Using a filler for the Marionette Lines and Botox to make it last longer?

Can you use a filler for the Marionette Lines and use Botox on the muscle to make the filler last longer?

Doctor Answers 11

Botox and fillers for the marionette lines

Thank you for your question JJ Johnson. Fillers can be used to enhance facial features. Products such as Voluma, Juvederm, and Restylane can restore volume and improve the marionette lines going from the corners of the mouth to the jawline. Botox is a purified protein used to address wrinkles associated with facial expression. Placing a small amount of Botox in the DAO muscle will help elevate the corners of the mouth by about one millimeter. Using both will improve the appearance but not necessarily make one last longer. Most people enjoy the results of Botox for 3-4 months and fillers for 6-24 months (Depending on the filler). Please consult with a doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 1 review

Marionette Lines and Fillers

I find that a combination of fillers such as Juvederm and Voluma and Sculptra can have an amazing long lasting effect in this area.  Please consult an expert.  Best, Dr. Green

Marionette lines and chin -- fillers / fat/ sculptra, you may need lifting, chin implants

I suggest you see a cosmetic dermatologist for a formal evaluation to determine if it just volume that is needed (which we often will do fat and combination layering of fillers) or if lifting is needed which may mean implants and/or surgery.  Botox can help in this area but often doesn't do much for the fillers.  Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Marionette lines can be treated with filler and Botox.

Marionette lines are caused by volume loss (fat, bone, and collagen) and is usually treated with a filler such as Juvederm UltraPlus or Voluma. I often also inject the DAO (Depressor Anguli Oris) muscle with Botox when treating the marionette lines with fillers. I'm not sure that the filler last longer because of the Botox but it certainly gives a more complete result by reducing muscle pull on the corners of the mouth. 

I do, however, believe that Botox does lengthen the time that filler last when the two are combined in other sites on the face such as the lips and glabella (frown lines).

Marionette lines, filler, and Botox

Marionette lines are effectively treated with filler alone. 

In some areas of the face, excessive motion may breakdown facial fillers at a faster rate. Some practitioners supplement the filler with a neuromodulator like Botox to decrease that motion. 

The marionette lines are formed by facial volume loss and tissue laxity, not excessive motion. Adding Botox would not improve the laxity or volume. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Using a filler for the Marionette Lines and Botox to make it last longer?

My advice would be to save your money and avoid wasting it on Botox for treatment of the marionettes. Ligamentous laxity and skin laxity result in settling of the skin in that area and would not be helped by Botox in my opinion. Filler alone should give you the best improvement.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Botox and filler combination

The combination of Botox and filler for marionette lines does make the correction last longer, but be sure you see a board certified dermatologist or plastic surgeon who is also skilled in the use of these materials

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Filler and Botox together

You can use botox on filled areas to prevent muscle activity and minimize breakdown of the product. This will result in longer lasting filler treatments. The marionette lines however are usually formed from laxity of ligaments in your face as well as volume loss and less from muscle activity. Because of this, you may not see the same benefit as seen in other places such as the glabellar ("11s"). Also, it would not be posisble to immobilize the lower face with Botox without affecting your daily function from facial expressions to oral competence when eating. For true long-lasting improvement of marionette lines, a lower facelift would be the best treatment option. Hope this helps!

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

There isn't any data to suggest using toxin and filler on marionette lines will make them last longer

Combinations of filler and toxin in the glabellar region (the area of your forehead between the eyes) have been shown to result in both a better and longer lasting result.  There haven't been any studies done to demonstrate that toxin and filler for the marionette lines will make it last longer. It is possible by injecting toxin into  the DAOs (Depressor Anguli Oris muscles- the muscles which pull the corners of the mouth down), may give you a better result with your marionette line filler.  It might result in a longer lasting effect but there is no data to confirm this.

Amy Forman Taub, MD
Chicago Dermatologic Surgeon
3.8 out of 5 stars 10 reviews

In some cases both filler and botox may be used

The lines around the corners of your mouth may be improved by using fillers, such as Juvederm, to fill in the grooves.  In some patients these grooves are aggravated my muscles that pull the corners of the mouth down too.  In these cases both filler and Botox simultaneously may improve your results.  I cannot say that the Botox prolongs the filler, but I can say that it might work synergistically to improve your results.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.