MARIONETTE LINE TREATMENT
with dermal filler
what are the marionette lines?
They are the lines that run from the corners of the mouth radiating to the chin. They get the term “marionette” due to the sad and down turned appearance of the corners of the mouth, resembling the appearance of a marionette puppet.
How do marionette lines form?
As we age the skin is losing its elasticity and bounce and volume in the fat pads change as the fat pads descend and move south. Add to the effects of gravity, and the face can start to appear heavier.
The marionette line starts as a crease and becomes a deeper fold with age.
How is the treatment performed?
The procedure involves injecting a dermal filler into the marionette wrinkle that is made up of hyaluronic acid. It is a naturally occurring substance (complex sugar) that adds volume, and softens and smooths out creases and wrinkles, while providing structure, support, definition and skin elasticity. These sugars are already present in your body and skin and these start to diminish as we age.
What other treatments will help my down turned corners of the mouth?
Sometimes a multi- modality treatment is needed to address the skin laxity as well as the volume replacement in the fat pads. These combination treatments will work in harmony to complement each other to lift the marionette crease.
Anti-wrinkle injections can be used to target the down turn muscle called the DAO, by lifting the corners of the mouth upwards.
A firm dermal filler might be needed to provide deeper structural support to the marionette line if it is deep and has become a fold. Then a lighter softer filler is injected over the top to soften the fine lines and provide support to the skin.
Skin booster injections are also used to improve the skin texture and tone.
PRP (Platelet Rich Plasma) will improve the skin laxity, texture and tone and lift the marionette crease.
It is during the consultation that the best course of treatment will be suggested according to the depth of your marionette wrinkle, and when assessing your entire face.
Other areas that can be treated at the same time as marionette filler to improve the sad appearance
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 Jawline fillers treated at the same time to pull back and lift the marionettes. This might be suggested before filling the marionette crease itself as it is targeting the cause of the wrinkle, rather than the symptom. Jawline filler might be enough to pull the marionettes back, without filling the marionette crease itself.
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 Sometimes marionette filler is still needed to soften the wrinkle but is assessed after seeing what lift the jawline filler has had. Jawline filler can last approx. 18-22 months.
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 Cheek dermal fillers to lift the nasolabial folds and lift the midface, by replacing lost volume where it is needed the most.
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 Chin dermal fillers to soften the chin crease and balance asymmetry and proportions and projection of your profile view.
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 Lip volumizing and perioral structural support with dermal fillers.
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 Pre- auricular filling to lift the lower face.
What treatment should I book in for?
With a variety of treatments available it can be confusing so the first step is to make an online appointment for a consultation. A detailed consultation will be performed to assess your face, discuss your medical history and listen to your goals. It gives you the opportunity to speak with a doctor about your treatment and to gather all the information you need to make an informed decision. It is during this time the risks, treatment itself, and post care instructions are discussed.