How Can I Get Rid of Marionette Lines Around My Mouth? 7 Different Treatments and Procedures Revealed

Posted February 03, 2022
What are Marionette Lines

The skin around your mouth is more likely to wrinkle because it’s thinner compared with the rest of your face. The facial movement around your mouth needs elasticity and flexibility to make these expressions. But the constant movement can produce visible creases, as the skin begins to lose collagen and elasticity as we age, creating marionette lines.

Marionette lines are vertical lines that start at the corners of your mouth and travel down towards the chin. Not to be confused with nasolabial folds (creases at the bottom of the nose to the end corners of the mouth), but they sometimes can appear together simultaneously. 

These superficial wrinkles are part of the aging process, but that doesn’t mean we have to live with them on our faces. There are a variety of cosmetic treatments and procedures that can help minimize the appearance to almost getting them from your face. 

In this article, we’ll explain the key information about marionette lines– what they are, why they appear, and how to get rid of them with non-invasive treatments to semi-permanent surgical options.

What are Marionette Lines?

Marionette lines start from the corners of your mouth down to your chin, and they run vertically. These facial lines got their name from marionette string puppets, which are known for having slits around the mouth so puppeteers can act out talking. 

This type of wrinkles can develop around your 30s and 40s, but for some individuals, genetics may play a role and show up in their 20’s.

What Causes Marionette Lines?

With every year we age, our body produces less collagen, a vital protein that supports the structure and buoyancy of the skin. As a result, the skin becomes thinner and looser, making wrinkles and creases more visible, especially where there is a facial movement around the mouth.

So, to effectively treat marionette lines, you need to address the loose and thinning skin that lacks collagen, plus combat the gravity causing the skin to sag around the chin, making the lines more noticeable. 

What are the Different Ways to Treat Marionette Lines?

Wrinkles like marionette lines are a part of the natural aging process, but it is possible to slow down the process and temporarily reduce their appearance. 

Here is a list of non-invasive to surgical cosmetic procedures that can help address marionette lines. 

  • Dermal Fillers such as Juvederm and Restylane
  • Neuromodulator injections like Botox, Dysport, and Xeomin
  • Energy-based or Laser treatments like Ultherapy or Co2 Lasers 
  • Thread Lifts (non-surgical facelift)
  • Deep plane facelift

We share a brief description of each treatment or procedure that can help reduce the appearance or smooth out the lines around your mouth.

Dermal Fillers for Marionette Lines

Dermal fillers injections made with hyaluronic acid (HA), a natural substance found in the skin that acts as a lubricant, is a viable option because it plumps the skin by pulling moisture from surrounding areas. And in addition to its natural plumping properties, most HA filler injections combine ingredients to help stimulate the body’s collagen production to form a more robust skin structure. 

Juvederm Volbella 

Juvederm Volbella is also an FDA approved dermal filler made of a specially formulated hyaluronic acid gel. The HA formula consists of smaller particles, allowing the distribution of the filler to spread evenly. 

Restylane Silk

Restylane Silk is an FDA-approved HA injectable dermal filler specifically designed to smooth out fine lines around the mouth. Restylane Silk is formulated with smaller, smoother hyaluronic acid particles to provide natural-looking results. 

Dermal filler injections can last from 6-18 months, depending on the brand and formulation. 

Botox for Marionette Lines

Botox and other neurotoxin-based brands such as Dysport or Xeomin can help relax the facial muscles around the mouth to reduce movement and smooth out the skin. When the neurotoxin is injected into a muscle near a wrinkle, the neuromuscular blockers limit muscle contractions, reducing the appearance of the lines and creases. Botox and similar neurotoxin injections are not permanent solutions and will require another treatment after 2-3 months to maintain the results.  

Laser or Energy-Based Treatments

Laser resurfacing with CO2 treatments involve using a carbon-monoxide laser that vaporizes the moisture from damaged skin cells, causing them to break down without wounding the surrounding skin. The energy and heat from the laser continue to the deepest layers of the skin to activate new collagen production, restructuring the layers to be more buoyant and firmer over time. The skin’s surface is free of blemishes and flaws, as the middle layer structure becomes stringer and prone to future lines and wrinkles. It can take 3-4 sessions to achieve the desired outcome, but the results can last 2-3 years.  

Ultherapy, also known as Ulthera, is a non-invasive FDA-approved facelift alternative using energy-based technology by ultrasound waves to “lift” and tighten the skin. The ultrasound technology heats the subcutaneous layer of the skin (where fat cells and connective tissue live). It sends energy from the device to tighten the layer’s structure and stimulate collagen production. This non-surgical procedure treats the neck, face, submental region (below the chin), chest, and eyebrows. The results of an Ultherapy treatment can take 4-6 months for the skin to appear firmer, but the results can last for up to two years. 

Thread Lift (Non-Surgical Face Lift)

Thread Lift, also known as thread lifting, is a minimally invasive cosmetic procedure that involves inserting a medical-grade thread into specific areas of the face to lift and slightly pull up the skin, creating a smooth and even surface. As the thread settles into the skin’s tissue, it activates the body’s natural healing process and stimulates new collagen production. The extra production of collagen creates more elasticity and robust skin structure, reducing the appearance of lines over time. The thread is made of dissolving a material that will eventually absorb into the body after 18-24 months, but results can vary from patient to patient. 

Deep Plane Face Lift

Deep plane facelift elevates the skin and muscle of the lower part of the face and neck as one layer by adjusting and tightening the ligaments of the face muscle. A ligament is a fibrous band of tissue that attaches to the muscle and the bone. The surgeon will adjust the four key ligaments upward during a deep plane facelift and reattach the ends to a higher area. The vertical placement lifts both skin and muscle around the cheek area, softening nasolabial folds, marionette lines, and reducing the jowls’ sagginess. A deep plane facelift is a surgical procedure that can last for up to 10 years.

Final Takeaway - How to Get rid of Marionette Lines

When the skin around the mouth has started to show the signs of aging with marionette lines, you may need a combination of cosmetic treatments of non-surgical or surgical procedures to help reduce their appearance. 

We recommend consulting with a board-certified cosmetic surgeon or dermatologist to examine the lines around your mouth. They can help guide you with the ideal cosmetic procedure that aligns with your desired outcome, budget, and expectations.

To find a board-certified cosmetic surgeon or dermatologist experienced in treating marionette lines around the mouth, use our “Find a Doctor” navigation tool for a medical professional in your area. 


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