Marionette lines are lines that originate at the corners of the mouth and can continue down to the chin and jaw line. These lines can cause the corners of the mouth to droop and make patients look sad and/or angry. With age, elastin and collagen components in the skin begin to weaken. This allows the skin to become thinner and to have more stretch resulting in lines and hollowness especially around the corners of the mouth.

In addition, the face contains many fatty layers deep under the skin.  In young women, these fat layers are in well-defined areas and are abundant throughout the skin. They are also the primary determining factor in facial shape and curvature. Over time, these layers tend to decrease in volume, or atrophy. Around the mouth, they can lead to deepening of the marionette lines and hollowness around the mouth.

For mild to moderate lines, dermal fillers can be used to not only eradicate these lines but also add volume to the hollowness around the mouth.  In addition, direct injection into this area can reverse the droopiness seen at the corners of the mouth. Patients believe that this procedure helps make them look less grumpy and angry. Juvederm Ultra Plus is the most common dermal filler to treat this area and, during the procedure, is injected into the surrounding areas of the marionette line to provide structural integrity. Patients can expect the results to last up to one year.

For moderate to severe marionette lines, dermal fillers can be injected into the corner of the jaw. This pulls away, or lateralizes, the fullness around the mouth resulting from fatty atrophy. As a result, the folds around the corners of the mouth are pulled away from the corner of the mouth. Juvederm Voluma is the best filler to achieve this result and can last up to two years.

For severe lines, patients require a combination of the above therapies. Ideally, Juvederm Voluma is used first, and patients are rescheduled three to four weeks post procedure to evaluate the
results. In most cases during this office visit, Juvederm Ultra Plus is injected directly into the marionette area to lessen the lines and add volume to the area around the corners of the mouth.

Interested in learning more? Please contact us at 925-989-6560 to schedule a consultation.

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