How Can My Marionette Lines Be Fixed?
Q: Dr. Eppley, I have a question concerning my “puppet” lines around my mouth that get infected often. Are some type of injections a reasonable answer to this problem? Thank you.
A: What you refer to as puppet lines are technically known as marionette lines. That is the groove area that develops as the face and jowls fall forward with aging against the fixed skin of the chin. They extend downward from the corner of the mouth to the jaw line. There are multiple treatment options for marionette lines, depending upon how severe they are. For mild to moderate depth marionette lines, injectable fillers may be a reasonable option albeit a temporary one. For moderate to deeper marionette lines, injectable fillers are not very effective at effacing them. Options include a jowl lift (mini-facelift) which really treats the cause of the problem or direct excision of them which may be a reasonable option in the older patient who does not want to undergo any form of a jowl lift. I would need to see a picture of your mouth or face to give you a more definitive answer.
You can always try injectable fillers first as they are easy to do in a few minutes in the office setting. An injectable treatment will prove, one way or the other, if it is effective. Whether that is ‘reasonable’ ultimately comes down to an issue of cost. Is the depth of the marionette lines worth that gamble? That is where seeing a picture of it will help.
Dr. Barry Eppley