Marionette Lines

[fusion_dropcap class="fusion-content-tb-dropcap"]M[/fusion_dropcap]arionette lines are a common facial feature that can affect the youthful appearance of your face. They are typically seen in people over the age of 40, but even these fine lines and wrinkles can appear in younger individuals as well.

Common jargon may dub them “laugh lines,” but they are scientifically known as marionette lines or nasolabial folds. These specialized wrinkles descend vertically from the corners of the mouth directly to the chin.

Named for their resemblance to the mouth of a marionette, a common misconception about marionette lines is that they are caused by laughter. They are heavily influenced by genetics and are a common result of the natural aging process due to the loss of elasticity and the depletion of fat our face undergoes as we get older.

In this blog post, we will discuss what marionette lines are, why they occur, and how you can treat them.

What Are Marionette Lines?

Marionette lines are wrinkles on either side of the mouth that extend down toward the chin. They occur when the muscles underneath the skin weaken and become less firm over time due to aging and environmental factors like sun exposure or smoking. As these muscles sag, the skin droops and creates visible wrinkles or creases around the mouth area.

Marionette Line Treatment

Why Do Marionette Lines Appear?

As we age, our skin loses its natural elasticity and firmness due to a decrease in collagen production. This process is known as elastosis and it causes wrinkles or folds to appear on our faces as our skin begins to lose its shape over time.

Additionally, environmental factors such as sun exposure, smoking, poor nutrition, lack of exercise, and dehydration can all contribute to the development of marionette lines.

Below we will discuss the roles of genetics, age, gravity, movement, and lifestyle choices in the development of marionette lines.

The Role of Genetics

Genetics indeed has a major role to play when it comes to developing marionette lines. Multiple studies have proven that genetic factors account for up to 80% of an individual’s susceptibility to facial wrinkles such as marionette lines. Thus, people who have family members with deep-set wrinkles may be more likely to develop these same wrinkles over time due to genetic predisposition.

How Genetics Impact Marionette Lines

Genetics also play a role in skin coloration and elasticity—which are both important factors in how quickly someone develops marionette lines. Individuals with lighter skin tones can produce less melanin than those with darker complexions; this means that they will be more susceptible to sun damage which can make their wrinkles become more prominent over time. People with lower levels of elastin (the protein responsible for keeping skin firm) may also develop wrinkles faster due to poor skin elasticity or laxity.

The Role of Age in Developing Marionette Lines

Age plays a major role in developing marionette lines because it affects our skin’s ability to produce collagen. Collagen is a vital protein for keeping our skin healthy and youthful looking; it helps keep the skin tight and hydrated. As we get older, collagen production slows down significantly which leads to sagging skin and wrinkles like marionette lines around the mouth area.

The Role of Gravity Causing Marionette Lines

Gravity affects our skin by constantly pulling downwards on it, which causes a loss in elasticity over time. Our collagen production decreases as we age, making our skin less resilient and more prone to wrinkling. This decrease in elasticity is why marionette lines occur—gravity pulls at the corners of your mouth, creating deep wrinkles over time.

The Role of Movement Causing Marionette Lines

It may come as no surprise that our faces are constantly in motion due to the expressions we make throughout the day. Smiling, frowning, scowling—all these expressions cause the muscles around our mouths to move and contract. Over time, those repeated movements begin to etch themselves into the delicate layers of skin on our face and this, plus the loss of collagen from aging may help form marionette lines.

Facial Expressions Trigger Movement

Of course, there is nothing wrong with expressing emotion through movement it’s quite normal! Unfortunately, our facial muscles naturally become weaker with age due to the loss of collagen and elastin production; this lack of strength makes it harder for them to bounce back after making these repetitive movements or expressions. As a result, you may find that your marionette lines become more visible over time.

How Lifestyle Choices Can Cause Marionette Lines

Lifestyle choices such as smoking or environmental factors such as sun exposure can add to your marionette lines.

