MARIONETTE LINES INJECTION : FILLING WITH HYALURONIC ACID

What are marionette lines ?

Marionette lines are wrinkles located on each side of the face, extending from the corners of the lips down to the jawline. The name comes from the sad and tired look these lines create. Aesthetic medicine techniques are effective in making marionette lines disappear.

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Key Points

Filling of the marionette lines in Geneva

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Caused by aging, the marionette lines give the face a worried appearance. Several techniques of aesthetic-oriented medicine are effective in reducing them. Hyaluronic acid injections, for example, are the reference treatment for filling the marionette line. Other treatments such as 

Sculptra injections and mesotherapy can be used, in addition to hyaluronic acid, to erase this unaesthetic concern.
For natural and harmonious results the procedure must be performed by an experienced doctor. In this page, the details of the treatments ‘against marionette lines’.

What causes marionette lines ?

The appearance of marionette lines is linked to aging. Several changes in the face are responsible :

photo folds of bitterness in Geneva
  •  Sagging (ptosis) of the malar fat : the fat located in the cheek area descends toward the jawline.
  • Loss of support in the central and lateral cheek area : the fat in the cheek melts, the bone resorbs, and their supporting role is lost.
  • Loss of support in the chin area : fat loss and bone loss at this level mean the corners of the mouth are no longer supported and begin to droop.
  • Action of the depressor anguli oris (DAO) muscle : these muscles pull the corners of the mouth downward.
  • Reduction in skin thickness.
  • An unhealthy lifestyle worsens the progression of these lines : it is important to avoid certain habits such as smoking, lack of sleep and hydration, sun exposure and an unbalanced diet. 

Severity stages of marionette lines

The appearance and progression of marionette lines vary depending on several factors such as age, genetics, repeated facial expressions and sun exposure.
Understanding the stages of severity of marionette lines is essential in order to choose the most suitable treatment, as treatment options vary depending on the stage. The possible solutions depend on the depth of the lines and the specific needs of each patient. A consultation with an experienced doctor will determine the most effective treatment.

Stage 1 : mild marionette lines

Description
Appearance of slight lines around the mouth, mainly visible during facial expressions.
The skin begins to lose a bit of its elasticity, but the lines are not permanent yet.


Treatment
Hyaluronic acid injections : performed to fill the first fine lines and restore lost volume.
Hydration and preventive care : use of moisturizing creams and anti-ageing treatments to slow the progression of wrinkles.

Stage 2 : moderate marionette lines

Description
The lines become more visible and are present even when the face is at rest.
Moderate loss of volume and skin elasticity around the mouth and cheeks.

Treatment
Hyaluronic acid injections : more product may be needed to fill the lines and restore the lost volume.
Sculptra injections : to improve skin quality and stimulate collagen synthesis. One vial is often enough.
Fractional ablative laser : to treat fine lines and improve skin elasticity.

Stage 3 : deep marionette lines

Description
The lines are deep and well defined, even at rest.
Significant loss of volume and sagging of the facial tissues.

Treatment
Hyaluronic acid injections : use of sufficiently volumizing products to fill deep lines.
Sculptra injections : to improve skin quality and stimulate collagen synthesis. One vial is no longer enough.
Continuous ablative laser : performing a medium peel.

Stage 4 : very deep marionette lines

Description
The marionette lines are very deep and accompanied by a significant sagging of the malar and buccal fat.
Very severe loss of volume and skin elasticity around the mouth and cheeks.

Treatment
Hyaluronic acid injections : combination of lifting techniques with hyaluronic acid injections and filling of the line.
Combination of treatments.

How to naturally reduce marionette lines ?

Marionette lines can be naturally reduced through lifestyle changes and proper skincare.
Here are a few tips to reduce these lines naturally.

easy gymnastics image for bitterness lines
  • Hydration.
  • Facial gymnastics : are you looking for an exercise for marionette lines ? The muscular component plays a small role in the appearance of marionette lines. The exercise consists of smiling and lifting the corner of the lips with two fingers.
  • Physical activity.
  • Skin care : use products containing hyaluronic acid, retinol and essential oils. Moisturizing creams, anti-wrinkle serums and nourishing masks help keep the skin supple and hydrated.
  • Sun protection.
  • Sleeping on your back : sleeping on your side or on your stomach can accentuate marionette lines because of the constant pressure applied to the face.
  • Quit smoking.
  • Stress management : chronic stress accelerates skin ageing.

