Would I benefit from Botox for marionette lines? (photos)

Question

Female, 27 years old. Do I have marionette lines? I am unsure because my mouth is not downturned but I do not like the appearance of these lines.

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your photo and question. You mention a few key things. The corners of your mouth are not down-turned. If they were, placement of Botox in the Depressor Anguli Oris, (DAO) muscle may help. Botox would not benefit you in this area. You do have marionette lines. We have used filler with good results in this area. Please seek out an experienced injector.

Jeffrey J. Roth, M.D., F.A.C.S

Board Certified Plastic Surgeon

Las Vegas Plastic Surgery

Jeffrey J. Roth, M.D., F.A.C.S

Board Certified Plastic Surgeon

Las Vegas Plastic Surgery

Anna Chacon, MD, FAAD · Answer

Marionette Lines appear as sagging skin due to the loss of collagen and elasticity. Looks like it's starting to show on you already. Non-surgical injectables like Botox and dermal fillers are also found to be effective in erasing the marionette lines off the face. By far our best treatment for marionette lines is dermal fillers. These help to restore volume in your face and smooth deep lines.

Dr. Kim Facial Plastic Surgery - San Francisco · Answer

Botox can be injected to relax the Depressor Anguli Oris muscle which could be accentuating the descending tissue near your mouth. Your provider can determine your candidacy by assessing the strength of this muscle at animation. It is likely that you will achieve a fuller correction of these shadows with filler.

Kelly O'Malley Mattone, MD · Answer

Smile lines from your nose to your mouth, called nasolabial folds (NLF) are not treated with Botox. It's best to treat the NLF with Ultherapy to lift the cheeks that are causing the folds to begin with. Another option is to inject cheek filler to temporarily lift the folds.

Atlanta Innovative Medicine · Answer

There are a number of treatments that can effectively reduce marionette lines, however, we typically wouldn’t recommend Botox for this particular issue. For deeper crevices like this, we usually recommend dermal fillers&mdash;especially Juvéderm Ultra or Juvéderm Ultra XC. Juvéderm Ultra is designed to reach deeper into the dermal tissue, making it an excellent option for major results on marionette lines. 
We invite you to visit our website to learn more about Juvéderm and Restylne formulas, as well as other treatments available for correcting marionette lines!

Niro Sivathasan, MBBS, MRCS, DU (Plast), FAACS · Answer

Yes, you do have Marionette lines. The simple answer would be to add filler to the areas of your concern; however, it appears (from your photos) that you already have a reasonable amount of filler in various areas of your face, and I do 'not' think it is aesthetically pleasing to continue to add filler. 
You should consider going sequentially as follows: (1) The judicious use of any of the botulinum toxins (to muscles around both corners of the mouth) and to your chin (you've got an evolving crease there); (2) Consider repositioning threads (such as Silhouette Soft) to the lower-half of your face, which would also improve your evolving jowls (with or without filler). 
Going in a step-wise fashion shall allow you to evaluate the changes and would also financially be in your favour.

Irena Kovacheva, MD · Answer

There is slight formation of marionette lines.A small amount of botox can be injected to the DAO muscle in order to improve the corners of the mouth.Subsequently the marionettes can be filled with hyaluronic acid

Camille Cash, MD · Answer

From your photos you should have a nice improvement of the marionette lines with HA fillers.  They are used to provide structure to the skin and lessen the appearance of these lines.  The treatment is done in the office and some improvement is noticeable right away.  Botox is used more to soften the appearance of dynamic wrinkles.  See an expert injector near you for treatment.

Peter Andolina, DO · Answer

After looking at your photos, I think you would benefit from some filler to the area.  In you, a little bit of filler would go a long way.  Botox will not help.  You have some lines forming but they do not appear too deep.  Starting with some filler now will definitely help, just dont overdo it

Would I benefit from Botox for marionette lines? (photos)

Answers (10)

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