Wrinkles around mouth - what's the best way to treat these? (Photo)

Marionette lines can develop for several reasons, including volume loss, changes in skin elasticity, and the natural way your facial tissues shift over time. The best treatment depends on what's causing the lines and how deep they are.

For deeper marionette lines, dermal fillers may help restore lost volume and soften the folds. If skin laxity is contributing, treatments that stimulate collagen production, such as certain laser or radiofrequency procedures, may also help improve skin firmness and texture. A good skincare routine with sunscreen and a retinoid, if appropriate for your skin, can help improve fine lines over time.

I wouldn't automatically recommend placing filler directly into the lines without assessing the surrounding areas, particularly the chin and lower face, since facial balance plays a big role in the final result. The goal is to soften the lines while keeping your features looking natural, not overfilled.

Hello MariAnne,

Thank you for this question! Marionette lines and the downturning of the mouth occur partially due to gravity over time- the increasing laxity of the skin, along with several other factors, allows the weight of the cheeks to draw downward, resulting in these shadows and lines. In our office we have a multitude of approaches for this area, including strategically placing filler and botox around the mouth so as to fill in the shadows and relax some of the downward pulling of the mouth. That being said, our first step would be to assess your face in its entirety so as to better understand the true cause of these marionette lines. We believe it is important to treat volume loss and laxity beginning with the upper face so as to optimize the maintenance of a youthful, natural appearance.

If you would like to learn more or see how we would approach your concerns, please feel free to contact our office and schedule a consultation. We would love to meet you!

All the best,

Genie Alexander, RN BSN
for Dr. Anna Petropoulos, MD FRCS
Center for Classic Beauty
80 Lindall St. Danvers MA
396 Commonwealth Ave. Suite A1 Boston, MA
978-739-9500

A fullface frontal photo would have been additionally helpful to evaluate any potential contribution of voume loss in the cheeks to the development of the marionette lines. If there is, then the use of a robust HA volumizing filler would not only contour the cheeks, but would likely secondarily improve the marionette lines below. If cheek volume is sufficient, then the use of a robust HA lifting filler can be used to elevate and straighten the downturned angles of the mouth. You would be wise to consult with an experienced, board certified cosmetic dermatologist and ask to see his/her personal before and after photos before agreeing to proceed. Hope this helps and best of luck.

Fillers are a great tool to improve the appearance of marionette lines. They work well in conjunction with other treatments such as Morpheus8 or lasers which address skin rejuvenation. See an expert injector near you to learn more.

You did not show your whole face and may need a facelift. However, the area around your mouth can be treated with micro-needling and radiofrequency for tightening and/or with fillers.

There are multiple different ways to help address your marionette lines. Filler can absolutely be used to help soften these lines. You may also benefit from a little Botox in your DAO muscles to help soften the pull. I would suggest a consultation with a medical professional who performs these treatments regularly.

The best way to treat marionette lines is a minimally invasive procedure of hyaluronic acid filler and Botox to the depressor muscle at the corners of the mouth. The surgical route would involve a deep plane Facelift and/or fat grafting to the marionette folds.