28 y/o & looking for marionette lines fix? They've gotten worse as I age (Photos)

Question

I've always disliked how my left side has a deeper more noticeable marionette line that creates a shadow. I've always had big cheeks even when I was underweight, and I do know my jaw is uneven and makes my face and smile uneven but the lines has gotten worse as I've aged (I'm 28) and I don't know what the best way to go about fixing this is. Fillers? Botox? Facelift? Or a combination of things. Not sure what options I have or what would give me best results.

Martin Jugenburg, MD · Answer

Hello thank you for your question. I would consult with your nearby plastic surgeon, there are some non surgical option to slightly fill in the nasolabial fold and marionette line. If you are planning to loose weight I would hold off on anything.

Alan Gonzalez, MD, FACS · Answer

Hello @Anika3555, thank you for your question and showing your pictures. A Facelift is a to invasive procedure for your. What you are presenting very well can be treated with non surgical treatment like Ultherapy to define the edges and improve skin elasticity, and Radiesse to improve the cheeks aspect and their relation to the over all face. those may be some of the non-surgical alternatives. Is important to consult one or several board certified plastic surgeon for more information and recommendations. Best wishes! Alan Gonzalez MD FACS

Suleyman Tas, MD, FEBOPRAS · Answer

Dear Anika3555 , 
Thankyou for providing pictures for reference. As per your pictures you seem to be experiencing face laxity, meaning your skin is losing its firmness and tightness which could be due to many factors like pregnancies weight loss stress, etc. In such a case a full-face lift is most beneficial for a permanent solution it would target neck, midface and temporal area. I would suggest to look into expert surgeons who deals in scarless endoscopic vertical facelift which would give you a natural look after full recovery. Moreover, scarless would mean that the lift incisions will be hidden in you hairline and after full recovery will be invisble to see. I recommend vertical facefiit so that you dont get a pulled or artificial look. Furthermore, fat injections is also a technique I would suggest for the areas around your mouth for any deep wrinkles and nasolabial folds which are permanent and will fill in the lack of volume in those areas.
Best Regards,
 TAS TEAM

Gianfranco Frojo, MD · Answer

The answer may be multifactorial depending on the physical exam. If you have excellent quality skin, fat grafting alone may be the solution. If the skin is too loose, the correct answer would be likely facelift/necklift with facial fat grafting. I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing images along with your question. While a proper evaluation of your skin is necessary to recommend the best treatment options, nasolabial folds and marionette lines can usually be addressed using dermal fillers. Fillers can be injected to either directly fill the fold or by filling the cheek to lift the fold. Fillers may also be injected to treat marionette lines by restoring volume to the areas beneath the wrinkles, smoothing out deep lines and giving the skin a lift to create a younger-looking appearance. 
Botox works can also be combined with dermal fillers to help achieve better facial symmetry. Profound RF (RF microneedling), and other laser and energy devices that boost collagen production can help tighten and rejuvenate the skin too. To determine the best course of action, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation of your skin, recommend the best treatment or combination of treatments, and ensure the best possible results.

Peter Chang, MD · Answer

Thank you for your question and photo submitted. Based off your information provided and your age range, you could achieve correction with less-invasive options than a facelift. If the facial fullness is causing drooping and folding, you could be a good candidate for a Buccal Fat Pad removal procedure, and possibly the introduction of some facial fillers to the nasolabial folds and marionette lines. A secondary option would be a surgical approach, in which facial or neck/jowl liposuction can take down the extra volume and give you a more contoured face and jawline. There are multiple options to consider, but your goals are achievable! The next step to take would be finding a qualified and experienced Board Certified plastic surgeon to do a full facial evaluation and provide you with a designated treatment plan to reach your desired goals.

Jeffrey Lisiecki, MD · Answer

It looks in these photos like you have large buccal fat pads. Buccal fat pad reduction, plus some filler or fat grafting to help soften the nasolabial folds and define the jawline would be great. Adding some radiofrequency microneedling to the lower face, jawline, submental region would be a nice addition, too!

Christian G. Drehsen, MD · Answer

The best course of action in this case would be either Botox or a cheek lift. The Botox will help to soften the line to minimize noticeability. If you want a more invasive approach, a cheek lift is the next best option. This can bring back the symmetry of the face you are looking for. Please do not hesitate to contact us for any further questions

Gurkan Kayabasoglu, MD · Answer

Hello, when I examine your photos, I see that your Nazolabiel and Marionette lines of your face have deepened, and at the same time, the jaw line is broken and sagging due to the weight of your cheek. Considering that your age is young, it is possible to offer two alternative options for you. The first is a mid-face lift with an incision under the eye. Secondly, if your skin laxity and elasticity is weak, it is possible to make both the neck, jaw line and face look younger and fresher with deep plan facelift. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the congress invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me. With all respect

David Plank, MD · Answer

Our face changes as we mature. I would suggest seeking out a consultation with a board certified plastic surgeon to address all your needs.

28 y/o & looking for marionette lines fix? They've gotten worse as I age (Photos)

Answers (12)

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