What can I do to get rid of these marionette lines? I am in my 30s. (photos)

It is almost always better to start with fillers in these cases as they are temporary and do a better job of correcting the problem. The underlying problem with marionette lines tends to be a loss of volume. Fillers can correct the underlying problem and also help to camouflage the transition zone by filling in the areas of depression.

If you have gained weight then weight reduction can be helpful. These lines occur from a transition from skin with underlying fat to skin without underlying fat and then forms the folds. However, I would not recommend a corner lip lift but would recommend a lip lift with extension laterally. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This may help the marionette lines and at the same time you may want to do fat injections to blend them.

Best Wishes,

Gary Horndeski, M.D.

The kind of marionette problem shown in the photos is an aesthetic problem treated with an appropriately robust HA lifting filler practically every day (frankly, usually several times a day) in an active cosmetic dermatology practice. In the hands of an experienced injector, the result of a nonsurgical filler treatment is immediate, typically evokes a "Wow! response, and the treatment engenders little to no significant downtime. Kind of a no-brainer when compared to surgery. Hope this helps.