What are Marionette lines?

The mouth is an area of particular concern for many people.  Often downturning of the mouth can result in a ‘sad mouth’ appearance. This is very difficult to treat and is often incorrectly treated.  The factors that lead to these lines are multiple.  First of all, as we age, the depressor muscles at the side of the mouth can become stronger than the elevator groups and can pull down on the sides of the mouth. While this is happening, most people lose volume in the cheeks, so the support provided by the cheeks, pulling up on the sides of the mouth slowly disappears.  Finally thinning of the lips and a strong mentalis(chin muscle) can accentuate the downward turn of the sides of the mouth.

Ways of treating Marionette lines?

These lines appear as a result of multiple problems, the first way to correct these lines is to correct the causes of them.  Weaking the depressor muscles (depressor anguli oris) can help with a small amount of muscle relaxant. Secondly a cheek filler treatment can help lift things.   Local treatment to the sides of the mouth can cause instant reversal of the drooping of the sides of the mouth.

Because of the contribution of the cheek volume loss and of the action of the depressor muscle, inexperienced injectors often overestimate the amount of product needed to fill this area, resulting in overfilling of this area. When the cheeks are lifted and the corners can’t pull down quite as much, a small amount of filler can go a long way in this area, and less is often more here.

How long does treatment take?

This is a relatively quick area to treat. 2-5 minutes is usually enough. Should there be a cheek treatment required or some muscle relaxation this time could be extended a little up to 10 mins.

Does it hurt?

The popular misconception that fillers can be very painful has been overturned with the recent developments in cosmetic anesthesia.  Most products used in our clinics are the local anesthetic containing versions, meaning that the pain that people used to experience from ‘stretching’ of the skin is much improved.  We also provide brand new ‘Ouchless needle’ technology as well as local anesthetic creams.  The cannula technique can also be used in this area, resulting in even less pain and minimal risk of bruising.

Are there any side effects?

The side effects associated with treatment in this area are quite limited, and it is important to aim to use the least amount of product to get the desired effect in order to minimize the small chance of these.  Common needle side effects include temporary (5-10 minutes) swelling and redness, less commonly bruising, and then much less commonly again, product specific side effects which your doctor will discuss with you before treatment.

What is the cost of treating Marionette lines?

Usually 1/2 to 1.5mls filler is needed. Costs range from €200 up to €600 depending on the type of filler used. Some fillers last 6 months others have a license for up to 18 months and are priced accordingly.