Excessive Sun Exposure

Too much sun exposure without adequate protection is one of the main causes of marionette lines. UV rays damage your skin at a cellular level, causing inflammation and oxidative stress which leads to premature aging. To prevent this type of damage, use a broad-spectrum sunscreen with an SPF of 15 or higher every day that you’ll be exposed to the sun and wear a hat when possible for extra protection. Additionally, try to limit your time in direct sunlight during peak hours (10 am – 4 pm).

Smoking Causes Marionette Lines

Another common cause of marionette lines is smoking because it produces free radicals that damage your skin cells on a deep level. If you’re currently a smoker, then quitting is an important step towards preventing further wrinkles from forming. Even if you don’t smoke but live with someone who does, secondhand smoke can still affect your skin so find ways to limit your exposure as much as possible.

How to Prevent Marionette Lines

Sleeping Better Prevents Marionette Lines

The best way to prevent wrinkles from forming while you sleep is to avoid sleeping on your side or stomach. Instead, try sleeping on your back with several pillows propping up your head and neck. This helps keep your face from smashing against the pillow or mattress which will keep those marionette lines from deepening.

Moisturize Before Bedtime

Using a night cream before going to bed every night helps keep your skin hydrated during sleep and can help prevent wrinkles from forming. Look for creams that are specifically made for nighttime use because they contain more intensive nourishment ingredients than regular day creams. Make sure you apply it evenly all over your face so that all areas get proper moisturizing treatment.

Gently Exercise Your Face Muscles

Before going to bed each night, gently massage your face muscles in an upward motion using a light moisturizer or face oil. This will help relax any tension in the muscles around the mouth while also helping stimulate blood circulation in the area which will encourage the growth of new skin cells and collagen production; both of which can help prevent wrinkles from forming or worsening over time.

Proper Hydration Prevents Nasolabial Folds

Your body needs a certain amount of water to function properly, and this is especially true for your skin cells. Drinking enough water helps ensure that your skin cells are nourished with moisture, which keeps them functioning optimally. Skin cells that lack proper hydration become weak and brittle, leading to an increased risk of wrinkles and fine lines forming on the face. This includes marionette lines.

Water Flushes Out Toxins

In addition to providing moisture, drinking water also helps flush out toxins from the body which may cause additional damage to the skin if left unchecked. Toxins are impurities in the body that can lead to inflammation and other forms of cell damage if not removed through regular detoxification processes. Drinking plenty of water helps support these detoxification processes so that you can keep your skin looking healthy and youthful.

How Much Water Should You Drink?

The exact amount of water required by each person will vary based on their individual needs, but it’s generally recommended that adults drink at least eight 8-ounce glasses per day (approximately two liters).

It’s important to note that this amount should come from all sources such as food, beverages, etc., not just plain drinking water alone. Additionally, if you live in a hot climate or partake in physical activity regularly then you may need more than this amount to stay properly hydrated throughout the day.

Sun Protection and Skin Care To Prevent Marionette Lines

The most important thing you can do to protect your skin against marionette lines is to use high-quality sunscreen every day. A good sunscreen will contain UVA and UVB protection with an SPF rating of at least 30. Make sure to apply it generously before heading outside for more than 10 minutes—even on cloudy days! Reapplication is key; if you’re going to be out in the sun for extended periods, make sure you reapply your sunscreen frequently throughout the day.

A Thorough Skin Care Routine to Prevent Wrinkles

Keeping your skin clean and moisturized is essential for preventing marionette lines. You should wash your face twice daily with a gentle cleanser and warm water, then moisturize afterward with an oil or lotion specifically designed for facial skin care. This will help keep your skin hydrated, which is key for reducing wrinkles and keeping your complexion looking young and healthy.

You should also be sure to exfoliate regularly; this will remove any dead skin cells that may be clogging up your pores, allowing new cells to regenerate faster. This helps keep your skin looking fresh, youthful, and wrinkle-free!

How To Treat Marionette Lines

If you have slight to moderate marionette lines, begin treatment immediately. Also known as shallow marionette lines, these can be part of the natural ageing process.

This will help buy you time before having to do more invasive treatment options for deeper lines and wrinkles. Many of these are sold over the counter to help you get rid of marionette lines.

