What Can I Do About Lines Coming Down from Each Side of my Mouth?

To get the very best and most effective treatment of marionette lines, we take a multipronged approach, and perform each procedure to the maximal degree without inducing artifact or a done look.

1.  Place fat-fascial grafts into the lines (LiveFill)

2.  Augment the lips, particularly the corners of the lips (LiveFIll)

3.  Divide the DAO (depressor anguli oris) muscle tethering the corner of the mouth down into a frown

4.  Perform a volume sparing and elevating facelift if necessary

Of course it is possible for patients who want a minimal or quick recovery intervention to have temporary hyaluronic acid fillers alone, but the above paradigm will give the best and most comprehensive result.

Those lines are referred to as marionette lines and they are often treated using injectable dermal fillers. There are a number of fillers that can work well in this area, but I particularly like Restylane Defyne because it fills in the lines effectively without limiting the natural movement of the face. Fillers are quick to administer and do not require any downtime afterward. Results can last anywhere from 6 months to 1 year in most cases. If you want a longer-lasting result, you will likely need to look at a surgical facelift, possibly combined with facial fat transfer to the midface, to achieve a more youthful contour. Improvements gained from this approach can last up to 10 years or even longer in some cases. I advise you to schedule a consultation with an experienced, board-certified facial plastic surgeon for a comprehensive examination and detailed discussion of your concerns and goals. With a customized treatment plan, you should see a result that is both natural and meets your expectations.

Yours is a concern I often see among my patients. The lines you describe are referred to as “marionette lines” and can be a tell-tale sign of aging. Marionette lines unfortunately cause patients to appear as if they are sad or displeased. Using hyaluronic-acid based injectable fillers, we are actually able to subtly fill the lines, reverse volume loss, and correct any signs of facial ageing. Often Juvederm can be a very helpful filler in the event that these lines are particularly stubborn. For best results, have an in-person evaluation with an experienced board certified plastic surgeon.  

Good news there is a treatment for your problem.  Fillers such as Restylane Defyne may be used for the marionette lines and DAO (depressor anguli oris) which are lines that run from corner of nose down to the chin area.  As far as these lines being gone permanently, filler is a temporary fix.  The fillers may work well for you though, so it is worth a try.  You may also be a candidate for dermabrasion to the area.  You should visit a Plastic Surgeon for a consult to see if fillers or a surgical procedure would be better options to reach your goals.

Hi - thanks for your question! These lines are often called "marionette lines." There are many ways to address these, ranging from fillers for a temporary and less invasive approach to a facelift for a more comprehensive, long-lasting solution. An in-person evaluation will help your surgeon guide you towards the treatment best suited to your needs.

The best way to treat the lines that run along the side of the mouth, more commonly known as marionette lines, would be with one of the hyaluronic acid fillers available today. If the folds are slight I would recommend Vollure or Restylane Defyne. If the folds are more severe, I commonly layer a filler that has more volume such as Juvederm Ultra Plus or Restylane Lyft, with a Juverderm Ultra or Restylane. The combination of the two really help to soften the lines and give a more youthful appearance. Treatment should be repeated about every 8 months as needed.

Best of luck!

Dr. Kaniff