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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Caused by aging, marionette lines give the face a concerned expression.
Several aesthetic medicine techniques are effective in reducing marionette lines.
Hyaluronic acid injections, for example, are the reference treatment to fill marionette lines.
Other treatments such as Botox injections, Sculptra, and
mesotherapy can be performed alongside hyaluronic acid to eliminate this cosmetic concern.
To achieve natural and harmonious results, the treatment must be carried out by a qualified and experienced doctor.
This page details the available solutions to get rid of marionette lines.
The appearance of marionette lines is linked to aging. Several changes in the face are responsible :
L’apparition et la progression des plis d’amertume varient en fonction de plusieurs facteurs dont l’âge, la génétique, les expressions faciales répétées et l’exposition au soleil.
Understanding the severity stages of marionette lines is essential to choosing the most appropriate treatment. Available solutions depend on the depth of the lines and the specific needs of each patient. A consultation with an experienced doctor will help determine the most effective treatment to reduce marionette lines and rejuvenate the face.
Here is a description of the different severity stages and treatment options according to the stage.
Stage 1 : mild marionette lines
Description
• Appearance of slight lines around the mouth, mostly visible during facial expressions.
• The skin begins to lose a bit of elasticity, but the lines are not yet permanent.
Treatment
• Hyaluronic acid injections : used to fill early fine lines and restore lost volume.
• Hydration and preventive care : use of moisturizing creams and anti-aging products to slow wrinkle progression.
Stage 2 : moderate marionette lines
Description
• Lines become more visible and are present even at rest.
• Moderate loss of volume and elasticity around the mouth and cheeks.
Treatment
• Hyaluronic acid injections : a larger amount may be needed to fill the lines and restore lost volume.
• Sculptra injections : to improve skin texture and stimulate collagen synthesis (one vial is usually sufficient).
• Fractional ablative laser : to treat fine lines and improve skin elasticity.
Description
• Lines are deep and well marked, even at rest.
• Significant volume loss and sagging of facial tissues.
Treatment
• Hyaluronic acid injections : use of moderately volumizing products to fill deep lines.
• Sculptra injections : to improve skin texture and stimulate collagen synthesis (more than one vial required).
• Continuous ablative laser : to perform a medium-depth peel.
Description
• Marionette lines are very deep and accompanied by significant sagging of cheek and jowl fat.
• Very significant volume and elasticity loss around the mouth and cheeks.
Treatment
• Hyaluronic acid injections : combining lifting injection techniques and direct wrinkle filling.
• Combination of treatments.
Marionette lines can be naturally reduced through lifestyle changes and proper skincare.
Here are a few tips to reduce these lines naturally.
Marionette lines can significantly impact the overall appearance of the face, making it look older and less cheerful.
Treating these wrinkles rejuvenates and refreshes the face, improves symmetry and harmony, and boosts self-confidence.
Aesthetic medicine techniques help reduce and sometimes erase marionette lines.
Advanced stages most often require surgical intervention.
The proposed treatment is determined after clinical examination. The protocol is personalized.
Botox injections are only useful in cases of hyperactivity of the depressor anguli oris muscle, which pulls the corners of the lips downward.
In some patients, this muscle is very active, and blocking it with a Botox injection lifts the corners of the mouth.
Some doctors perform this injection systematically.
According to doctor Romano, it only makes sense when properly indicated.
This injection must be carried out by an experienced practitioner, as a failed procedure can deform the mouth, cause drooling, and require the patient to eat through a straw.
The main cause of marionette lines is the sagging of superficial malar fat.
The most physiological treatment — that is, aiming to rejuvenate the face without creating roundness or volume — consists of lifting the descended fat.
This therapeutic approach should come before any direct injection into the wrinkle to avoid adding weight to the lower face and making it appear puffy.
This is the medical lift technique with hyaluronic acid injections developed by doctor Mauricio di Maio.
This method, part of the MD Codes approach, provides immediate results and aims to restore the youthful triangle of the face.
Hyaluronic acid can be injected directly into the wrinkle.
In the treatment protocol, wrinkle filling is done after the lift technique.
Injections are often done with a cannula to avoid bruising.
The result is immediate.
Depending on the indication, doctor Romano will use a volumizing hyaluronic acid if fat needs to be replaced, or a Skinbooster if there is a skin break.
Most often, doctor Romano uses a technique known as the “sandwich” technique : during the same session, she applies a fairly dense hyaluronic acid in depth and a hyaluronic acid with very small particles on the surface.
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.
Sculptra is an innovative and effective treatment to improve marionette lines.
This product, made from poly-L-lactic acid, a biocompatible and biodegradable substance, stimulates the natural production of collagen in the skin.
It produces a gradual result, visible three months after injection.
This treatment should be combined with hyaluronic acid injections and is strongly recommended starting in one’s thirties.
Sculptra alone cannot treat or prevent the appearance of marionette lines.
Its purpose is to treat or prevent skin thinning and the resulting sagging.
By stimulating collagen production and increasing skin thickness, Sculptra restores a more youthful and harmonious appearance to the face, significantly reducing marionette lines.
Marionette lines can be reduced with fractional ablative laser.
Laser does not act on the sagging fat or the loss of subcutaneous tissue under the fold.
