Voluma to reduce marionette lines? (Photo)

Hi @Susie1360! You would be a great candidate for cheek fillers and Morpheus 8! Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

 Hyaluronic-acid fillers in your marionette lines will not make your face look bottom-heavy. However, I wouldn’t recommend Voluma for those creases because it is quite a thick filler. A better choice would be a thin, flexile filler such as Restylane Defyne or Refyne, which move easily and naturally when you make facial expressions. If you want more volume and lift in your face overall to replace the fat and collagen that was lost to aging, then yes, Voluma would be an excellent choice. It would not make your cheeks look big. Be sure to consult a board-certified dermatologist who knows how to create beautiful facial rejuvenations using Voluma and other fillers.

Thank you for sharing your question and photographs.  Depending on your desired outcome, speed of correction, and duration of results I would favor filler treatment with Voluma into your cheeks and jawline, Sculptra layered on top and in the hollow of the cheek and a thinner filler like Juvederm Vollure or Ultra Plus into your Marionette lines.  Ultimately find an injector who best understands your goals, their skill is what matters more than the specific filler material used. Hope this helps.

A combination approach will give the most improvement. I recommend fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Thank you for your question and for attaching photos. Usually it is a combination of both filling the marionette lines and adding volume to the cheeks to achieve a subtle change. An experienced injector will know that if too much volume is added to the marionette lines it will actually make the area look heavier, therefore it is also important to lift the tissue from above. Best of luck.

A little bit of filler to lower face marionette line filler often does not cause significant sagging. The current gold standard therapy to lift the lower face is to combine judicious filler amounts with Ultherapy® ultrasound lifting. For best results please consult a board certified aesthetic dermatologist for a consultation.

I vote 100% for Voluma with your anatomy. You have high cheekbones but have lost volume below. You can get a great fill that will not make you get “apple cheeks” but will create a mini facelift like result making you look younger and less drawn.  I agree that if you proceed with filling of your lower face that you will create an imbalance.  While Voluma is more expensive it last much longer and I’m seeing results in my patients lasting for 3-4 years.  Hope this helps and best of luck.

I think you would get the best results with combination treatment. I would consider Restylane Lyft or Sculptra into the midface/cheeks which would restore age related volume loss and lift the face. I would combine this with a flexible gel hyaluronic acid based filler like Restylane Defyne injected into the marionette lines. I would also recommend Thermage FLX for skin tightening (improving jawline definition and reducing jowls) and a good at home skincare regimen (antioxidant, sunscreen, and retinol). 

You would definitely benefit from adding volume with Voluma and Sculptra. A combination of skin tightening with Thermage and Kybella to help reduce the fat under the next and tighten the jowls would also be very beneficial.  Please consult an expert in facial lasers and cosmetic injections for the best results.  Best, Dr. Green

Good morning and thank you for your question. Voluma is indicated to correct age-related volumeloss in the midface giving a lift effect, however, for your specific concern of the marionette lines I would suggest trying another product from the Juvederm line such as Juvederm Ultra Plus or Juvederm Vollure.