What will help get rid of marrionette lines and lift my face ever so slightly, non-surgically? (Photo)

I'm 27, and hate my smile lines; I would like something to either fill them in or, ideally, lift my face like i'm doing with my hand - and also take care of the lines under the eyes. I'm considering thermage, but I want something I won't have to upkeep every few months as I'm still a student. I've also heard that we have collagen supplies, and if I activate them now with thermage or something similar I'll be using up my stores of natural anti-aging supplies - is there any truth to this?

Doctor Answers 21

Voluma or Sculptra

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Thank you for your photo. You have great skin and youthful face so you don’t need a lot of fillers/injectables. We usually use Voluma or Sculptra to treat nasolabial folds. Voluma is a hyaluronic acid which is a moisturizer found naturally in your body and works by replenishing the natural moisture in your skin restoring structure, volume and softer contours to the face. Sculptra is an injectable treatment that functions as a volumizer and causes your body to produce its own filler. It is used to add volume to the face. Sculptra is a purified treatment of poly-L-lactic acid. When injected in the face, it stimulates your body to produce additional collagen, which will fill in the desired areas. Your body will begin producing collagen after a few weeks. For more information, it is best to get a in person consultation with a board-certified dermatologist.

New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

Midface Volumization is an Ideal Option Here

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Hi superficiAlly!

Thanks for your question. I presume the lines you refer to here are you nasolabial (nose-to-lip) lines rather than marionette lines (which go from the edge of your lips down to your jawline). In a young person like yourself a great option for putting tension on these lines is to place a filler into the 'midface' or 'cheek' area. Lines under they eyes can be caused by a number of factors (and can be quite complex), so whether this treatment will help is impossible to say without examining your anatomy. It is likely that another approach would be required to address this.

To answer your question about collagen - we do not have limited 'stores' of collagen. Our body continually breaks down and re-forms collagen, using amino acids (the 'building blocks' of all proteins). Therefore treatments targeted at increasing collagen formation will not 'use up stores', but rather continually build more collagen within the skin.

As always, I recommend consulting with a local, reputable aesthetic practitioner (plastic surgeon, aesthetic dermatologist or aesthetic physician) so that they can perform an examination, make a thorough assessment of your individual anatomy and provide further guidance (including discussion of realistic treatment outcomes) to help you make any treatment decisions.

Hope that helps!

Dr Scott.

Marionette Lines and fillers and Thermage

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One of the best combinations to achieve that mid face "lift" is through dermal fillers like Juvederm Voluma or Restylane Lyft combined with Thermage.  Both will increase collagen and restore facial volume.  Best, Dr. Green

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Fillers For Marionette Lines

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You are an excellent candidate for dermal fillers. In addition, you may wish to consider skin resurfacing options such as microdermabrasion, chemical peels, or laser resurfacing. These services would help restore your skin and block out any existing fine lines and wrinkles.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
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Marionette lines

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Marionette lines can be treated with fillers very easily. Another alternative is to have your own fat transferred from a sort of your body to the lines. It tends to last longer if the cells are accepted thrive.

Kevin R. Smith, MD
Houston Facial Plastic Surgeon

Improving marionette lines and lifting the face

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You can non-surgically lift and improve Marionette lines with dermal fillers such as Juvederm or Restylane or Radiesse, or other less studied/used products on the market. Skin tightening lasers may also help to some degree. Best to speak with your dermatologist or plastic surgeon about your best options.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Reducing Marionette Lines

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Thanks for your question and as others have noted, you have several options, all good, which you can consider and should consider before jumping into the first procedure that someone tells you about. I would recommend a consultation with a board-certified dermatologist or plastic surgeon and learn about the energy-based systems for tightening including Ulthera, including Thermage, but also including the Venus Legacy, the EndyMed 3Deep, and Ellman Pelleve. I would also learn about using fillers in the mid face such as Voluma or Perlane, and then if needed in the tear troughs where we use Restylane, Belotero, and Juvederm. All will work, all work well in combination given by very skilled clinicians.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Treatments for marionette lines

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Classically when one sees improvement from "lifting with their hands" it is because they have some mid-face volume loss. I would encourage you to have a consultation with a board-certified dermatologist or plastic surgeon to assess this, as it is not a decrease in collagen turnover that accounts for the nasolabial fold one sees, but bony remodeling and fat loss that mid face volumization can address. Thermage and Ultherapy do help stimulate new collagen production (Thermage more superficially, Ultherapy deep and superficial) to counteract some of the decrease in collagen turn over we see with age. There is a place for all of these tools, which is why it is important to be evaluated by someone who has a fundamental knowledge of the anatomy of the aging face who can choose the appropriate tool to personalize the treatment plan for the patient. Good luck.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 91 reviews

Non surgical lifting of the face

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Given your photo and your age, I would recommend fillers to help you achieve the look you are going for.  I would suggest Juvederm Voluma to the cheeks and Restylane to your tear trough / under your eyes.  I would use a microcannula when performing these injections to minimize bruising and swelling when having these injections performed.  Skin tightening modalities such as Thermage, Ulthera, and ThermiSmooth can also give a little extra tightening to your skin but will not produce the result you are simulating with your hand. 

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 73 reviews

Liquid Facelift

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At your age the best treatment is probably filler injections.  There are many different fillers on the market today and after a complete evaluation your physician can recommend the best ones for you.  Voluma can be used to lift the cheeks and Juvederm or Juvederm UltraPlus can be used to fill the marionette lines.  These fillers are not permanent and the treatments will need to be repeated to maintain the result.

Scott Greenberg, MD
Orlando Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.