Marionette lines, fat pocket near corners of mouth, what will help this? (Photos)

a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

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

Dear thenurseassoc,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Facial contour is primarily determined by facial bone structure.

Soft tissues are highly consistent among the great majority of people.

You didn’t have an abnormal fat distribution and fat is not the underlying cause for your facial contour.

For this reason attempting to correct or fix what you feel is a problem with fat removal will only create problems and not fix the issue.

Individuals with amendable that is small or lacks forward projection in comparison of their maxilla tend to have a variety of lower face soft tissue characteristics that are sometimes of concerned. These include a premature double chin, lack of jawline definition, premature jowls and other contour issues around the oral modiolus including peri-oral mounds.

Other attributed characteristics include dental overbite occlusion and profile pictures showing the upper lip having more forward projection than the lower lip.

There are no issues with your soft tissues and manipulating them are unlikely to resolve the areas of concern and are more likely to create problems.

Sometimes working with fillers to camouflage areas of fullness by giving volume to adjacent regions can help to some degree.


I think you’ll find all of the suggested treatments to be a waste of time and money.

Based on your pictures you have an attractive young appropriate face without any significant problems or clear indications for treatment.

If you actually want to change your facial appearance then it needs to be done on a skeletal level.

For that consult with local oral surgeons to see what they have to say.

The only exception to that is most likely going to be working with fillers despite your problem being described as a concern of fullness.

Inappropriate fat removal on someone with a normal fat distribution is most likely going to cause a negative aesthetic outcome.

Best,

Mats Hagstrom MD