Marionette Lines Treatment


Vitamin C and Vitamin E are two powerful antioxidants that can help reduce oxidative stress on skin cells and promote collagen production. When applied topically to the skin around marionette lines, antioxidants like vitamin C and vitamin E can help improve elasticity and even out your complexion. However, it’s important to note that these ingredients should always be used in combination with other treatments for the best results.

Vitamin B3 (Niacinamide):

Niacinamide is a form of Vitamin B3 that has been shown to promote collagen growth in the skin. This ingredient helps moisturize and protect against environmental damage while also helping to reduce wrinkles by increasing cell turnover. Additionally, niacinamide can help soothe inflammation which is often associated with marionette lines due to prolonged sun exposure or other environmental factors.

Collagen Peptides:

Collagen peptides are amino acids that have been linked to increased levels of collagen production when applied topically to the skin. Collagen peptides can help reduce wrinkles while also promoting cell regeneration and improving overall skin health.

They also help restore skin elasticity. However, it’s important to remember that collagen peptides alone won’t make much difference; they should always be paired with other treatments for optimal results.

Hyaluronic Acid:

Hyaluronic acid is an ingredient found naturally in our bodies that helps keep our skin hydrated and plump-looking. When applied topically around marionette lines, hyaluronic acid can help reduce wrinkles while also promoting cell regeneration and boosting hydration levels in the skin for a smoother, more youthful appearance.


Retinoids are derivatives of vitamin A that have been proven effective at exfoliating dead skin cells from the surface of the face while stimulating new cell growth beneath them.

By removing dead cells from around marionette lines and encouraging new cell production underneath them, retinoids can help minimize their appearance over time without causing any discomfort or irritation when used correctly. These should all be added to your daily skin care routine.

Treatment of Severe Marionette Wrinkles

When your nasolabial folds become too prominent for the above treatments, we recommend these safe and effective cosmetic treatments and procedures. These deep lines, named for the mouth of marionette string puppets have a downward and inward pattern.

How Dermal Fillers Treat Marionette Lines

Dermal fillers are non-surgical injectable treatments used to reduce the appearance of wrinkles and restore facial volume. The main ingredient in dermal fillers is hyaluronic acid (HA), which is naturally produced by our bodies and helps keep skin hydrated and healthy.

When injected into problem areas of the face, HA adds volume to the skin where it is needed most. This can help reduce wrinkles and fine lines while adding fullness to your cheeks and lips for a more youthful appearance.

Treating Severe Facial Wrinkles with Dermal Fillers

When treating deep marionette lines with dermal fillers, it’s important to choose an experienced practitioner who understands how the filler will interact with your body’s existing anatomy and facial structure.

During the treatment session, your practitioner will inject small amounts of HA into the target area using a very thin needle or cannula. Once injected, the dermal filler, like Radiesse, will immediately add volume to the target area which will help smooth out wrinkles and give you a more youthful look without any downtime or recovery time needed. Depending on your desired results, you may need multiple sessions for maximum efficacy.

It’s important to note that dermal fillers are not permanent solutions; they typically last 6-12 months before needing touch-ups or additional injections for continued results. This makes them ideal for those who do not want surgery but still want dramatic results in a short amount of time while avoiding needles or scalpels altogether!

Botox As Treatment For Severe Marionette Wrinkles

Botox and other neurotoxins are injectable medications designed to temporarily relax facial muscles and reduce wrinkling caused by muscle movement. When injected into areas around the marionette lines, they can help soften the creases and make them less noticeable.

Neurotoxins are most effective when combined with dermal fillers like Restylane or Juvederm for a comprehensive approach to reducing wrinkles in this area of the face.

What Are The Risks Of Using Neurotoxins?

Neurotoxins have been used safely for decades with few side effects and complications reported. However, as with any medical procedure, there are some risks associated with using neurotoxins for marionette line treatment.

