Best procedure for marionette lines? (Photo)

Hello, Thank you for the question. A soft filler may be used to soften marrionette lines. However, Volume loss to the cheeks (midface) should be corrected first. Marrionette heaviness appears heavier due to volume loss in the midface. After midface correction, then we can see how much correction is actually needed for marrionette lines and volume loss. If the marrionette lines are treated before the volume loss in the midface is treated, it will look unnatural and results may not be satisfactory. Be sure to seek out a registered nurse or physician trained in facial anatomy and injectables.Good luck in your beauty journey!

Hi rachelc101! You can help soften the marionette lines with dermal fillers. In addition, I would recommend PDO threads. PDO threads help to lift facial anatomy for structural changes and can help promote collagen and myofibroblast stimulation improving overall skin texture and health. I hope this was helpful :)

While a facelift will likely be the most effective treatment, careful placement of filler can help soften the lines. It won't remove them completely, but rather, provide a softer appearance. All the best!
-Dr. P

Good Morning, Rachel! Great question. Filler is a great first choice. There are a number of different products most being in the hyaluronic acid family. Some choices would be Juvederm Vollure, RHA 3 or 4, or Restalyne Refyne or Defyne. These provide nice volume to support those areas specifically the corners of the mouth. I would try something like filler first being that it's reversible. If you like it, you can continue or consider fat transfer for longer-lasting results (closer to 5-10 years). Hope this helps!

Fillers are a great option to help soften the appearance of marionette lines. To help improve overall skin tone and texture you can consider Morpheus8. These treatments combine microneedling with RF technology. Optimal results are seen after three treatment sessions.

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

Marionette lines can be improved with the use of injectable fillers such as hyaluronic acid to blend the transition from the jowl to the chin. Although the underlying cause is not treated, the appearance of the marionette line can be well camouflaged using this approach.

Relax. Nowadays, there is very often no need for any expensive, aggressive facelift surgeries with their attendant prolonged post-surgical downtimes and assurances that in six months "you'll see the full benefits." For the past fifteen or more years , problems such as volume deficit in the cheeks, tear troughs, smile lines and marionette lines (and also neck problems) have been treated nonsurgically via the appropriate use of HA fillers and very often, particularly in experienced hands, all of the aforementioned can be done in one half-hour treatment session. I personally perform these treatments practically every dasy. So, simply do your due diligence and seek consultation and treatment by an experienced, board certified cosmetic dermatologists and best of luck.

Hi,

Thank you for your question regarding the best treatment for marionette lines. At our practice we like to keep everything really natural. We like to combine tightening treatments like Thermage with Filler for your type of concerns, as it gives the face a nice lift and smooths out the lines that age us. Filler can be placed at 4 corners of the face to pull back and lift sagging skin, to naturally rejuvenate the look of the face. Then we can use a very thin filler to fill in any left over lines directly in the marionette later on if needed. But if we only fill the marionette lines, patients can look heavy in that area and it looks artificial.

It will be important to see an expert injector who is Board Certified.

Best of luck,

Nissan Pilest, M.D.

If you aren't ready to commit to a facelift then a combination of treatments can help soften and reduce marionette lines. I would recommend a small amount of botox/dysport/xeomin into the frowning muscle (DAO) to lift the corners, followed by the use of dermal filler (I like RHA4 Teosyal in this region due to its combination of strength and stretch). If you aren't interested in injectables then the 4D Fotona Facelift treatment is excellent to give lifting and smoothing in this region. It is important to understand that only a surgical facelift gives surgical facelift results - all other modalities will soften the lines but not give equivalent results to surgery.