles that cause wrinkles.  Generally speaking, these products are used from the eyes upward.  The outer eye, the forehead and the frown lines between the eyes (generally speaking).
Dermal fillers are used below the eyes and provide volume where it has been lost.  You look to be a good candidate for a lower facelift and liposuction in the neck area.  But if surgery is not in the cards right now then your next best option is dermal fillers to soften the nasolabial folds at the sides of the nose and mouth.  Best of luck.
 

A combination approach will give the most improvement. I recommend fillers for the folds themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Thank you for sharing your question and photographs.  Unfortunately Botox offers little treatment to the marionette lines and if you are looking for a non-surgical improvement this would better be obtained with a combination of dermal fillers to address volume loss and tissue sagging in the cheek and back jawline.  I would advocate seeing a series of ASPS board certified plastic surgeons in consultation to discuss. 

Thank you for your question and photograph.  Botox cosmetic can be injected to elevate the downward corners of the mouth.  My advice would be to consider a dermal filler to augment the depressed areas in the marionette lines.  Best of luck.

Botox is more commonly known to treat the lines in forehead and around the eyes. However, it can be used to relax the muscles in the lower face as well. In my practice, I often use Botox to relax and soften the downward turn of the corners of the mouth. Based on the photos you provided, I believe you are a better candidate for volume replacement with dermal fillers to help soften the crease of your marionette lines and soften the fold of your nasolabial folds. 

Botox could bring minor improvement to the areas of concern but these would be so minor that you should question the necessity and the expense. There are many other things that could be done from injectables to surgery. However, if you are, as you said, not miserable and the changes you observe are not on the top of your worries, I would suggest to concentrate on the skin quality. This would be very inexpensive, easy to accomplish and always beneficial. Good luck!

Fillers such as Juvederm are the treatment of choice for Marionette lines.  Botox placed carefully into the depressor anguli oris (DAO) muscle in small quantities will provide some help and can be done in conjunction with fillers to maximize results.

I would focus first on your marionette lines as they are a tell tale sign of age. Everyone has nose to mouth lines, or as we refer to them, Nasolabial Folds, even 16 year olds. As we age we develop marionette lines due to a loss in volume. Botox, which relaxes the muscle, is used to decrease the appearance of wrinkles and prevent us from forming new wrinkles. 
I would recommend using Dermal Fillers to replace the volume loss in this area, giving you a rejuvenated, youthful look. Restylane Refyne and Restylane Defyne are great fillers for this area, as they are formulated to move naturally with everyday facial expressions, and can last up to 12 months. Overall, in your case, restoring volume would be the best option, as it would fill the hollowness from age and decrease the appearance of fine lines around the mouth.

Hope this was helpful.

Botox is best used to smooth out fine lines and wrinkling. In your case, you are looking for replacing volume loss, with a little lift. For a non surgical lift, I recommend facial fillers using juvederm or restylane. This works excellent in treating marionette lines / frown lines.  There is zero down time, no surgical risks, the results are instant and lasts up to 12 months. Hope this helps, thank you for your question.

Botox and Dysport are neuromuscular blockers which prevent a muscle from contracting , creating a crease in the skin. They can not fill the creases. The area you are concerned about would best be cared for by a dermal filler and there are plenty to choose from. Dermal fillers in your area could be Radiesse, Juvederm family , Restyline family  of fillers. The results are immediate and last many months