Marionette Lines

Marionette lines are the vertical creases that extend from the corners of the mouth down toward the chin. They arise from a combination of factors including loss of facial fat and collagen, thinning skin, repetitive movement of the lower-face muscles (such as the depressor anguli oris), and gravitational descent, and they often become more pronounced with age or changes in facial volume.

Evaluation of marionette lines considers skin quality, underlying volume loss, and muscle activity to guide treatment. Options range from minimally invasive approaches like dermal fillers to restore volume and neuromodulators to reduce downward muscle pull, to skin resurfacing and fat transfer for texture and volume, and surgical procedures such as lower facelift for significant laxity; expected recovery and results vary by technique and individual factors.