How to fill marionette lines ?

Marionette lines can have a significant impact on the overall appearance of the face, making it look older and less cheerful.
Treating these wrinkles rejuvenates and refreshes the face, improving its symmetry and harmony.
Techniques of aesthetic-oriented medicine help reduce and sometimes erase marionette lines.
Advanced stages most often require surgical management.
The proposed treatment is decided after a clinical examination, and the protocol is personalized.

photo filling of bitterness folds with hyaluronic acid

Hyaluronic acid injections to lift the face without surgery

The main cause of the appearance of marionette lines is the descent of the superficial malar fat.
The most physiological treatment, that is to say aiming to give the patient a rejuvenated face without creating roundness and volume, is to lift this descended fat.
This therapeutic approach must precede any direct injection into the line in order not to weigh down the facial contour or make the face puffy.
This is the technique of medical lift by hyaluronic acid injection invented by Doctor Mauricio di Maio. This technique, one of the variations of the MD Codes, provides an immediate result and aims to restore the youthful triangle of the face.

photo of bitterness folds filled with skinbooster

Hyaluronic acid injections into marionette lines . Skinboosters

Hyaluronic acid can be injected directly into the line. In the treatment protocol, the filling of the line must be performed after the lifting technique.
The injection is often done with a cannula to avoid the appearance of bruising. The result is immediate.

Which hyaluronic acid for marionette lines ?

Depending on the indication Doctor Romano will use a volumizing hyaluronic acid if the melted fat needs to be replaced, or a hyaluronic acid of the Skinbooster type if there is a skin break.
Most often Doctor Romano performs a technique called “sandwich” : during the same session the doctor uses in depth a fairly dense hyaluronic acid and on the surface a hyaluronic acid with very small particles.

photo bitterness fold treatment by injection

Filling marionette lines with hyaluronic acid injections

A firm, volumizing hyaluronic acid is injected in the chin, para-chin, and cheekbone areas in cases of bone and fat resorption.
The goal is to replace the structures that support the face and have diminished over time. The injection is often performed with a cannula.

photo bitterness fold treatment by Sculptra

How to correct marionette lines ? Sculptra injections

The Sculptra is an innovative and effective treatment to improve marionette lines. This product, made of poly-L-lactic acid, a biocompatible and biodegradable substance, stimulates the skin’s natural production of collagen.
It gives a progressive result, visible three months after the injection.
This treatment must be combined with hyaluronic acid injections and is strongly recommended from the age of thirty. Sculptra injection cannot, on its own, treat or prevent the appearance of marionette lines.
The goal is to treat or prevent skin thinning and the resulting laxity.
By stimulating collagen synthesis and increasing skin thickness, Sculptra gives the face a younger and more harmonious appearance, while significantly reducing marionette lines.

How to eliminate marionette lines ? Laser for smile lines

Marionette lines can be reduced thanks to the fractional ablative laser.
The laser does not act on the sagging of fat nor on the loss of subcutaneous tissue located beneath the line.
The aim of the treatment is to stimulate collagen production and improve the density and firmness of the skin. Thicker skin slightly corrects the marionette line, and the real benefit of this technique is to soften the skin break associated with the line. Indeed, the alternative to this procedure would be a medium peel, but this treatment is rarely performed because a demarcation (difference in colour) is frequent.
Two to four sessions are necessary. If, afterwards, the marionette line is treated annually with hyaluronic acid injections, it is not necessary to repeat the laser treatment.

