Turning Back Time: Discovering the Best Injectable Treatments for Marionette Lines
Also known as puppet mouth lines, marionette lines are those troublesome vertical divots extending from the corners of the mouth down to the base of the chin. They’re often extensions of nasolabial folds, which begin higher up on the face and come down to the corners of the mouth.
Where there’s one, there’s usually the other. They’re natural consequences of the aging process, with accelerating factors like smoking, sun exposure, poor diet and hydration, and volume loss due to declines in sub-skin collagen production.
Fortunately, there are several minimally invasive treatment options for both marionette lines and nasolabial folds. Today, we’re going to cover injections for marionette lines specifically.
The Best Injectable Treatments for Marionette Lines
These are the most popular, most evidence-based marionette line treatments that don’t require general anesthesia or surgical incisions.
Botox® for Marionette Lines
Few know that Botox (and other botulinum toxin-derived injectables) can treat marionette lines with ease.
There are some important limitations, however. In general, Botox works best for fine lines and wrinkles, which means it’s not ideal for deep marionette lines. It also doesn’t last as long as the two other treatments described here — Botox typically begins wearing off after three or four months. And it’s not beginner-friendly: You should never work with an unlicensed providers, nor any injector who hasn’t completed an accredited Botox training course.
For these reasons, Botox is best paired with one or both of these other treatments for marionette lines. Here’s what you should know about both.
Dermal Fillers for Marionette Lines
Dermal fillers are perhaps the best-known treatment for marionette lines. The most popular type uses hyaluronic acid as its active ingredient, followed by calcium hydroxylapatite (CaHa) and PLLA. Talk to your provider about:
- Restylane®: This hyaluronic acid filler family’s formulations include Restylane (original), Restylane-L, Restylane Defyne, and Restylane Lyft.
- Juvéderm®: The most popular Juvéderm formulations for marionette lines are Volux, Vollure, and Ultra Plus.
- Versa®: Patients appreciate this newer entrant for its delicate touch and low incidence of side effects.
- Radiesse®: This CaHa filler brand is specifically indicated for moderate to severe facial lines, including marionette lines and nasolabial folds.
- Sculptra®: This PLLA filler stimulates collagen production for years, delivering durable results that look (and feel) natural.
All filler types last longer than Botox, but durability varies quite a bit:
- Hyaluronic acid: six to 18 months
- CaHa: Two to three years
- PLLA: Two to five years
Thread Lift for Marionette Lines
The third and final option, the thread lift, is often combined with dermal filler treatment for marionette lines.
Thread lifts often target other areas of the face, like the cheekbones and eyes, but they’re effective for marionette lines as well. The secret: dissolvable medical-grade threads that gently lift the surrounding skin while stimulating collagen production to boost volume.
When combined with fillers, thread lifts produce sustainable reductions in marionette line depth and length for anywhere from 12 to 18 months. They’re generally well-tolerated, with side effects similar to those observed after Botox and dermal filler injections.
