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Marionette lines are the lines / folds which start at the mouth corners and go downwards ending at the jawline.

Dermal filler is a simple and effective way to treat the marionettes lines. The marionette lines are very ageing on a face. They make a person look sad and negative. Filling marionettes make a person look happier and more positive.

With aging, the bone and soft tissue dissolves in the face, and in women, the skull rotates with the chin moving backwards. These features contribute to loss of structural support which creates the jowl and adjacent to the jowl the marionette.

Dermal filler can fill in the depression of the marionette fold. Some practitioners will describe this area as “the bottomless pit” for dermal filler, as such a high dose may be required.

We offer dermal filler for the marionette lines at both of our clinics in Sidcup and Brighton.

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TREATMENT OF THE MARIONETTES WITH DERMAL FILLER

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 In addition to  to treatment with dermal filler, the client should be assessed and treated with muscle relaxing injections in the DAO muscle if required. This is important in some clients who overuse their DAO muscle which pulls down the corner of the mouth. Injecting this with muscle relaxing injections will give a more attractive appearance, with a less down-turning negative appearance to the mouth.

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CHOOSING THE DOSE

The dose required for marionette folds is variable. It depends on the anatomy and the desired result. Some clients will be satisfied with 1ml, others will need more get the results that they want.

The practitioner will assess the face and decide on the best dose after taking a history and examining the client. If a client has a history of complications with dermal fillers, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen to start with.

With dermal fillers, a typical way to plan marionette improvement is to inject 1ml at a time,  injecting  every  month until the the client and practitioner are satisfied with the appearance

Typically, I will inject 1 ml at a first treatment then review the client a month later. If they said ” I liked the swelling after the last treatment and was disappointed when it went away” then I would recommend them to have a further 1ml, and repeat this until they don’t like the swelling afterwards.

Volume loss in the upper and lower face should be assessed and treated to give the best results.

WHAT HAPPENS DURING THE TREATMENT?

The face will be cleaned with alcohol and a numbing cream such as EMLA or LMX will be applied to ease any discomfort. The practitioner will inject using a very fine needle. Sometimes it is better to use a cannula. If this is the case a fine needle will be used to create an entry point for the blunt cannula to enter. 

AFTER TREATMENT

The effect of the dermal filler will be obvious immediately. There may be some swelling and redness in the area. Most of the swelling from the dermal filler will have resolved by 2-3 days after the procedure.

AFTERCARE

  • No makeup for 24 hours

  • No heavy exercise that day

  • No face products for 24 hours

  • No sunbeds, spas or saunas for 7 days post treatment

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