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 5

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.  


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
4.5 out of 5 stars 22 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! 

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
5.0 out of 5 stars 35 reviews

Voluma/Marionette Lines/No progress--Fillers, Fat, Scuptra

I suggest a combination treatment for diminishing marionette lines. Folds can be improved with fillers or fat, Scuptra will build collagen long term.  Marionette lines often needs lasers, skin tightening and face/neck lifting too.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 150 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.