I'm 70 years old. My marionette lines make me feel older. What do you recommend I use? (Photo)

Hi @Sabrina7777! I would recommend a combination of PDO threads and fillers. Best of luck, Dr. Nima!

There are a lot of options for improving marionette lines and this often means fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we use J Plasma, rf treatments and ultherapy to provide skin tightening and lift combined with sculptra with other fillers "layered" on top with lasers and microneedling/prp to improve texture and tone. Please see a facial sculpting expert for a formal evaluation. Best, Dr. Emer

Your best bet, in terms of cost and effectiveness, would be to start with a dermal filler such as Juvederm.  In proper hands, you can achieve major improvement in your facial lines.
Make sure the practitioner is experienced and has done numerous previous clients.  Some before and after photos would be helpful for you to see.
Hope that helps.

If you don't want surgery, the combination of fillers and non-invasive skin tightening like Ulthera, Thermage, Exillis or minimally invasive ThermiTight can give very good results. Fillers for the cheeks and PDO threads can be added for additional lift to the lower face. Make sure you see an experienced board certified physician to discuss all your options. Good luck!

Thank you for your question Sabrina7777.
I understand your concern. Fillers are used to restore lost volume in and
enhance the appearance of the face. Marionette lines are the lines that go from the corners of the mouth to the jawline. This is a common concern. To address this concern it is important to understand the cause: loss of volume in the mid-face and loss of collagen in the skin. Voluma can be placed in the upper cheeks to restore volume loss in the mid-face. This will pull up the lower face and decrease the appearance of marionette lines along with jowls and nasolabial folds. Some patients benefit from Vollure placed directly into the nasolabial folds or marionette lines in conjunction with Voluma in the upper cheeks. Collagen is the protein in the skin that keeps the skin firm, tight, and youthful. Over time collagen is lost. Treatments such as fractional CO2 laser resurfacing stimulate the skin to produce its own natural, new, fresh, and healthy collagen to provide a tight and youthful appearance. I find that a combination of fillers and laser resurfacing works best for such concerns. Please consult with a doctor for specific
recommendations.  Good luck!

I would use a combination of Fillers and Botox. The fillers will help fill below and lift the mouth corner. Botox will relax the DAO muscle that is causing a lot of the problem. Best Wishes, Maurice Vick MD

Hi and thanks for your question. A combination therapy is always more effective. Injection of filler and skin tightening treatments like laser , Rf or threadlift can improve it significantly. 

Really do need to see the whole picture for facial balance, filling in the lines are easy, but this will give you a heavy look. Possibly a combination of non- invasive devices like Thermage, Ultherapy, and strategically placed fillers - cheeks, mid face can be effective. Surgical options should also be explored. A good 3 D examination is the very first step. Dr Davin Lim. Brisbane. Australia.