Thermage for Marionette Lines?

How effective is Thermage for the crease from nose to mouth which is the smiling lines and the sad lines beside the chin? thank you.

Doctor Answers 1

Thermage for Marionette Lines

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Thermage is a global skin tightening procedure that is somewhat limited in it's ability to affect wrinkles and lines.

Because Thermage works by implementing heat for collagen "remodeling", it can have some minimal effect on lines and wrinkles, but from the perspective of making a true visible difference in marionette or smile lines, your best options are temporary fillers.

This area of the face is generally quite mobile, so a hyaluronic acid gel should give you the best result. Buttressing the mouth corners with a collagen structural filler like Evolence can literally "lift" drooping mouth corners.

If you find you have overall skin laxity, Thermage could be a worthwhile option, though dramatic changes are not common. There is really not a direct correlation between Thermage and alleviation of discernible lines in the face, especially in areas where there is repeated movement and muscle contraction.

That said, you "may" have some improvement in your marionettes with Thermage, in which case you could consider it a bonus. But for the lines themselves, if that is your only concern, I'd definitely recommend investigating the filler options.

Irvine Dermatologic Surgeon
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