Possible side effects include bruising at injection sites, temporary drooping of facial muscles (such as eyebrow drooping or eyelid ptosis), and rare cases of anaphylaxis (a severe allergic reaction). To minimize your risk of experiencing any side effects, it is important to consult with a board-certified professional before undergoing treatments with neurotoxin injections.

Other Neurotoxin Treatments

In addition to Botox injections, there are other types of neurotoxin treatments available such as Dysport (abobotulinum toxin type A) and Xeomin (incobotulinum toxin type A). These treatments work similarly to Botox but may have different properties that make them more suitable for certain individuals depending on their needs or preferences. All three types of treatments offer similar results but should only be administered by a qualified medical professional to ensure safety and optimal results.

How PDO Threads Can Reduce Nasolabial Folds

PDO Threads are a type of facial filler made from polydioxanone (PDO), a material that has been used in medical sutures for decades. The threads are inserted into the dermal layer of the skin where they create a scaffolding effect, which helps to lift and smooth out wrinkles and fine lines. The threads also stimulate collagen production, which further helps to reduce wrinkles and improve skin elasticity over time.

How does it work?

The procedure is performed under numbing cream or local anesthesia, so it’s relatively painless. During the treatment, the doctor will insert the PDO threads into targeted areas using very thin needles. Once in place, the threads act as anchors to help pull up sagging skin and reduce marionette lines. In addition, they help stimulate collagen production in those areas, which helps to smooth out wrinkles even further over time.

Results You Can Expect

Results from PDO Thread treatments usually become visible within 2-3 weeks after treatment as your skin starts producing more collagen. Results typically last between 6 months and 1 year depending on lifestyle factors such as sun exposure or smoking habits. It is important to note that this treatment is not permanent; however, many people find that their results last longer than expected with proper skincare routine maintenance afterward.

What is Ultherapy?

Ultherapy is an FDA-approved ultrasound therapy treatment that uses sound waves to target deeper layers of skin to stimulate collagen production. By stimulating collagen production, Ultherapy can help reduce wrinkles and improve skin elasticity around the mouth and chin. Like other popular skin tightening treatments, the procedure is non-invasive and is a popular choice for those who are looking for results without surgery or injections.

How Does It Work?

The Ultherapy device delivers targeted energy beneath the surface of your skin using a handheld applicator. This energy stimulates collagen production in the targeted area while protecting surrounding tissues from thermal damage. During each treatment session, multiple passes are made to ensure even heating of the targeted area and complete coverage of all marionette lines. The entire process usually takes around 90 minutes and requires no downtime afterward.

Results for Marionette Wrinkles

The results from an Ultherapy treatment can vary depending on several factors including age, health condition, overall lifestyle habits, etc. Generally speaking, however, patients can expect to see an improvement in their marionette lines within 3 months after their initial treatment session. Results can last for up to 1 year with proper maintenance and follow-up treatments if needed.

Other Options for Treating Marionette Lines

  • Collagen Induction Therapy
  • Laser Treatments
  • Skin Tightening Treatments
  • Wrinkle Creams
  • Topical Treatment
  • Anti Aging Serum
  • Cosmetic Surgery
  • Chemical Peel
  • Laser Resurfacing

Marionette lines are a common sign of aging that can be difficult to avoid. As we age, we lose facial fat, gain excess skin, and have volume loss. This can cause moderate lines in our underlying tissues as a natural part of the lower half of our face and sometimes in the deep layers of the skin.

However, at Indulgence Med Spa, we offer many different treatment options that can help reduce the appearance of marionette lines and give you a more youthful appearance. If you’re interested in learning more about our services or booking an appointment, please contact us today. We would be happy to answer any questions you have and help you achieve the beautiful, rejuvenated skin you deserve.

About the Author: Cosette Saba Saliba, APRN

Avatar of Cosette Saba Saliba, APRN
Cosette Saba, ARNP, is the dedicated owner of Indulgence Medical Day Spa since 2012. With her expertise as an Advanced Registered Nurse Practitioner, Cosette ensures personalized skincare and advanced medical aesthetics for every client. She is committed to health, wellness, and delivering transformative results as a premier destination for beauty and rejuvenation.

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