What's the best solution for my marionette lines? (photo)

Question

Please see the attached photo. I’ve never had anything done on my face aside from facials and chemical peels on occasion. These lines around my mouth make me look permanently sad. Should I get fillers, laser, lift? Please advise.

Alexander Rivkin, MD · Answer

Hello and thank you for your question.  You seem to be a great candidate for a combination treatment of filler and Botox in the marionettes.  With fillers such as Juvederm or Restylane can help to fill in those deep creases by the corners of the mouth.  When placed strategically and precisely, the corners of the mouth can also be turned upward to give a more youthful look.  Additionally, a couple units of Botox in the depressor anguli oris muscles (those muscles which are responsible for drawing the corners of the mouth downward) can also be helpful.  Be sure to seek an experienced injector who specializes in facial aesthetics for best results.

Nima Shemirani, MD · Answer

Hi @Sim072071! You would be a great candidate for HA dermal fillers in the marionette lines. Restylane Defyne works great. Best of luck, Dr. Nima!

Nelson Lee Novick, MD · Answer

A full face photo would have been extremely helpful for determining the potential contribution of volume depletion in your cheeks to the formation of the marionette lines. If there is insuficient volume in the cheeks, then reflating them appropriately with a volumizing filler may provide sufficient secondary improvement in the droopy corners of the mouth to obviate the need for treating the angles directly or possibly reduce the amount needed to do so. If there is sufficient cheek volume already, then directly treating the angles with a volumizing filler--a process that in experienced hands should take no more than about five or ten minutes to perform--would be in order and typically yields an immediate "Wow!" reaction. In my NY office, I would opt for Restylane Lyft for the angles of the mouth. In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would choose Hyabell Deep for this purpose. Make sure that you consult with a board certified aesthetic physician and be certain to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

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

Bhavlene Panesar, MD · Answer

Thank you for your question.
Marionette lines are the result of volume loss in the upper lateral face causing the tissue to "fall" forward creating the Marionette line.
Traditionally, practitioners have simply filled the area of the Marionette to smooth things out.   However, this can result in an unnatural appearance.  
In my opinion, the best way to deal with the Marionette's is to restore the volume to the upper first and then deal with the chin and lower jawline to support the lower face.  Then adding some filler to the Marionette lines at that point will result in a refreshed natural appearance. 
Good luck!

Tonya Boudreaux, MD · Answer

Hello! Thank you for the photo. It seems that you would be a great candidate for filler in the marionette lines. I think you would see great improvement with just 1 syringe.
Best of luck to you!

Chad Robbins, MD · Answer

Hello and thank you for your question and photo.  I would recommend dermal fillers for your marionette lines.  Make sure you find an experienced injector.

Anshul Gambhir, MD · Answer

Thank you for your message! Typically our office would recommend a medium thickness filler, such as Vollure for adding volume to the lower face. A lot of times the midface (cheek region) needs to be filled with something like Voluma to help pick up the lower face. Botox can also be used in the muscle that causes us to frown, which will gradually upturn your smile over time! I would recommend a consultation with a provider in your area!

Mehdi Sina, MD · Answer

Hi,A full face photo would be helpful in determining which treatment will give the optimal aesthetic outcome. Based on the picture we have, the corners of your mouth are downturned and you have early marionette lines. Botox to the lip depressor muscles and carefully placed fillers will help. There are also re-suspension sutures that may be helpful in lieu of fillers.Best,

Joyce Davis, MD · Answer

The simplest way to treat these lines is with a filler like Juvederm or Restylane.  The work immediately and should last up to a year.  Find a good cosmetic dermatologist.

What's the best solution for my marionette lines? (photo)

Answers (14)

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