Marionette Lines Treatment With Botox and Fillers

A Picture of a woman showing treatment of Marionette Lines Before and after Botox
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What Are Marionette Lines?

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Marionette lines Treatment are one of those aptly named wrinkles that conjure up a pretty clear visual. They are named from their resemblance to a marionette puppet with a jointed mouth! It has lines that run from the edges of the mouth to the chin so that the puppet’s jaw can open up and down to imitate talking.

Marionette lines look similar on a human face. They are creases or folds that start at the outer corners of the mouth and run down to the outside edges of the chin. In some cases they run straight down while in others they curve outwards.

Marionette lines are very subtle, so much so that it may be impossible to trace the exact line. However, they have a negative impact on the face because they create a shadow between the chin and cheek creating the look of a droopy jowl. Vertical lines at the corners of the mouth can also make it appear as if you are frowning or scowling even when you’re happy.

People typically begin developing marionette lines in their late 30s or early 40s. In the early stages, marionette lines are barely visible. When they become noticeable is different for everyone and is dependent on race and ethnicity, in addition to other factors.

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Best Treatments for Shallow Marionette Lines

Shallow marionette lines typically appear as fine lines that don’t create many creases or cast a shadow. Treating these lines early is important, as they will otherwise get progressively worse.

Some of the most effective antiaging treatments for facial rejuvenation include:


Botox and other neurotoxin-based brands injected around marionette lines help relax the facial muscles and smooth out the skin. The results from most of these treatments last several months before requiring reinjection.

Injections alone cannot stop the skin from aging, but they can slow down the formation of wrinkles by relaxing the dynamic surfaces of the face.


Topical creams containing Retin-A (retinoids) help promote the production of collagen in the skin. Regularly using a retinoid cream restores facial skin elasticity, smooths out existing wrinkles and prevents them from becoming worse.


Some laser resurfacing treatments remove the damaged outer layers of skin to reveal the smoother, healthier skin underneath. Other types promote collagen production under the skin. Both treatments can diminish the appearance of shallow lines and wrinkles.

Dermapen Microneedling

This process makes tiny punctures in the skin around the marionette lines. These punctures stimulate collagen production, which heals the skin and softens the look of wrinkles.

Chemical peels

Throughout this treatment, a chemical gel solution is applied to the skin to make it blister and eventually peel off, exposing a fresh layer of skin underneath. Following the chemical peel, the skin will appear smoother and less wrinkled.

The extent of the results depends on the percentage of acid used in the solution. Deeper marionette lines will require a deep chemical peel, which can remove skin cells both from the epidermis and lower layers of the skin.

Best Treatments for Deep Marionette Lines

Deep marionette lines occur after the skin loses significant amounts of fat and collagen, creating a sunken appearance. Since the problem is with the underlying structure of skin rather than the surface, a different type of treatment is necessary:


Facial fillers made from hyaluronic acid (HA) are injected into the area around the marionette lines. They give lift and volume to the areas under these wrinkles, smoothing out deep lines and restoring a youthful appearance to the surface of the skin.

The volume boost from filler products loses effectiveness over time, and not all of them are appropriate for treating marionette lines. While Juvederm, Radiesse and Restylane are generally used to treat marionette lines, you should consult with a professional to determine the most effective filler for your situation.


A facelift is a surgical procedure used to tighten facial skin by repositioning the deep tissues underneath it. In some cases, fillers and fat grafts are used after the surgery to give contour to the restored skin.

Medical advances have turned facelift surgery into a minimally-invasive procedure that requires little downtime, while producing natural-looking results.

How Do I Prevent Marionette Lines?

While avoiding the facial expressions that cause marionette lines may be impossible, there are preventative measures that will ensure they take longer to appear.

Get enough sleep

Sleep is an important factor for multiple physiological processes, including skin regeneration. Chronic poor sleep quality has a negative effect on skin health, and is associated with accelerated intrinsic aging, as well as decreased function of the skin barrier, the outermost layer of the skin’s surface.

Avoid smoking

Smoking accelerates skin aging, causing wrinkles to form faster than they would naturally.

Wear sunscreen

Apply a high SPF broad-spectrum sunscreen before any amount of sun exposure, not just at the beach. Day-to-day exposure to UV rays may damage the skin in small increments, but it damages it nonetheless, and the results will eventually become visible.

You can apply sunscreen as a standalone product, or use a moisturizer with a sunscreen factor in your daily skincare routine.

Skincare routine

A daily skincare regimen that includes cleansing and moisturizing helps prevent wrinkles from forming by supplying the skin with the vitamins and minerals it needs to preserve elasticity.


Marionette lines are caused by a combination of internal and external factors, as well as genetic predisposition. Although these lines are natural and common, they are avoidable and reversible.

A healthy lifestyle and regular preventative skin care can delay marionette lines from forming and limit their appearance once they do form.

Alternatively, corrective treatments ranging from dermal fillers to toxin injections can minimize the appearance of existing marionette lines by addressing the underlying causes – facial volume loss and diminished skin elasticity.

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