What is the best option for marionette lines and fat pockets around the corners of my mouth? (Photo)

With some mid-face descent, a combination of cheek fillers and thread lifting would provide a "lift" without undergoing a surgical procedure. Additional filler in the area beneath the corners of your mouth can also provide improvement for a down-turned smile. A small amount of botox to the depressor muscle also help

Hi @aehartman! I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. In addition, I recommend getting a few units of Botox into the DAO muscle. The injections stop the DAO muscle pulling down the corners of the mouth. Treatment will cause the corners of the mouth to be slightly lifted, giving the mouth a more relaxed, happy, youthful and pleasing appearance. Best of luck, Dr. Nima!

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

Hi,Thank you for including your photos.  I think an in-person evaluation would be very helpful - specifically because it's hard to tell if you have down-turned corners of the mouth or little pockets of fat that are associated with the marionette lines. The treatments can be very different. If muscles that pull the corners of your mouth down are overactive, then botox/dysport and maybe a little filler to that area will solve the problem. The other non-surgical option may be resuspension sutures (Silhouette InstaLift). These are dissolvable sutures that can help to pull the sagging tissue to a higher position and soften the transition between your cheek and chin (they last 2-3 years). Again, the best starting point for you is to visit a board certified facial plastic surgeon to discuss your concerns and review your treatment options.Best,Mehdi Sina, MD

The best option would be restyline injected to fill the fat pockets around your mouth.  Restyline can also be used to fill marionette lines.  Botox or Dysport would also be a good option for the lines as well

Without an in-person examination that allows me to visualize your face at rest as well as when you are animating, it is difficult to give exact recommendations.  However, from the pictures you sent, it appears as though you could benefit from fillers.  We all lose volume in our chin area as we age, which in part contributes to the development of marionette lines and the appearance of fat pockets around the mouth.  I prefer to use fillers such as Juvederm or Vollure in this area, both of which are very natural looking.There are also skin tightening procedures such as Ulthera which stimulate collagen production and muscle tightening that are nice adjuncts to fillers.I recommend that you have a consultation with a physician who specializes in aesthetic medicine.

There are several different ways in which this area can be addressed.  On the more conservative side, a filler injection of Juvederm can camouflage that area and elevate the corners of your mouth.  The next possible treatment is to combine this with a cheek filler, like Voluma, to provide a slight lift to help eliminate that area of concern.  Next, lasers can be incorporated to tighten the skin and stimulate collagen growth.  Given all of the available options, I recommend that you have a consultation with a facial plastic surgeon or dermatologist to discuss all of the options and pick one that is most inline with your goals.

It looks like you have some skin laxity and loss of volume causing your issue.  It is difficult to give particular recommendations without and in person exam and discussion. However, filler are going to be a part of what you need in order to improve the appearance of the area.  Please find and experienced injecting physician to discuss you issue and what can be done to improve your appearance.  Good luck with your transformation.

Thanks for your question and the photo. I encourage you to schedule a consultation with a qualified physician. You would be a great candidate for fillers by looking at your photos. The marionette lines and fat pockets are due to volume loss. This can be addressed by having a filler injected into the cheekbone area to give you the "lift" you desire. Voluma is an excellent choice for this area.  Juvederm and Vollure can be used for marionette lines. Schedule a consultation and see what is best for you!

Thanks for your question and the photos and we always recommend that you consult with a board certified dermatologist or plastic surgeon to learn the best treatment options for you.  From your photos, you do some volume loss in your cheeks and having a filler injected there may improve all that you are looking to improve – fillers such as Juvederm Voluma or Restylane Lyft may be the best for you.  Find the right provider and you will do just fine.