Marionette lines are lines which develop from the corner of the mouth and head diagonally down towards the sides of the chin, towards the jowl area. They often are a continuation of the nasolabial fold (nose to mouth line) and typically begin to develop in your late 20s and early 30’s. Like any other facial lines, they will deepen with age as the elasticity of the skin reduces, and volume is lost.
There are several treatments which we can consider to prevent marionette lines. Skincare which is tailored for your skin type and concerns and also helps stimulate new collagen and elastin such as ZO Skin Health will prevent the development of lines and wrinkles, especially around dynamic areas.
For younger patients, ZO Growth Factor Serum is a product which targets areas of frequent muscular activity where dynamic lines start to develop such as crow’s feet, nasolabial folds and marionette lines.
Older patients in their 40s – 60s where we want to stimulate collagen and elastin, but also address textural problems and pigmentation, ZO Wrinkle and Texture Repair, or ZO Advanced Night Repair would be more appropriate due to the retinol content.
Rejuvenation skin treatments such as SkinPen Microneedling or LED light therapy which can stimulate collagen and elastin can also help prevent fine lines and wrinkles developing such as marionette lines.
Patients in their 40s-60s often want treatments which make them look less sad as they start to notice the downward turning of the corners of their mouth and the marionette line developing from this and down to the chin or jowl area. They often complain that makeup sits in these creases emphasising them further.
Marionette lines are caused by strong muscular activity in the lower face and chin. Overactive chin muscles, genetics and a reduction in facial volume all contribute to marionette lines developing and deepening.
Naturally, some patients have stronger chin muscles than others, and overuse can lead to chin dimples or altered texture to the skin giving a golfball or orange peel appearance. If the muscles of the chin are strong and overactive, one treatment to consider is anti-wrinkle or muscle relaxing injections using botulinum toxin or the more frequently used term Botox® injections (Botox® is a brand name similar to Azzalure and Bocouture).
Muscle relaxing injections to treat marionette lines as they start to develop will reduce the muscle activity causing marionette lines, but also creases on the chin. Maintenance of the treatment can also prevent deepening of marionette lines.
If marionette lines have developed due to weight loss, with age due to a reduction in volume, or naturally there is an overbite, then fillers could be a treatment option. Dermal fillers placed with a needle in tiny amounts around the marionette lines can structurally strengthen the line to prevent it creasing and folding. Alternatively, fillers placed with a cannula can replace lost volume and create shape improving your profile to the lower face and chin, while also smoothing the marionette lines and other lines around the mouth area.
Treatments to marionette lines give a smoother, more youthful appearance and can also help create upturning of the corners of the mouth, giving a happier appearance!
Often a combination of treatments give the best results long term.