{"id":61759,"date":"2026-02-18T16:16:12","date_gmt":"2026-02-18T15:16:12","guid":{"rendered":"https:\/\/drromanovaleria.ch\/?post_type=infographie&p=61759"},"modified":"2026-06-12T06:26:36","modified_gmt":"2026-06-12T04:26:36","slug":"marionette-lines-formation","status":"publish","type":"infographie","link":"https:\/\/drromanovaleria.ch\/en\/infographie\/formation-plis-amertume\/","title":{"rendered":"Comment se forment les plis d\u2019amertume ?"},"content":{"rendered":"

HOW DO MARIONETTE LINES FORM ?
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Marionette lines are wrinkles running from the lip corner to the chin. Their appearance immediately changes how the face is perceived, giving it a stern, sad or tired expression, sometimes completely at odds with the patient's actual emotional state. These folds are partly caused by natural skin ageing, form part of overall lower-face ageing and result from combined muscular, cutaneous, structural and behavioural factors. Their formation is gradual, explaining why patients may notice them fairly suddenly once they become permanently visible at rest. Understanding the precise mechanisms of their development allows management that respects facial dynamics and identity.<\/p>\n

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Muscles and marionette line formation<\/h2>\n

Marionette line formation is closely associated with muscle dynamics in the lower third of the face. Over the years, the balance between the muscles raising and lowering the lip corners gradually changes. In many patients, the muscles lowering the mouth corners become dominant. This muscular hyperactivity repeatedly pulls downwards on tissues between lips and chin. With every contraction, however subtle, a wrinkle<\/a> forms. Over time, this wrinkle becomes static rather than solely dynamic, visible even at rest. Expressions of disapproval, concentration or fatigue repeated daily contribute to gradual establishment of these folds. Some patients have constitutional muscular hyperactivity independent of age, encouraging earlier marionette lines. In others, this hyperactivity appears gradually with ageing and loss of overall facial muscle balance. The intensity of these dynamics largely explains the depth and early onset of the folds observed.<\/p>\n

Loss of facial support and volume<\/h2>\n

Beyond muscle dynamics, volume loss is one of the essential mechanisms of marionette line formation. With age, facial volume gradually changes in both superficial and deep fat compartments. This reduced support causes tissues to descend towards the lower face. The lip corners, previously supported by harmonious volume, are gradually pulled downwards. The area between mouth and chin becomes a crease point concentrating mechanical and gravitational tensions. This support loss is not solely age-related. Weight fluctuations, genetic factors or particular facial structure can accentuate it. Faces with limited chin projection or an underdeveloped jaw are more likely to develop early marionette lines when supporting volume diminishes.<\/p>\n

Skin laxity and gradually declining skin quality<\/h2>\n

Skin quality plays a central role in marionette line development. Over time, collagen and elastin production decreases, gradually reducing skin firmness and elasticity. The skin becomes thinner and less resistant to mechanical stresses. This altered dermal structure encourages lasting marionette lines. Skin laxity also accentuates tissue descent towards the lower third, increasing fold depth, with folds becoming permanent when skin loses its ability to retract. Chronic sun exposure often worsens this by degrading skin support fibres and accelerating dermal ageing. Smoking is another major aggravating factor, impairing skin microcirculation and promoting collagen degradation. In some patients, these environmental factors add to physiological ageing and hasten marionette line development.<\/p>\n

The influence of facial expressions and lifestyle<\/h2>\n

Les plis d\u2019amertume ne sont pas uniquement le r\u00e9sultat du vieillissement biologique. Ils refl\u00e8tent \u00e9galement la mani\u00e8re dont le visage s’exprime au quotidien. Les expressions r\u00e9p\u00e9t\u00e9es, conscientes ou non, participent \u00e0 leur formation. Les patients qui contractent fr\u00e9quemment les muscles du tiers inf\u00e9rieur du visage lors de situations de stress, de concentration ou d\u2019effort d\u00e9veloppent souvent des plis plus marqu\u00e9s. Cette tension chronique du tiers inf\u00e9rieur du visage favorise l\u2019installation de rides persistantes.
Lifestyle also plays a significant role. Prolonged stress, insufficient sleep and certain postural habits influence muscle tone and skin quality.
Substantial weight fluctuations can accentuate skin laxity and change facial volume distribution, indirectly contributing to marionette lines.
These often underestimated factors explain why relatively young patients may have pronounced folds while older people develop them later.<\/p>\n

When do marionette lines become visible ?<\/h2>\n

Marionette lines generally develop gradually. Initially, they appear only during facial expressions. Patients may see them when smiling slightly or speaking, but they disappear at rest. This dynamic phase can last several years. Over time, skin and volume changes turn these dynamic folds into static ones. They then remain permanently visible and change facial expression even without muscle contraction. This development depends on many individual factors, particularly skin quality, facial structure and each patient's muscle dynamics. In some patients, marionette lines appear from their thirties. In others, they become visible only after forty or fifty. Their establishment is rarely abrupt. It results from accumulated anatomical and functional changes that eventually become visually apparent.<\/p>\n

Preventing marionette lines through an early medical approach<\/h2>\n

La pr\u00e9vention des plis d\u2019amertume repose sur une approche globale du vieillissement facial. L\u2019objectif est de pr\u00e9server l\u2019\u00e9quilibre musculaire, la qualit\u00e9 cutan\u00e9e et le soutien volum\u00e9trique du tiers inf\u00e9rieur du visage. Une prise en charge pr\u00e9coce permet souvent de ralentir significativement leur apparition. Le maintien d\u2019une peau de bonne qualit\u00e9 constitue un \u00e9l\u00e9ment fondamental. L’application quotidienne de la protection solaire, l\u2019hydratation cutan\u00e9e et les soins dermatologiques adapt\u00e9s contribuent \u00e0 pr\u00e9server l\u2019\u00e9lasticit\u00e9 et la fermet\u00e9 de la peau.<\/p>\n

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Article written by Dr Romano Valeria<\/a><\/p>\n

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