Hello, and thanks for your question and photos. You appear to be an excellent candidate for facial rejuvenation with hyaluronic acid (HA) fillers. In particular, I think you would benefit from Voluma placed in your malar area (i.e., mid-face). Voluma is a thicker HA filler, meant to be placed deep so as to provide structure and lift. If placed appropriately and in sufficient quantities, I do think this would soften your marionettes. You may then also benefit from placing some filler directly into these lines, so as to further soften them. Everyone's tissue responds a little differently to filler, so I like to start with the Voluma before deciding what other products, if any, may be necessary. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Best of luck, Dr. Frucht.
Dear Betty2010:Great question. Looking at your photo, cheek reflation with a dermal filler would soften up your marionette lines. I would suggest having your cheeks filled initially by an expert injector and re-assess your marionette lines 2-4 weeks thereafter. Hope this information helps and wishing you treatment success.