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.
 

Your lines at rest and those that are superficial, may be helped with fillers.  They dynamic lines which are increased with animation can only be softened with fillers.  My suggestion would be to start with one syringe and see how you like the result.  It is always easier to add more filler then to try and remove it.  Also, I would suggest starting with an HA like Juvederm or Restylane since these can be melted away with another injection.  Who injects you would have to be based on experience as every plastic surgeon does not do fillers and some injectors treat thousands of patients a year with fillers while others do it a few times a week.  

 

Good Luck.

Many nurses under a doctors oversight are excellent injectors. Stay away for medical spas nd Botox/filer parties. If you want a lip fill that must be done first in order to have enough to make sure they are equal.  The remainder goes into marionette lines. One syringe should do it but, be prepared for two.

Thank you for your question and photos, First and foremost, I would trust what your plastic surgeon has chosen for you, as they have seen you in person and evaluated your face in animation. With that being said, from the photos it appears you would be great candidate for Restylane Defyne in the nasolabial folds, "smile lines". Hope this helps, Good Luck

I generally recommend staying away from nurse injectors unless the nurse has tremendous injecting experience.  You also want somebody who can inject all the different products, not just Juvederm.  In this case, it doesn’t look like the marionette lines are so much an issue as the fact that you need more lifting.  Sculptra will thicken the skin and minimize the lines.  I think it’s very important to go to someone who can do injections for all products such as Radiesse, Sculptra, and Juvederm because in this photograph it looks like Sculptra would be more appropriate.  But, I cannot be sure without looking at you in person. 

It depends on the injector's skill and some nurses are better than the doctor, and, vice versa.

You don't really have marionette lines. You have nasolabial lines and cheek lines and they are noticable when you animate your face. Fillers will only 'help' because you have a strong dynamic smile which causes these lines. I'd suggest Sculptura for the cheek and Juvederm ultra plus or Voluma or Radiesse for the nasolabial lines. You may need 2 syringes for the nasolabial lines and 2 syringes for the cheeks.

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. 

Personally, I like to inject my patients myself.  Although I am sure there are many nurses qualified to do it. The marioneet lines can certainly be filled out with hyaluronic acid.  The depressions behind your marionette lines can be treated as well.

Great posted photos, thanks. Either of these HA's will accomplish the "job". I recommend being prepared to have 2 cc's injected, but start slowly to see if one or one and a half or all of two cc's is needed. As far as a nurse injector, I have no issues with nurse injectors but than you should be paying them. Oh right they can not purchase HA's it has to be a licensed M.D. Well than I want the responsible person, the doctor, to inject then. It is the old "what if issue". What if there is a problem are you going to go back to the nurse injector or the doctor? Of course the doctor takes the responsibility.