Marionette lines
Marionette lines, the lines running down from the corners of the mouth, usually have more than one cause: a muscle that pulls the mouth corners down, volume lost around the chin, and sagging from the cheeks above. Small, careful filler helps some people; for others botox, a lifting device or treating the jowls above does more.
“People keep asking if I'm upset. Is it my mouth corners?”
“Will filler fix marionette lines, or make my face look heavy?”
The muscle at the corner of the mouth (depressor anguli oris) can pull the corners downward and deepen the line.
How a doctor tellsThe doctor watches you speak and frown. If the corners pull down noticeably with movement, muscle is part of it.
With age, the area beside the chin loses volume, leaving a groove that shadows downward.
How a doctor tellsA visible hollow at rest, even when the face is relaxed and the cheeks are not heavy.
Jowls and descending cheek fat push down onto the line from above, deepening it.
How a doctor tellsLifting the cheek gently with a finger softens the line. Then the cause is above, not in the line itself.
Skin that has lost collagen creases more easily around a moving mouth.
How a doctor tellsFine lines across the area rather than one deep groove.
A map for your consultation, not a prescription. The doctor decides which cause applies to you.
Care and makeup
Injections
Devices and lasers
Surgery
Doing nothing
| Cause | Usually discussed | Caution |
|---|---|---|
| Muscle pulling down | Botox at the mouth corners | Conservative dose |
| Hollow beside chin | Filler, collagen stimulators | Small amounts |
| Sagging above | Ultherapy, thread lift, facelift | Filler alone may weigh it down |
| Thin creasing skin | Skin care, collagen stimulators | Expect gradual change |
Not sure which cause is yours? Send us your concern and dates; we match you to a doctor who will tell you honestly.
Talk to a coordinatorOn our partner list, Korean HA fillers are about $65–$105 per cc and imported brands about $180–$285 per cc. Many people need 1cc or less for this area. Ask whether VAT is included.
It can, when a muscle is pulling the mouth corners down. It takes days to two weeks to work, and should be dosed conservatively.
Often six to twelve months, but the mouth area moves a lot, so it can fade sooner. Your doctor will tell you what to expect for the product used.
Yes. Botox and small-volume filler fit a short trip; expect some swelling or bruising for a few days after filler.
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