Besides a facelift or fillers, what is the best thing for marionette lines and nasolabial folds? Which laser tightening?

Your question is a difficult question. It is made more difficult because of a lack of pictures. There are several modalities that can be applied to the region that you are concerned about. The most important thing is to pick the modality that will provide you with the most natural, longest lasting improvement. In some patients, surgery is the best tightening option for the lower face. For others, replacement of volume is the best option. Laser resurfacing using a CO2 laser platform can soften wrinkles and create a blending effect in this area. Often times, a combination of the above is required. Follow up with an experienced facial plastic surgeon who can give you options.

Dear Ms. Whatcanmynamebe,Thank you for your story and questions. Nothing substitutes for a personal evaluation, a review of your medical history/medications and a face to face discussion of your options.Unfortunately without a photos or examination I can advise you in general terms, however I hope you will find them helpful.Contour improvement of the face can be divided in the following:I. SurgicalA) face liftB) brow liftC) blephroplasty D) etcII. Minimally invasive A) fillers ie hyaluronic acids (Juvederm, Resylane, etc), hydroxyapatites (sculptra, etc)B) fat injectionsC) etcIII. Non invasiveA) Radio Frequency (RF) ie Thermi, ELOS Sublative, etcB) CO2 lasers ie ELOS CO2REC) Chemical peels ie TCA ,phenols, etcEvery Plastic Surgeon will have their preferred technology and preferences depending on their background, training and experience.Caveat: like in golf "it's not the club but rather the golfer"I trust that you have chosen a Plastic Surgeons who is experienced and Certified by the American Board of Plastic Surgery. In addition ideally is member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).I wish you my best and success,R. A. Hardesty, MD, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.com4646 Brockton AveRiverside, Ca 92506(951) 686-7600

Thank you for your questions.  Lasers work to improve skin tone and texture and can offer minimal lifting with more aggressive CO2 or Erbium ablative lasers.  Typically nasolabial folds and  marionette lines are loss of volume in addition to loose skin.  Free fat transfer may be an alternative to fillers and can be done in the office. The gold standard for skin tightening is still a facelift.Best Wishes!