Marionette lines and shadowing not improved with filler - do I need more Restylane? (photos)

Question

I recently turned 40 and am becoming increasingly self conscious about marionette lines, and shadowing, particularly on one side. A month ago, I had 1 ml of Restylane injected into marionettes and jaw area, with an additional 1 ml injected into the mid face are, but I barely notice a difference. Would more Restylane help? If so, how much? What else could I do to help correct these? Thanks so much!

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  When injecting patients I tend to use multiple syringes.  For someone like yourself I would recommend a minimum of 2 syringes possibly 3.  This would allow us to fix the nlf folds, marionette lines and add a little volume to the cheek area.  There are also different Restylane filers.  Typically for the NLF fold and marionette lines I like Restylane Refyne and depending on how much volume one wants in the cheek either Restylane Defyne or Restylane Contour.  I would recommend speaking with a Board Certified injector to discuss your options.  Best of luck to you.

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Arthur G. Handal, MD, FACS · Answer

Hello,
Morpheus might be the best treatment for you. Its amazing as a preventative treatment. Morpheus will help to create a fuller more youthful appearance by helping create collagen.

Camille Cash, MD · Answer

You should notice more of a difference with additional filler.  One of the great things about filler is that you can go slowly and build up to the result you are wanting.  You can also consider other treatments to improve overall skin tone and texture, such as Morpheus 8.  Meet with your injector to discuss your concerns and learn more about your options.

Darryl J. Blinski, MD · Answer

Great posted photos. I would try Juvederm Vollure ( higher G prime or thicker then Restylane products) in 2 syringes and the new 4 PDO threads (ELASTY) that act as filler not lifting. Fee $2,800. Otherwise a anterior mini FL with SMAS plicaton to lift NL lines. that fee $4,000. If combine both fee becomes $6,800. Best to virtual consult with...

Marionette lines and shadowing not improved with filler - do I need more Restylane? (photos)

Answers (5)

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