Which Filler for Marionette Lines and is One Syringe Sufficient? Can a Nurse Inject?

  I find that Juvederm and Restylane are more alike than they are dissimilar and both will work well for the Marionette lines you show.  Personally, I do not delegate filler injections to my R.N. and although many R.N.s will do a fine job, my patients prefer me to do this for them and it is a service that I am happy to provide.  After viewing your photos, it looks like you may benefit  more from 2 syringes of these fillers than trying to get by with just one.   In such cases, I usually advise my patients to consider Radiesse which comes in a 1.5 cc size, is wonderful for Marionette Lines, and which probably lasts twice as long as the HA fillers.  It costs less than two syringes of the HA filler and I think it is a better value for the money.  hope that this helps!  

I would suggest Sculptra as it seems you have lost a lot of fat in your cheeks, which is the underlying cause of the smile lines.  I would suggest only letting an MD do your injections, especially if you move to a filler like Sculptra.
 

A filler  like restylane or juvederm might help soften the marionette lines but I'm not sure that that will make you happy. It will improve what you see when you are still, not smiling. It will not improve the lines lateral to that that occur with motion. Sculptra or Radiesse would be better to add volume. If you are on a budget and want to take the edge off things and add some volume to lips I would choose Restylane as one syringe will get you started well. You should see no blue if injected properly. If you are paying for this service, why would you have a nurse do it when a physician with years of experience can do your treatment.