Which procedure would be best for eliminating marionette lines long-term? (photos)

You may want to consider fat grafting to the face or dermal fillers with combination of botulinism toxin like xeomen, botox,jeaveu..I like the rha fillers that have fda approval for the perioral area specifically for dynamic muscle movement.

Marionette grooves tend to be indentations that extend from the corner of the mouth down to the chin. Depending on someone's examination, these may permanently be reduced with microdroplet silikon 1000 injections. I hope this helps. Sincerely, Dr. Joseph

Marionette lines, the vertical wrinkles that run from the corners of the mouth down to the chin, can indeed be challenging to address, especially when they become more pronounced with weight loss. There are several procedures available that can effectively reduce or eliminate these lines, each with varying degrees of invasiveness and longevity of results. Here are some of the most effective options:

1. **Dermal Fillers:**
- **Hyaluronic Acid Fillers (e.g., Juvederm, Restylane):** These fillers add volume and smooth out wrinkles by attracting water to the treated area. They provide immediate results and can last anywhere from 6 to 18 months, depending on the product used and individual metabolism.
- **Calcium Hydroxylapatite Fillers (e.g., Radiesse):** These fillers not only add volume but also stimulate collagen production, which can provide longer-lasting results, typically around 12 to 18 months.

2. **Fat Grafting (Fat Transfer):**
- This procedure involves harvesting fat from another area of your body (such as the abdomen or thighs), processing it, and then injecting it into the marionette lines. The results can be very natural and long-lasting, often several years, as the fat integrates with the surrounding tissues. However, the procedure is more invasive compared to dermal fillers.

3. **Thread Lifts:**
- This minimally invasive procedure uses dissolvable threads to lift and tighten the skin. The threads also stimulate collagen production, which can improve the appearance of marionette lines. Results can last from 1 to 3 years. The procedure usually has a short recovery time and provides immediate lifting effects.

4. **Laser Resurfacing:**
- Techniques such as CO2 laser or fractional laser resurfacing can tighten the skin and improve the texture by stimulating collagen production. This can help reduce the appearance of marionette lines. The results can be long-lasting, though multiple sessions might be required, and there is some downtime associated with the recovery.

5. **Surgical Facelift:**
- For the most dramatic and long-lasting results, a surgical facelift may be the best option. This procedure involves tightening the underlying muscles and removing excess skin, which can provide a significant improvement in marionette lines and other signs of aging. The results can last for 10 years or more, but it is the most invasive option with a longer recovery period.

**Recommendation:**
Considering your desire for long-term results and the pronounced nature of your marionette lines due to weight loss, a combination approach might be the most effective. For instance, starting with dermal fillers or fat grafting to restore lost volume and then considering a thread lift or laser resurfacing for additional tightening and collagen stimulation could provide comprehensive and lasting results.

Ultimately, the best procedure for you should be determined in consultation with a board-certified dermatologist or plastic surgeon who can assess your individual case, discuss your goals, and recommend the most appropriate treatment plan. They can provide detailed information on the benefits, risks, and expected outcomes of each procedure to help you make an informed decision.