Can marionette jowls be liposuctioned out. To fix downturned lips?

Thanks for your question. The best technique is a Labbé lift. Sculptra is effective in patients in their 50’s max. The problem with fillers in the lower face is they make the face look square  and this is not a youthful look. RF and US together with Sculptra and structural fat will improve the problem but not a permanent fix owing to the issue with adding weight to the lower face. The opposite problem with fat removal using liposuction would produce flattening along the lower jaw and loosening of the skin which  isn’t aesthetically pleasing unless the face and neck are fat as well. A picture would have been helpful. If you have further questions you should consult a board certified plastic surgeon. 

Marionette lines and jowling almost always result from sun damage to the surface, stretching of the skin, an actual loss of fat, or both, so suctioning fat out usually does not help. An in-person consultation really helps with narrowing down the options, since it is important to diagnose the cause before jumping to a solution. Fillers are a great way to camouflage these issues for many people and might buy time before a lift is done. Finer lines respond well to surface treatments like laser. Any of these treatments look unnatural if they are overdone. All of them, including surgery should look great if done properly!