How to get rid of these lines? (photo)

39 year old female. Had Voluma 5 weeks ago which no caused marionette lines. What can I do to get rid of them?

Doctor Answers 11


Without seeing before photos it is difficult to assess where the Voluma was placed. Voluma is an excellent tool for restoring volume defects.  I recommend returning to the physician who performed the Voluma to see whether you would benefit from additional treatment (either Voluma or otherwise) as well as to discuss your concern and review your before photos. 

New York Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Voluma results

Without seeing your before pictures, it is impossible to say whether or not the Voluma was placed too low. My best advise would be for you to schedule an appointment with the surgeon who did the injections to discuss your concerns. 


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 35 reviews

How to get rid of these lines?

Ulthera® laser is a great option to lift any sagging parts of the cheeks or neck. Please consult a board certified aesthetic dermatologist for a consultation.

Manjula Jegasothy, MD
Miami Dermatologist
4.6 out of 5 stars 10 reviews

Voluma placement

Voluma can be a nice option to lift the cheeks and other areas of the face.  However, in patients with some sagging of the lower face, fillers can accentuate sagging if placed incorrectly.    It is not possible to guess if this is what happened in your case.  Best advice would be to return to your treating doctor to voice your concerns and look at before and after photographs.  From your photographs, the best solution currently would be to enhance volume of the lateral jawline and chin with filler or possibly a chin implant as that is the cause of most of the sagging in the lower face in your case.  Best of luck.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 11 reviews


Thank you for your question. Voluma is a phenomenal filler for increasing the volume to the cheeks and mid-face, which commonly become drawn as the human body ages and collagen production slows. Please remain patient for the filler to take effect. Keep in mind that the filler can deliver results for up to 2 years. Please post before pictures on your next progress post and consult in person with you board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 121 reviews

Lines from Voluma

I would recommend showing the before and after photos so that we can tell where the Voluma was placed since it may have been placed too low.  Thermage would be very helpful for you to lift the jowls and tighten the skin in the lower face.  Please consult an expert.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

How to get rid of these lines?

Hello, and thanks for your question and photo. It is unclear where you had Voluma placed, as there are no before photos with which to compare. What I see is a need for more Voluma in your upper and lateral cheek. Voluma is a thicker HA filler that is meant to be placed deep so as to provide structure and lift. You also may benefit from some filler placed around the mouth, but these lines may soften to your liking with the Voluma alone. In your case, Radiesse or Voluma in your chin would produce more projection, and would further help soften your marionettes. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Hope this opinion is helpful to you. Best of luck, Dr. Frucht.  

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Marionette lines treatment

I don't see how the Voluma caused this. However this can be treated with filler in this area. For optimal results, PDO threads might be beneficial as well. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Marionettr e L ines

Marionette lines are typically caused by atrophy of the labiomandibular fat pad. This is a small triangle that sits below your commissure (or the corner of your mouth) by the chin area. As we age, this starts to go away, and this coupled with skin laxity can start to cause marionette lines and slight jowls. If you didn't have them prior to your Voluma injections, it may be that since another area (presumably your nasolabial folds and/or cheeks) were filled, this created a slight contour deformity. This can be corrected by filling that labiomandibular fold or sulcus - basically right where the marionette lines are, to gently plump this area.

You have some slight skin excess, so chances are it won't get rid of the lines, but will help to soften them. I suggest following up with the person who injected you to show them what you are concerned about. Hopefully before photos were taken and you can see if these lines existed beforehand and were maybe made more noticeable now given that you volumized another area of your face. Best of luck! 

Anthony J. Taglienti, MD
Smithtown Plastic Surgeon
5.0 out of 5 stars 18 reviews

How to get rid of these lines?

Thank you for sharing your question and photograph.  It is unclear if you felt that the placement of Voluma may have caused your marionette lines or if you were only left with marionette lines and desired treatment.  If you felt the Voluma resulted in your current appearance you can dissolve the filler with hyaluronidase but if you are seeking correction, dermal fillers such as Juvederm and Sculptra can be used to smooth the transition from the cheek to chin/lower lip.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 69 reviews

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.