Facial Injections: Info, Prices, Photos, Reviews, Q&A

Marionette lines are among the more challenging lines to completely correct. The actual cause is descent of the cheeks due to age and volume loss as well as recession of the jaw and chin. Often a combination of cheek volumizers, placement of volumizer deep to the jawline in that prejowl sulcus and threading of either a hyaluronic or collagen stimulator through the marionette line area are all part of the correction.(Steven Swengel, MD, Los Gatos Dermatologic Surgeon)

Marionette lines need filler

Filler is what’s needed for marionette lines. Also, expect improvement but not complete eradication of these. I like cannulas for this area so there is less bruising and swelling afterwards. (Steven F. Weiner, MD, Panama City Facial Plastic Surgeon)

Hyaluronic Acid Fillers Can Help Soften Up The Marionette Lines

Juvederm or other HA (Hyaluronic Acid) Filler

Marionette lines are due to facial volume loss and the natural aging process.

In order to address this concern, a hyaluronic acid filler, such as Juvederm Ultra Plus, can be strategically placed around the oral commissures and in the lines themselves.

For the most natural appearance, filler injections can also be done in the cheek area which is the main site of the volume loss in the aging face leading to the appearance of these marionette lines. (Claire Wolinsky, MD, New York Dermatologist)

How to treat prominent marionette lines

The marionette lines can be treated with any one of several dermal fillers and sometimes requires a thicker filler layered beneath a thinner filler. Botox does not work particularly well in this area of the face. (James R. Gordon, MD, FACS, FAAO, New York Oculoplastic Surgeon)

Lines Coming Down From Each Side Of Mouth

Botox can help to some degree but will not correct Marionette lines. I would still try it though, and then supplement with fillers. You can achieve a great result in the right hands. (Brian Arslanian, MD, Atlanta Plastic Surgeon)

Botox is not used to soften a nasolabial fold, it is used to stop muscles from moving like in the forehead and so wrinkles soften. Filler will help soften the fold. (Steven Wallach, MD, New York Plastic Surgeon)

Fillers will work well to minimize marionette lines

I always recommend you have a consultation with a board-certified dermatologist or plastic surgeon to learn all the best options for you.

We are the experts in the anatomy of the area and what works best and what does not.

Most Effective Treatment Of Marionette Lines

We also have the most experience with the dermal fillers, such as Juvederm or any of the other products out there.

To fill the marionette lines, you will do well with Juvederm or Restylane Silk – but with a careful examination of the area, you may also do well with some volumizing in the cheek areas, which will then make these lines much less apparent.

For these, I recommend Voluma or Restylane Lift. Toxins can be added if there is a need based on your examination, but I think with the proper placement of fillers, this will take care of all of your concerns. (Michael Gold, MD, Nashville Dermatologic Surgeon)

Marionette lines–treat with Botox or Juvderm?

Marionette lines are a result of facial aging, loss of facial fat and loss of skin elasticity. Facial fillers are very helpful in camouflaging these lines. Juvederm is an excellent option. It is a hyaluronic acid filler.

Puppet (marionette) Lines

A more thorough approach to treating these lines would address mid face volume loss. Bringing the volume back to the cheeks with larger fillers–like Voluma–is very helpful in improving Marionette lines as well. Botox relaxes muscle and does not play a role in these lines. (Sean Doherty, MD, FACS, Boston Plastic Surgeon)

Management of marionette lines

Filler works best for marionette lines like yours. I’d probably pick something thick like Radiesse to get the best correction for you. (Robert S. Schmidt, MD, Richmond Facial Plastic Surgeon)

Botox or Fillers for Marionette Lines Around The Mouth

In general think of folds as deep wrinkles that need filling with a dermal filler. I like Radiesse and the Hyaluronic Fillers for this area (Restylane). Wrinkle blockers (the botulinum neurotoxins-Botox, Xeomin, Dysport) are better to help relax the muscles that cause the wrinkles.

Treating Puppet (marionette) Lines

Your main concern would be best treated with a dermal filler, but some wrinkle blocker to your depressor angularis oris below and just to the side of the outer corner of your lips can help relax the down pull of your lip in that area.

I like to encourage for most patients that a combination of wrinkle blockers and wrinkle fillers act together to optimize and prolong the results (John R. Burroughs, MD, Colorado Springs Oculoplastic Surgeon)

Botox or juvederm

In general keep in mind that Botox (neurotoxins) are most effective at treating dynamic lines or folds (those caused by muscle movement) . Fillers are best for volume loss, folds and lines. (Michael L. Schwartz, MD, West Palm Beach Facial Plastic Surgeon)

Botox or Juvederm for marrionette lines

Treatment For Lines Coming Down Each Side Of The Mouth

You should consider having both -Juvederm will fill the folds. But there appears to be downward pull of the muscles at the corner of the mouth. This usually only takes about 5 units of Botox to correct -Start with the Juvederm first since it is the fold, not the muscle pull that seems more troublesome. (Elizabeth Morgan, MD, PhD, Atlanta Plastic Surgeon)

Botox NOT indicated for the MLs. Juvederm or any ha filler would need 4 syringes with a cost of $2,400. I might suggest beside a surgical face lift try the Silhouette Insta Lift suspension sculpture sutures foa minimal surgical option. (Darryl J. Blinski, MD, Miami Plastic Surgeon)

Juvederm (likely ultra plus) would be best used to treat your marionette lines. It is sometimes difficult to say exactly how much will be needed without the benefit of an in-person consultation. I would likely recommend two syringes to start and let you know that additional treatments may be necessary.

It is sometimes necessary to work on it in multiple sessions which allows the product to set before adding more. (Quenby Erickson, DO, FAAD, FACMS, Chicago Dermatologic Surgeon)

Juvederm for Marionette Lines

Juvederm is a fabulous injection for the marionette lines. You would also benefit from injections on the oral commissaries to minimize the jowls. If you have Juvederm Voluma injected into the mid-cheek area it will lift the cheeks away from the marionette lines and help minimize the nasolabial area as well. (Michele S. Green, MD, New York Dermatologist)

Botox or Juvederm for marionette lines?

Fillers, such as Juvederm, work best for improving marionette lines or folds. Botox would not really help with this issue. Ultimately, some sort of lifting procedure such as a facelift or Ultherapy can provide more improvement if needed in the future.. (Michael I. Echavez, MD, San Francisco Facial Plastic Surgeon)

Botox or Juvaderm for Marionette lines? (photos)

Marionette lines are best treated by camouflaging them with the use of a dermal filler, such as Juvederm. (Nelson Castillo, MD, Atlanta Plastic Surgeon)

Botox is of little use for Marionette lines Use Juvederm and you will see results. (George Commons, MD, Palo Alto Plastic Surgeon)