The treatment for your marionette lines consists of using dermal filler products to reduce the shadows that start from the corner of the mouth and run down towards the jawline, either side of the chin. They look similar to the lines on marionette dolls and hence are often described as marionette lines. Marionette lines could be caused for a number of reasons including the loss of skin collagen and loss of mid-face volume causing the skin on the face to fall down towards the jaw. This results in the formation of jowls and marionette lines.

As we age marionette lines become more visible due to the reduction in tissue elasticity, increase in laxity and volume loss above and below the oral commissures. All these age-related changes can contribute to the key component of ageing in the lower face – the development of the marionette lines, resulting in the facial profile to appear tired. Dermal Filler products can be used to treat deep and fine marionette lines, to smooth out the fold and reduce the appearance of shadowing. The treatment for marionette lines can be achieved using two different techniques, the first technique is the lifting to the dropping cheeks by injecting dermal filler along the cheekbone; the benefit of this is to lift the heavy skin that forms the marionette lines. The second technique is by injecting the dermal filler product directly in the area between the chin, jawline and corner of the mouth to re-contour the area, this will provide support to the corners of the mouth and reduce the appearance of the marionette shadows. The benefit of this would be to reduce the depth of the marionette lines and give an instantly smoother appearance to the treated area.

To treat the marionette lines to create a smooth and youthful appearance, a range of dermal fillers which have different densities could be used for your treatment. All fillers we use consist of local anaesthetic gel which minimises discomfort. The treatment results are immediate, and results can last up to 6 to 15 months depending on the dermal filler injected.

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It is important you tell your practitioner about any medicines or dietary supplements you are taking, some medicines can adversely affect the way the filler works or increase your risk of bruising.

If you are taking supplements such as Vitamin A, C or E, Gingko Biloba, Garlic, fish oils, or some pain killing medicines such as aspirin or ibuprofen, then these can increase your risk of bruising and it may be advisable to stop taking them a few days before your treatment. It is also advisable that you do not drink alcohol the night before your treatment, for the same reason.

It is not advisable to have treatment if you are feeling at all unwell.

Make-up will need to be removed prior to the injections and you will be advised not to reapply it for 12 hours in order to reduce the risk of infection or irritation at the injection sites.

Be aware of the necessary aftercare advice and that your schedule allows for you to follow it.

A full consultation will be conducted with yourself and your Practitioner to discuss your treatment. In the consultation, your practitioner will assess the area of concern, answer any of your questions, show you examples of before and after treatment images and develop an effective treatment plan for you. Areas may be marked to illustrate the overall look you are looking to achieve. After the treatment plan has been confirmed by you and your practitioner, your practitioner will take you through the consent process and take some pre-treatment photographs. All treatment areas will be sterilised and prepped for treatment.

Lidocaine (numbing cream) will be applied or there is an option for a full dental block (numbing injections) to ensure your treatment is totally pain-free. The dermal filler is then injected into the lips using micro-needles or a cannula ensuring minimal discomfort and bruising. The technique will allow your practitioner to sculpt the lips to the desired shape and fullness. In many cases, your practitioner may use a round, blunt-ended micro cannula to deliver the dermal filler to the entire lips. The cannula technique requires an invisible entry point either side of the mouth, the benefits of this technique reduces the risk of bruising from injection sites.

Once treatment has been delivered, your practitioner will massage the areas, re-sterilise the treatment sites and show you your immediate results. Aftercare instructions will be explained thoroughly and provided to you by your practitioner. After all treatments you will be offered a review appointment, usually 2 weeks post-treatment, details will be sent to you in an email confirmation.

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Procedure Time

30-45 MINS

Results Seen



0-48 HOURS





1 ml from £250


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Volume loss in the marionette lines could be due to a number of reasons including:

• Volume loss of skin integrity in general.
• Volume loss of the malar fat pat in the cheek.
• Slippage of the malar fat pad (more common in long-distance runners).
• Increased skin laxity due to age and photodamage.
• Rapid or significant weight loss (commonly after gastric bypass)
• Any serious disease or medical condition.

The marionette lines are not always an age-related problem, it is often present even from birth, but it does become longer, deeper and acquire creases with age and accompanying volume loss and skin laxity.

The deepening shadow is one of the primary unconscious indicators of the ageing midface, and therefore this treatment is one of the simplest ways to rejuvenate the midface. With age, the action of zygomatic muscles when smiling can also highlight the lines, and over time this will have an impact on the surface of the skin where creases may appear deeper. It is common to see volume loss with overlying creases.

Dermal fillers are a safe procedure if basic safety is understood. When your practitioner is treating the marionette lines, they will ensure that all-important steps are taken and understood regarding how to prevent, recognise and treat the area safely, reducing any rare and serious complications.

The marionette lines dermal filler used by your practitioner will always contain lidocaine, this is a local anaesthetic providing a more comfortable and less painful experience. You will not need to take any extra pain relief prior, during or after treatment. You may experience the treatment as a mild discomfort, but it is a well-tolerated procedure. In addition, your practitioner could apply a local anaesthetic cream (numbing cream) to the treatment area for the additional numbing effect.

When your practitioner performs marionette lines treatment, the practitioner will be using reversible hyaluronic acid fillers pre-filled with lidocaine. There is a range of dermal filler products your practitioner will advise you on regarding performance, expectations, results, and longevity. During your consultation, your practitioner will advise you from the range of products below, which is best suited for your treatment outcome and expectations.
• Teoxane
• Restylane Refine/ Define
• Intraline M range
Face Aesthetics is a medically led, results-driven clinic founded by Tina Niravane, who is a fully qualified Registered Nurse and Aesthetic Practitioner. We offer marionette line filler from our clinics in Francis Street, Leicester and Harley Street, London. You can book in for an appointment online or contact us on 011 6309 0182.