Marionette Lines Treatment
The so-called ‘marionette lines’ are long vertical lines that commonly develop on each side of the chin as a result of the ageing process and other lifestyle factors. They get their name from marionette string puppets, which are known for having split jaws so puppeteers can open and close their mouths to make them look like they are talking.
The skin around your mouth is thinner compared with the rest of your face, so it is particularly prone to wrinkling. Marionette lines are caused by a combination of collagen breakdown and loss of elastin that leads to the loosening of skin in the cheeks and lower part of the face.
People typically begin developing marionette lines in their late 30s or early 40s. In the early stages, marionette lines are barely visible, but as time goes by these creases can become very deep and noticeable. Once they have appeared, the only way to fix marionette lines is to get to the source of the problem.
Marionette Lines Treatment options
Marionette lines can be treated with different non-surgical treatment options. During the initial consultation, Dr Nina will discuss these options with you and devise a bespoke treatment plan to achieve the best outcome.
Treatment options to get rid of marionette lines might include:
- dermal filler injections
- botulinum toxin injections
- skin boosters
- PDO threads
- chemical peels
Dermal Fillers Injections
Dermal fillers made with hyaluronic acid can be injected below the corners of the mouth to lift the smile and fill out minor creases. They replace the lost volume in your face by hydrating and treating deep wrinkles and folds, improving your skin’s health and youthfulness for a natural look.
There is no downtime for this treatment and results are immediate, lasting 6 to 12 months or longer.
Botulinum Toxin Injections
In the case of early-stage marionette lines, botulinum can be injected into the facial muscles to keep you from making the kinds of expressions that can cement marionette lines into place. In turn, your skin will become smoother with a reduced appearance in wrinkles.
In order for botulinum injections to treat marionette lines, patients will need to repeat the treatment every 3 to 4 months.
Skin Boosters
Skin boosters can help to gradually improve your skin’s condition, stimulating collagen production, hydrating the skin from the deeper layers, increasing elasticity, and reducing fine lines and imperfections. Unlike traditional dermal fillers, they are not injected beneath the skin to volumize or accentuate certain features of the face. Instead, they are injected directly into the dermis to hydrate and improve overall skin quality.
Dr Nina uses Restylane Vital, a skin booster made of hyaluronic acid in a liquid form that gets injected in the cheeks, nose to mouth, chin, neck and décolletage areas. It contains a unique form of stabilized hyaluronic acid (HA) to plump and hydrate the skin, with results that have been proven to last up to 6 months.
Skin boosters work best to prevent marionette lines, or to correct fine lines. They have a cumulative effect, so between 3 to 6 sessions every 2/4 weeks are recommended.
PDO threads
Correcting marionette lines using PDO threads is another non-surgical, minimally invasive cosmetic procedure designed to provide a more youthful facial appearance without leaving scars and with minimal downtime. PDO threads are used to lift and tighten the skin and the lower part of the face to remove deep lines and correct saggy cheeks.
Dr Nina uses MINT PDO threads, the latest innovation from South Korea. They consist of a dissolvable suture made from a complex sugar called PDO (polydioxanone), which has been used in biomedical and pharmaceutical applications for many years because of its extremely safe profile.
This material is non-allergic and non-antigenic and is also completely biodegradable, meaning the body completely absorbs the PDO material over time.
This procedure consists in inserting the threads into the skin to lift it, providing an immediate rejuvenating effect. PDO threads also stimulates the production of collagen, which helps to regenerate the skin over time by increasing firmness, volume, and making the skin look younger.
Before the treatment, a strong topical numbing cream is applied. After 30 minutes the treatment area is thoroughly cleansed and prepped. Local anaesthetic is injected into all the areas where the threads will be placed, so the patient does not feel any pain during the thread insertions.
The PDO threads are inserted underneath the skin in the predetermined areas, and then lifted upwards to achieve an instant rejuvenating effect. Because the threads are dissolvable, the results will last about six months.
Chemical Peels
Chemical peels are designed to remove the outer layer of skin (epidermis) as well as parts of the middle layer (dermis). The process reduces the appearance of facial wrinkles and age spots, and the new skin cells that generate are stronger.
With the treatment lasting up to an hour, you can squeeze a facial peel into a lunch break. The effects can be seen instantly with superficial peels or within a week to 10 days for deeper peels, depending on which treatment is right for you.
With a range of treatments available, the key is to choose the most suitable one for your face and skin. A private consultation with Dr Nina is always the starting point for all patients to receive a detailed facial and skin assessment and discuss the desired results.

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Tel: +44 (0)7340 093939 or email: info@facialsculpting.co.uk
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