Age 36 - are these beginning marionette lines & could they be fixed? (Photos)

Question

I am bothered by this downward turn of my skin next to my mouth corners. Are these beginning marionette lines? I am 36. How could these be fixed? On a side note, I also have this slight nasolabial fold.

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing photos along with your question. Based on these images you do appear to show early signs of marionette lines, and they may become more prominent with age. Fortunately, marionette lines can be addressed by injectables. Botox, for instance, is an effective treatment for relaxing the muscles that pull down the corners of the mouth, while dermal fillers can add volume to the mid and lower parts of the face, reducing the appearance of marionette lines. Combining these injectables can create a liquid facelift and help achieve the best results. To learn more about your options, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with extensive experience with injectables. Your surgeon can assess your skin quality, customize the best treatment plan, and ensure the best possible results.

Marc Polacco, MD · Answer

Thank you for your question. Given your age and the pictures, most likely fillers will be your best treatment option. They help by adding volume and reducing shadowing. I hope that helps, and all the best.
-Dr. P

Camille Cash, MD · Answer

It's never too early to begin a great skin care routine.  Begin by visiting with an experienced aesthetician at a med spa near you.  Together you can create the right combination of medical grade skin care products, like those from Transform MD, to address your skin type and concerns.  Other adjunct treatments such as microneedling, hydrafacial, and fillers can be discussed based on your needs.  Also, remember to use sunscreen every day.

William C. Harris, MD · Answer

Hi,
The slight shadowing you see at the corners of the mouth going downwards and from nose to corners of the mouth are minimal from what I can tell. Over time, these areas do deepen and dermal fillers are always an option for helping to diminish these shadows. There are several types, but the main class is hyaluronic acid fillers, which offer an immediate change and last about 9-12 months for most people. A specialist such as a well trained facial plastic surgeon offers these fillers should you choose to try these down the road. Make sure to do your research when choosing a provider and I hope this helps answer your question.

Maria Chuquer, MD, FRCPC · Answer

Hello there! You may benefit from volume replacement with dermal fillers in cheek area to soften those issues, followed by very carefully placed fillers on the marionette lines and/or corners of the mouth. The best is always to consult a certified cosmetic doctor in your area so you can be examined in person. Best of luck!

Rosa B. Lipin, MD · Answer

At rest, it does not appear that the corners of your mouth are downturned, however, during animation that may be the case. If it is, we can use a neuromodulator (dysport or botox) to treat the DAO muscle, which will prevent the corners of the mouth from pulling down. Sometimes a small amount of filler under the corner of the mouth is helpful to provide a bit of support to this area as well.

Beverly Friedlander, MD · Answer

Thank you for your question!  Marionette lines are a common concern that our patients come to us to address.  It's a normal sign of aging for a patient in their 30s.  The best option for this concern is dermal fillers.  It's a simple and effective treatment that provides immediate results.  We would recommend that you see an experienced injector, preferably a board-certified plastic surgeon, that could analyze the structure of your face and provide balance.  Best of luck to you!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,
You are a perfect candidate for fillers.  You have lost volume mid face which is causing some heaviness in the lower face.  Have a consultation with an expert injector for volume restoration. 
Best of luck!

Age 36 - are these beginning marionette lines & could they be fixed? (Photos)

Answers (9)

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