The goal of the treatment is to stimulate collagen production and improve the skin’s texture and firmness.
Thicker skin slightly corrects marionette lines — the main interest of this technique is to smooth out the associated skin break.
The alternative would be a medium-depth peel, but this is rarely performed due to frequent skin demarcation (color difference).
Two to four sessions are necessary. If the marionette line is treated annually with hyaluronic acid injections, there is no need to repeat the laser treatment.
Although the procedures described above to treat marionette lines without surgery are generally effective, they do have some limitations. When the patient has excess skin forming a bulge above the jawline, results may be less satisfactory. In this case, for optimal results, it is best to consult a cosmetic surgeon for a possible cervico-facial lift.
After surgery, hyaluronic acid injections into the marionette lines may still be necessary to fill residual folds and achieve a perfect result. It is therefore essential to consult an experienced physician to evaluate the best therapeutic options.
The result is immediate and improves over the three weeks following treatment. It lasts approximately one year. The lift technique restores the youthful triangle and refines the jawline. The face appears rested, and wrinkles will be physiologically reduced or completely erased, depending on the patient’s request and anatomy.
Immediate after-effects include slight swelling and rare small bruises, which disappear within a few days. Regular activities can be resumed immediately after the injections.
For Botox injections, results appear after seven days and last five to six months. On the day of injection, it is important to avoid touching the treated points. For two days, sports should be avoided. For one week, avoid saunas, steam rooms, facial massages, and exposure to steam.
Combien coûte le traitement des plis d’amertume ? Le prix des injections pour traiter les plis d’amertume varie en fonction de plusieurs facteurs : le type de produit utilisé, la quantité nécessaire et la technique réalisée qui est liée à l’expertise du médecin.
Dr. Romano welcomes you to her practice in Geneva. All procedures are performed using high-quality products, in strict compliance with safety and hygiene standards. Prices vary depending on the chosen treatment plan and the required quantities, but remain transparent from the very first consultation. A detailed quote 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 :
What do patients say ?
Patient reviews of medical treatments to reduce marionette lines are positive.
Patients describe a noticeable improvement in facial appearance. They feel rejuvenated and more confident after the procedures.
The results are considered natural and preserve facial expressiveness.
The procedure is described as quick, minimally painful, and accessible, as it requires no downtime.
Les traitements pour les plis d’amertume sont très peu douloureux. Des anesthésiques locaux peuvent être utilisés pour réduire la douleur pendant les injections.
Une séance de traitement pour les plis d’amertume dure généralement 20 minutes, selon la technique utilisée.
The objectives of bitterness fold treatment are :
Il n’y a pas d’âge spécifique pour commencer à traiter les plis d’amertume. Cela dépend des besoins individuels et de l’avis du médecin.
Après un traitement pour les plis d’amertume, il est recommandé d’éviter l’exposition au soleil, de ne pas masser la zone traitée et d’éviter les activités physiques intenses pendant 24 à 48 heures.
Les plis d’amertume peuvent commencer à apparaître dès la trentaine, mais ils deviennent généralement plus prononcés avec l’âge, notamment à partir de la quarantaine.
Les résultats des injections d’acide hyaluronique sont immédiats, tandis que le Sculptra agit progressivement sur plusieurs mois. Le résultat définitif est obtenu 3 semaines après l’injection.
Yes, the treatments are safe when carried out by a qualified professional. They are approved by the health authorities and widely used in aesthetic medicine.
Les résultats des injections d’acide hyaluronique pour les plis d’amertume durent généralement entre 6 à 12 mois, selon le type de produit utilisé et les caractéristiques individuelles du patient.
L’acide hyaluronique est un produit de comblement qui ajoute du volume pour lisser les rides, tandis que le botox détend les muscles responsables des rides. Les deux peuvent être utilisés conjointement pour des résultats optimaux.
Les traitements pour les plis d’amertume doivent être réalisés par des médecins qualifiés et expérimentés.
Le coût du traitement des plis d’amertume varie en fonction du type de produit utilisé, de la quantité nécessaire, des traitements associés et de l’expérience du praticien. Une consultation personnalisée est nécessaire pour établir un devis précis.
Les résultats des injections d’acide hyaluronique sont visibles immédiatement après le traitement. Les effets du botox sont visibles quelques jours après. Les résultats s’améliorent généralement dans les deux semaines suivant le traitement. Les résultats du Sculptra sont visibles après quelques mois.
Il n’est pas possible de prévenir l’apparition des plis d’amertume. Cependant il est possible d’éviter les facteurs aggravants. Il est recommandé de maintenir une bonne hydratation, de protéger la peau du soleil avec un écran solaire, d’adopter une alimentation riche en antioxydants, de pratiquer des exercices faciaux, d’arrêter de fumer et de gérer le stress.
Le choix du traitement dépend de la gravité des plis d’amertume et du résultat attendu. Une consultation avec un médecin spécialisé permettra d’élaborer un plan de traitement personnalisé.
Le pli d’amertume se situe de chaque côté de la bouche, s’étendant des coins de la bouche vers le bas, en direction du menton. Ces plis verticaux sont également connus sous le nom de inverted smile lines.
