I would like a surgery or treatment to eliminate the marionette lines and nasolabial folds. What is the current, best, most effective way to do this? I'm open to facelift, cheek implant or augmentation, mid facelift, lower face lift, or fillers / laser. If suggesting surgery, could you please specify where the scars/incisions will be & the exact name of the surgery so I can research it? age 46.
Answer: Best procedure for face and perioral You're going to get plenty of answers that may differ about this. Certainly, from your pictures, the mainstay of your treatment will be a lower face and neck lift. There are various forms of this procedure, involving different approaches, but in my opinion, this can either be with a SMAS plication or a deep plane facelift, as both address the deeper structures which are the foundation of support.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 plication2-platysma plasty and neck liposuction3-facial fat injections, with a focus on the marionette linesand potentially, 4- lip lift and corner-lip liftI hope this helps.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA
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Answer: Best procedure for face and perioral You're going to get plenty of answers that may differ about this. Certainly, from your pictures, the mainstay of your treatment will be a lower face and neck lift. There are various forms of this procedure, involving different approaches, but in my opinion, this can either be with a SMAS plication or a deep plane facelift, as both address the deeper structures which are the foundation of support.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 plication2-platysma plasty and neck liposuction3-facial fat injections, with a focus on the marionette linesand potentially, 4- lip lift and corner-lip liftI hope this helps.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA
Helpful 3 people found this helpful
Answer: Fillers Can Help I generally advise against
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Answer: Fillers Can Help I generally advise against
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April 2, 2016
Answer: Current and most effective procedure to correct marionette lines and nasolabial folds Thank you for your question.
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April 2, 2016
Answer: Current and most effective procedure to correct marionette lines and nasolabial folds Thank you for your question.
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March 24, 2016
Answer: Ultimate BEST way to correct the #marionettes and #nasolabial folds? #facelift #fatgrafting #fillers Your question is a common one asked by my patients too.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.
Helpful 1 person found this helpful
March 24, 2016
Answer: Ultimate BEST way to correct the #marionettes and #nasolabial folds? #facelift #fatgrafting #fillers Your question is a common one asked by my patients too.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.
Helpful 1 person found this helpful
March 15, 2016
Answer: Faceless generally do an excellent job with the marionette line but the nasolabial fold will reemerge over time. The development of a marionette line is passive in that is generated by the dissent of soft tissue not facial expression. Nasolabial fold is generated by facial expression and will reemerge in time after a facelift because of the active function in the area. When they do occur fillers do a nice job of solving the problem.
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March 15, 2016
Answer: Faceless generally do an excellent job with the marionette line but the nasolabial fold will reemerge over time. The development of a marionette line is passive in that is generated by the dissent of soft tissue not facial expression. Nasolabial fold is generated by facial expression and will reemerge in time after a facelift because of the active function in the area. When they do occur fillers do a nice job of solving the problem.
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March 13, 2016
Answer: Facial Rejuvenation Hello,Given your significant mid face volume loss, I would actually opt for a combined malar/submalar implant. I would also overdraft with fat in the mid face, nasolabial fold, and marionette lines. Finally, I would perform a face and neck lift to redrape lower face, jawline, and neck.Best of luck!
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March 13, 2016
Answer: Facial Rejuvenation Hello,Given your significant mid face volume loss, I would actually opt for a combined malar/submalar implant. I would also overdraft with fat in the mid face, nasolabial fold, and marionette lines. Finally, I would perform a face and neck lift to redrape lower face, jawline, and neck.Best of luck!
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