The marionette lines are wrinkles that run from the corners of the mouth down toward the sides of the chin. They are wedged between the jowls and the chin.
Marionette lines start to appear by the late 30’s or early 40’s, but the age when they become noticeable varies considerably by person. They are called marionette lines because they resemble similar lines seen on marionette puppets.
Why Do Marionette Lines Appear?
Marionette lines develop due to the loss of volume and elasticity in our face as it ages. As we age, we lose bone and fat which supports the 3-D architecture of our face. This loss of support, coupled with the loss of collagen in our skin making it weaker, causes our skin to sag. One of the places is bunches as it sags is at the marionette lines. Read more about how the face ages here.
Best Way to Treat Marionette Lines
The best way to treat marionette lines is to fill them. Restylane, Radiesse, and Juvederm are all frequently used. I find Radiesse best for deep lines, and Restylane and Juvederm for average and shallow wrinkles. Sometimes, I layer Juvederm or Restylane on top of Radiesse to fill both the deep component and the more superficial portion of the line.
In addition to filling marionette lines directly, re-volumizing the areas of the face that have become hollow with age helps to lift the skin back to where it should be which also lifts and smoothes the marionette lines. Sculptra and Radiesse are particularly good for adding volume back to the temples and cheeks.
How Old Should You Be to Treat Marionette Lines?
There is no exact age at which you should start treating marionette lines; however, treating sooner is probably better than later. The reason for this is that fillers stimulate your own natural collagen, and it would seem that areas that have more collagen would age more slowly.