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

I don't recommend liposuction for this. A combination approach will give the most improvement. I recommend fillers for the lines 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

Downturning of the mouth corners are not going to lifted by reduction of jowl fat. If the mouth corners ares substantially tuned down only an actual corner of the  mouth lift will be effective to make them more level.

Marionette lines are the "puppet" lines that go from the corner of the mouth to the chin, the jowls are the fat and skin which sag behind the lines. Jowls are best treated with a lower face lift. Kybella can be used to reduce the fat and blend the area. Liposuction is not ideal as it can leave irregular lines and shadowing along that area of the face. Fillers can help especially along the marionette lines but will not help with the jowls. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

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!

It depends on the quality of your skin and the cause of the marionette lines.  If you are young and it is due to excess fat deposits in the area liposuction may be an option.  If there is laxity of the skin you may need a surgical procedure to fully address marionette lines and jowling.