What is Your Opinion on Marionette Fold Excision?

   Marionette Lines or Nasolabial Fold Excision can usually be avoided by facial fat grafting and proper facelifting techniques.  Kenneth Hughes, MD Los Angeles, CA

if you are looking for a permanent solution to this your best bet wold be a permanent filler such as on the link below.  Surgical excision would result in a scar in a place that may not be so easy to hide.

Very simple-  in my experience, I would not excise the marionette lines, either directly or with a lateral corner lift lip, due to the risk of scarring.

Do not do this.

Even an optimal scar will still be noticeable in this location, and will likely require make-up to disguise it.

Instead, consider fillers to the area, or a further SMAS and skin tightening along the jawline.  A good facelift is very effective for treating this problem.

I highly discourage excision of these. Sounds like what you needed was a full facelift instead of a 'partial' one. Please consider a full facelift before attempting excision. Best wishes, Dr. H

Direct excision of marionette lines is not a great idea.  Excising nasolabial folds is better in certain people, but also not a great idea.  I would recommend filler, laser, chemical peel, or just living with it before I would recommend excision.  

The "extended corner lift" you refer to is a good option when performed for the correct indications in carefully selected patients.  If the creases and sad look bother you and you believe your surgeon can manage the scar, go for it.

Definitely do not do this. Excising these directly illustrates a lack of understanding on the underlying problem. The problem is either volume deflation, excess skin of muscle laxity.

I can think of no worse idea than an excision of marionette lines.  These are caused either by loss of facial volume or skin laxity.  These must be corrected first. 

The socalled Marionette lines are an integral result of facial aging. Their presense usually indicates that aging has progressed to the point that surgical intervention is necessary. I'm not quite sure what a "partial" facelift is but it must provide a  "partial" result. All facelifts regardless of variety make an attempt to improve both nasolabial and Marionnette lines. Fillers give additional improvement. Resorting to direct excision of these lines is to admit utter defeat in using the standard techniques and in addition to the obvious need for an unhappy scar, there is no guarantee that the fold will be totally gone. There may be indications to use this technique such as in the case of a unilateral facial paralysis,  most accomplished Plastic Surgeons do not believe in leaving scars in such awkward places for cosmetic improvement.