Marionette Fold Excision

Q: Dr. Eppley, I am really feeling confident with what you have advised for other procedures and was wondering if after having everything we discussed whether I could possibly have marionette fold excision. I can’t stress enough how much I detest these lines. They are extremely prominent and appear to take over my face. I have researched my options and I’m not really sold on the filler injection as I would much prefer a permanent solution. And having typed in marionette fold excision your name came up. I have my fingers crossed this may be possible. 

A: Marionette fold excision can be done and is a permanent solution. But it is almost always reserved for older patients with really deep (inverted) marionette lines/folds who are more than willing to trade off a scar for the fold. That can be an easy tradeoff in much older people, usually 65 years or older since they already have many lines and wrinkles. That tradeoff may be more suspect in someone younger…or at least one should give very careful consideration of it. In addition an older person’s facial skin stretches more due to being thinner with less elastic fibers. Thus they scar much better. This is why skin cancer excision and reconstruction has such good results on older people.

Dr. Barry Eppley

Indianapolis, Indiana