Male, 23 - Marionette lines only on one side. How can I fix this? (Photos)

Question

I recently noticed that I seem to have marionette lines only on one side of my face. I wonder what could be the causes and how i can fix it

Anna Chacon, MD, FAAD · Answer

It’s actually more common than people realize to notice facial lines or folds that are more visible on one side — even at a younger age like 23. Faces are naturally asymmetrical, and marionette lines (the lines that run from the corners of the mouth downward) can show unevenly depending on structure, muscle movement, and daily habits.

Here are some of the most common reasons this can happen:

1️⃣ Natural facial asymmetry
No face is perfectly symmetrical. One side may have slightly less volume, different muscle pull, or a deeper natural fold, which can make a marionette line appear earlier or more prominently on that side.

2️⃣ Muscle movement patterns
Some people consistently use one side of their mouth more when talking, smiling, or chewing. Over time, repeated movement can deepen a line on that side first.

3️⃣ Sleeping position
If you tend to sleep on the same side of your face, compression and friction over time can contribute to uneven fold formation.

4️⃣ Volume distribution
Early volume differences in the cheeks or lower face can make one marionette area look more pronounced. Even small structural differences can show up in photos.

What can help improve it

Non-invasive options:

Good daily skincare with sunscreen and a retinoid can help collagen support over time.

Hydrating and barrier-supporting products can make lines look softer.

Being mindful of repetitive facial tension on one side can sometimes help prevent progression.

In-office treatments (most effective for visible asymmetry):

Hyaluronic acid filler — often the most direct way to balance a one-sided marionette line by restoring volume and smoothing the fold.

Biostimulatory fillers — can help build collagen gradually in some cases.

Neuromodulators — occasionally used if uneven muscle pull is contributing.

Collagen-stimulating treatments like RF microneedling or ultrasound tightening can also help with early laxity.

At your age, if the line is already noticeable, it’s usually very treatable and often requires only small amounts of correction when addressed early. The key is matching the treatment to the underlying cause — volume loss, muscle pull, or structural asymmetry.

— Dr. Anna Chacon

Camille Cash, MD · Answer

We all have facial asymmetry to some degree and yours is within normal limits.  There are various ways to improve this.  The best place to begin is by visiting with an experienced aesthetician to customize a skin care routine.  We recommend using medical grade skin care like Transform MD and wearing sunscreen every day.  In addition treatments such as fillers can help add lost volume.  Treatments such as Morpheus8 can improve overall skin tone and texture.  I've included a video that I hope you find helpful.

Male, 23 - Marionette lines only on one side. How can I fix this? (Photos)

Answers (2)

More Dermal Fillers Questions

Does beta-carotene impact the longevity or lead to the breakdown of dermal fillers?

Best treatment for dark circles, blepharopasty or filler? (Photos)

Weak infraorbital rim - Should I get infra-orbital implants or would filler in that area help? (Photos)

Filler and Invisalign - is it okay to start Invisalign a few weeks after filler? Does it increase migration chances?

Would losing weight help lessen nasal folds? Will fixing my maxillary alveolar ridge help? (Photos)

How do I fix undereye dark circles and hollowing?

WE SEND PRETTY
EMAILS