Best treatments for marionette lines/lumps? (Photo)

The problems here are seen practically every day in any active cosmetic dermatology practice. The good news is that they are relatively simple to fix and even better, the results are immediate, I.e. seen on the spot right after treatment.
The sunken cheeks, which are contributing both to the smile lines and the marionette lines can be easily augmented with an HA volumizing filler. This would undoubtedly improve the smile lines and to some extent the jowling along the jawline and the marionette lines. The use of an additional HA lifting filler for the angles of the mouth would directly address the latter issue and would result in straightening of the angles of the mouth.
Treatment for both areas at the hands of an expert injector should take no more than 20 minutes or so and engender little to no significant downtime. So, nothing to fret about. Just make sure to see the right doctor. Hope this helps and best of luck.

Looking at your photo, the areas you’re noticing—commonly referred to as marionette lines and the slight fullness near the jowls—are typical signs of early volume loss and tissue descent that happen naturally with aging. The downturned appearance of the mouth can also be related to this, as the support from the midface and cheeks diminishes over time.

There are several approaches that can help:

Dermal fillers – Hyaluronic acid fillers can be used to restore volume in the cheeks, along the jawline, and directly into the marionette lines. This can soften the lines, lift the corners of the mouth subtly, and reduce the “lumpy” appearance without surgery.

Skin tightening treatments – Non-surgical options like radiofrequency or ultrasound-based devices can help lift and tighten the skin, giving a smoother contour to the jawline.

Botulinum toxin – Small, targeted injections near the corners of the mouth can help relax muscles that pull the lips downward, which can improve the appearance of a downturned smile.

Combination approach – Often, the best results come from combining volume restoration with skin tightening and minor muscle relaxation to create a natural, balanced improvement rather than just filling one line.

It’s important to approach this gradually and conservatively—overfilling can look unnatural. With careful planning, you can achieve a lifted, softer, and more refreshed look while keeping your natural expressions intact.