Aesthetic medicine treatments and marionette lines

Although the procedures described above to treat marionette lines without surgery are generally effective, they do have certain limitations. When the patient has an excess of skin forming a bulge above the jawline, the results may be less satisfactory. In this case, for an optimal outcome, it is better to consult a cosmetic surgeon for a potential cervico-facial lift.
After the surgical procedure, hyaluronic acid injections in the marionette lines may be necessary to fill the residual folds and obtain a perfect result. It is therefore essential to consult an experienced doctor to evaluate the best therapeutic options.

Before / after results of marionette line fillers

The result is immediate and improves over the three weeks following the treatment. It lasts about one year.
The lifting technique restores the youthful triangle and refines the facial contour.
The face appears rested, the wrinkles will be reduced in a physiological way or completely erased, depending on the patient’s request and her anatomy.
The immediate after-effects include slight swelling and the appearance of small bruises. These are rare and their duration does not exceed a few days. Usual activities can be resumed immediately after the injections.

Marionette line injections , prices

How much does the treatment of marionette lines cost ? The price of injections to treat marionette lines varies depending on several factors : the type of product used, the quantity required and the technique performed, which is linked to the doctor’s expertise.
Doctor Romano welcomes you to her practice in Geneva. All procedures are carried out with high-quality products, in strict compliance with safety and hygiene standards. Prices vary according to the chosen treatment plan and the required quantities, but remain transparent from the very first consultation. A precise estimate is provided during the initial consultation, after medical evaluation. Each treatment is personalized and may combine several techniques for an optimal result.
The prices for the treatment of marionette lines are :

  • Hyaluronic acid : 600 CHF per syringe.
  • Sculptra : 900 CHF per vial.
  • Skinbooster : 400 CHF per syringe.
  • Fractional ablative laser : from 300 CHF per session.

Marionette line filler reviews

What are the reviews on marionette line injections ?
Patients’ reviews on medical treatments to make marionette lines disappear are positive.
Patients describe a noticeable improvement in the appearance of the face, they feel rejuvenated and more confident after the procedures.
The results are considered natural and respect the expressiveness of the face.
The procedure is described as quick, minimally painful and convenient because this treatment does not require recovery time.

Are the treatments for marionette lines painful ?

Treatments for marionette lines are very minimally painful. Local anesthetics can be used to reduce discomfort during the injections.

A treatment session for marionette lines generally lasts 20 minutes, depending on the technique used.

The objectives of bitterness fold treatment are :

  • Rejuvenate the appearance of the lower third of the face.
  • Reduces deep wrinkles.
  • Soften a stern or upset expression.
  • Restore a fresh, radiant look to the face.

There is no specific age to start treating marionette lines. It depends on individual needs and the doctor’s opinion.

After a treatment for marionette lines, it is recommended to avoid sun exposure, not to massage the treated area and to avoid intense physical activities for 24 to 48 hours.

Marionette lines can start to appear as early as the thirties, but they generally become more pronounced with age, especially from the forties onward.

The results of hyaluronic acid injections are immediate, while Sculptra works progressively over several months. The final result is obtained 3 weeks after the injection.

Yes, the treatments are safe when performed by an experienced doctor. They are approved by health authorities and widely used in aesthetic-oriented medicine.

The results of hyaluronic acid injections for marionette lines generally last between 6 to 12 months, depending on the type of product used and the individual characteristics of the patient.

Treatments for marionette lines must be performed by trained and experienced doctors.

The cost of marionette line treatment varies depending on the type of product used, the quantity required, the associated treatments and the doctor’s experience. A personalized consultation is necessary to establish an accurate estimate.

The results of hyaluronic acid injections are visible immediately after the treatment. The results of Sculptra are visible after a few months.

It is not possible to prevent the appearance of marionette lines. However, it is possible to avoid aggravating factors. It is recommended to maintain good hydration, protect the skin from the sun with sunscreen, adopt a diet rich in antioxidants, practise facial exercises, stop smoking and manage stress.

The choice of treatment depends on the severity of the marionette lines and the expected result. A consultation with an experienced doctor will make it possible to establish a personalized treatment plan.

The marionette line is located on each side of the mouth, extending from the corners of the mouth downward toward the chin. These vertical folds are also known as inverted smile lines.

Other areas to be treated