What is currently the best, most effective procedure to correct marionette lines and nasolabial folds? (Photo)
Doctor Answers 29
Treatment for marionette lines and nasolabial folds
Ultimate BEST way to correct the #marionettes and #nasolabial folds? #facelift #fatgrafting #fillers
Best way is to address the many components, with a facelift and an extension into the temporal area (so a low and mid-face facelift), high-SMAS lift, and fat grafting to both NLF and the marionettes lines. I would need to see your forehead entirely to see if the composite facelift would not be indicated (adding the browlift to the procedure).
You may also still need a smaller amount of HA fillers such as restylane and juvederm over time to maintain the results.
Hope this helps!
Dr. Marc DuPere, Toronto Aesthetic Plastic Surgeon
Marionette lines and nasolabial folds
Thank you for your pictures and question. As my other colleagues have alluded to, aging is multi-factorial and involve the skin (elasticity), fat (loss and atrophy), muscle (atrophy and loss), and bony chnages. Because aging affects your face in multiple ways, in order to address your folds, we need to address each layer. What makes the nasolabial folds and marionette region difficult to treat with one modality is it can look unnatural. Thus, from your pictures, I would recommend a facelift, necklift, fat transfer or filler to the nasolabial folds and marionette lines, and possibly cheek implants. There are surgical procedures that can eliminate the folds, but those incisions are rarely performed over the folds and creases just because of the location. Best of luck to you!
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Facial aging and correcting the nasolabial folds and marionette lines
- skin elasticity diminishes
- soft tissue droops down more from ligament laxity
- volume loss occurs
I would seek consultation with several board certified plastic surgeons in your community and look at their before and after photos as well as discuss your goals and options with them.
I hope this helps.
NLF and ML treatment
Nonsurgical: soft tissue filler such as Radiesse/Juvederm Ultra/Restylane Lyft can get you 6-12 months duration but needs to be repeated.
Surgical: Facelift with microautologous fat grafting (using your own fat and injecting small parcels of fat directly into those lines). Lift the lower 2/3 of the face and fill the "valley" with your own fat. Potential long term duration of fat survival. You look like you have some fat under the chin and we can use the fat from there as well in addition to obtaining more from the belly area.
Thank you for the pictures. They do look like deep lines and we can soften significantly but difficult to completely make them disappear.
Procedure to correct marionette lines/nasolabial folds?
suspension will improve both areas. The SMAS is a deeper layer of connective tissue which has much
greater strength to support the lift, as compared to the skin alone. Your photo also shows a somewhat
flattened malar (cheekbone) area which can occur with normal aging and/or weight loss. This area would
benefit from added volume, either in the form of an implant, fat graft or filler. After your facelift, laser
treatments can improve the tone/texture of your facial skin. However, both lasers and fillers work best as
adjuncts to, and not replacements for, a good surgical lift. I hope that this information is helpful.
Most effective procedure to correct marionette lines and nasolabial folds?
If you have "jowls" this represents sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). 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 Restylane Lyft) 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.
The best choices for marrionette lines and nasolabial folds
Likely the combination of volume replacement and tightening will have the greatest impact. It is reasonable to start with dermal fillers and then consider surgery if you did not get the results you are looking for. Face (and I almost always also do the neck) lifting in young patients can seem aggressive, but I have been thrilled with the results and longevity. Volume replacement in the cheeks, NL creases and lower marrionettes with fat transfer at the time of the facelift is a nice adjunct, and then you can use fillers later closer to your mouth since these products are well suited for this area.
Best of luck to you!
Marionette Lines around my mouth: What can be done?
Best procedure for face and perioral
I would make certain this involved an incision behind your chin to address your neck muscles with a platysma plasty, and potential liposuction there. A nice complement to these procedures is fat grafting to help restore lost volume. All of the above will help with your nasolabial folds. However, the marionette lines will only be slightly improved by the facelift. These are notoriously difficult to treat. In my experience, once I have slightly softened them with a judicious facelift, usually adding fat or filler in this area generously can really help blunt them. The most powerful maneuver in this area is called a corner lip lift, which directly removed skin in the area and will elevate what has fallen. However, this must be done in expert hands as if the area is overdone or the scarring is poor, it can distort the corners of the mouth. Done well, it can really improve this difficult area. So,
1-lower face/neck lift with SMAS plication
2-platysma plasty and neck liposuction
3-facial fat injections, with a focus on the marionette lines
4- lip lift and corner-lip lift
I hope this helps.
Best of luck!
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA
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