As we age, subtle changes begin to occur in our facial area. As we begin to lose collagen and elasticity in our face we begin to develop marionette lines. These lines are on the sides of and usually follow downward toward the outer parts of the chin. These will cause a person to seem “sad” or “angry” as the mouth and lips can turn downward.
Prevention is always possible with a healthy diet; not smoking; proper skin care; and sun/UV protection. Of course, there are many times that genetics and other factors will take over and the marionette lines will occur.
Causes can include, smoking, age, poor diet, weight changes, stress and sun damage. When fat or collagen is lost in the skin then the areas can sag and droop. In this case, around the mouth and chin. It will then cause “jowls” to form and a laxity will be created in the tissue and ligaments surrounding the area.
There are a few treatments for marionette lines such as surgery (most invasive method), radio frequency skin tightening such as Thermage or ThermiSmooth or the most common is with dermal fillers. Dermal fillers with hyaluronic acid are used to fill the wrinkled area or folds. This is done with a very small needle and injected directly into the area. Most dermal fillers contain lidocaine (a local anesthetic) to help numb the area and are minimally invasive with little to no down time.
There are many types of dermal fillers out there. The most common for marionette lines would be Restylane, Perlane and Radiesse. Dermal fillers can last 9 months to a year depending on the patient metabolism.
It is always best to meet with a dermatologist to discuss which treatment regimen is right for you!