Please Help! How can I get my marionette lines fixed? Does anyone know of a doctor in my general area?

I've had fillers done a couple of times and neither worked. The first Doctor put filler in my upper lip thinking this would lift the marionette lines up and out... it didn't. Another doctor used the cross threading method which just made the overhand on the marionettes lines worse. Isn't it possible to just inject the filler directly in the wrinkle to fill it?

Doctor Answers 7

Marrionette lines fixed?

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It would help to see photographs of you marionette lines.There is a variety of fillers that can help if properly placed. We frequently utilize stem cell/fat injections because these lines actually indicate both facial volume loss and decreased structural collagen support which occur with aging.The goal is to improve overall facial vitality using these supportive measures and volume restoration.

Orange County Plastic Surgeon
4.6 out of 5 stars 22 reviews

Filler to correct marionette lines

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Thank you for your question.

A picture would better allow a more individualized recommendation.

I frequently inject juvederm to fill the marionette lines. Bruising can be present up to a week, but usually resolves in 2-3 days.

I inject the filler where it is needed most, directly at the base of the wrinkle. I prefer not to cross-hatch.

I hope this helps.

- Dr. Bryson Richards

Marionette lines

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It would be great if you could add a photo.  Without seeing you it is hard to give any recommendations.  I have been seeing great success with using Voluma to in the mid face to help correct marrionette lines.  It will depend on the person but often times I will use Juvederm or Belotero to help correct the line itself at the same time. I would recommend seeing a board certified plastic surgeon in your area or submit photos. 

Kevin Rose, MD
Provo Plastic Surgeon

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Correction of Marionette Lines

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Correcting marionette lines is a very reasonable request.  A photo of the lower part of your face would help determine your anatomy and perhaps why there has been difficulty with your injections.  There are a number of different injections which can help rejuvenate this area from Juvederm to Restylane or Sculptra.  For the best cosmetic results please consult a board certified dermatologist in your area with experience in cosmetic facial injections.

Please Help! How can I get my marionette lines fixed? Does anyone know of a doctor in my general area?

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Hi Karen,

There are a ton of different techniques to smooth that dreaded "marionette look". Generally speaking for most patients this facial sagging is due to volume lose through out the whole face. So in my opinion rarely when treating something locally does it address the real problem. However, there are a variety of fillers that work well for that area. A lot of the times in my opinion I've found that voluma or radiesse in the midface helps to give a lift to that area, then you can do minimal filler through out the lower face to give support and smooth out fine lines and wrinkles. However, it would be helpful to see a picture of your concerns. Finding a Doctor, surgeon, or nurse injector that has good before and after pictures can sometimes be helpful as well.

Good luck!

Marionette Lines Respond Well To The Proper Choice(s) Of Volumizing Filler(s) & Technique(s)

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Photos would have been helpful. Speaking in general terms, however, the choice or combination of choices of volumizing filler, the amounts needed, and the particular technique or techniques used, in experienced hands, will depend upon tailoring the treatment plan to the individual circumstances.

As an example, literally minutes ago, I finished treating a 66 year old woman with pronounced marionette lines, more deep on her left than her right side. In her case, I did in fact need to help buttress and pull upward on the marionette lines by beginning with injection of Perlane L to the lateral regions of the white portion of her upper lip using a cannula technique. Following this, I then placed Radiesse, another volumizer radially within a triangular area below the outer corners of her lower lips to provide the necessary deep support volumetry to impart foundational support from below. Finally, to complete the job, I injected a small amount of Juvederm Ultra XC filler directly into the angles themselves to complete the job. The foregoing volumizers and fillers would be my agents of choice in my Upper East Side Manhattan office. In my Israel satellite facility, where a far greater number of regulatory agency approved volumizers and fillers are available, I would opt for Emervel Volume, Teosyal Ultra Deep, and Princess Filler for each of these indications, respectively.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Filler for Marionette Lines

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Hi Karen. Thanks for your question.  Technique does make a difference in how much value you achieve from your injection procedure.  So too does product choice as there are many different injection products available, some that may work better than others for your particular concerns.  

We are a bit confused by the idea of injecting filler in the upper lips for marionette lines (below the mouth).  In addition, the cross threading technique is a good one, but because we do not have photos, not sure if it's appropriate for you.  As always, an in person consultation helps to clarify things.

To see an example of our before and after pictures for Restylane injections in the marionette lines for another La Habra, CA patient, click on the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.