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Lift the lines that pull the corners down.
The lines that run from the corners of the mouth toward the chin can make the face look tired or sad, even when you feel neither. They are mostly a structural problem, so the most natural results come from rebuilding support, not just filling a crease.
Marionette lines are the vertical creases that run downward from the corners of the mouth. As they deepen, they can give the mouth a downturned look and add years to the lower face. They are one of the most common concerns we treat, and one where the right strategy matters most.
Marionette lines are mostly a loss of structure, so the most natural results come from rebuilding support underneath, not from chasing the crease itself with more and more filler.
Because these lines form as the face loses collagen, fat, and bone support with age, treating them well means restoring that foundation. Depending on the depth and cause, that may be building collagen, restoring targeted volume, resurfacing the skin, or a combination. We build the plan around what is actually driving yours.
Why they form, and what they respond to
Marionette lines come from a loss of support in the lower face. Knowing what is driving yours points to the right treatment.
What causes them
- Collagen and elastin loss. As the skin’s support network breaks down, it can no longer hold the lower face taut, and creases settle in.
- Volume and fat loss. The cheeks and mid face lose volume with age, and that lost support lets the corners of the mouth descend.
- Bone changes. The jaw and chin remodel over time, reducing the framework the skin drapes over.
- Gravity and repeated movement. Years of expression and the constant downward pull settle the lines deeper.
- Sun exposure and lifestyle. UV damage and smoking accelerate collagen breakdown and deepen the folds.
A crease is a symptom, not the cause
This distinction changes everything about treatment. It is tempting to see a marionette line as something to fill, but the crease is the visible result of lost support beneath it. Filling only the line, without addressing the foundation, tends to look heavy and unnatural.
The more natural approach rebuilds structure first. Stimulating new collagen restores the skin’s own scaffolding, targeted volume supports the mid face and the corners of the mouth, and resurfacing refines the skin’s surface. Most people benefit from a combination, which is exactly what we design at your consultation.
How we treat marionette lines at Renew
Five complementary approaches, matched to what is driving your lines. Most plans combine two or more, built to layer over time.
Sculptra
Sculptra stimulates your own collagen to gradually rebuild the support the lower face has lost, softening marionette lines from underneath. It is our lead choice for a natural, build-and-layer result rather than simply filling a crease.
Learn about Sculptra →Dermal Filler
Placed thoughtfully in the mid face and around the corners of the mouth, hyaluronic acid filler restores lost volume and lifts the structure above the lines. Used to support the foundation, not to overfill the crease itself.
Learn about dermal filler →Helix CO2 Laser
Our fractional CO2 laser resurfaces the skin and stimulates new collagen, refining the surface and improving the tone and firmness of the lower face. A strong complement to structural treatments for a smoother overall result.
Learn about Helix CO2 laser →DAO Botox
A small dose of neuromodulator relaxes the depressor anguli oris, the muscle that pulls the corners of the mouth downward. Easing that pull lets the corners sit more neutrally and softens the downturned look, complementing the structural work underneath.
Learn about neuromodulators →Medical-Grade Skincare
Retinoids, antioxidants, growth factors, and daily sun protection support collagen, slow new lines from forming, and protect the results of your other treatments. The foundation that every plan is built on.
Explore medical-grade skincare →Common myths about marionette lines
Just fill the line and it is gone.
The crease is a symptom of lost support beneath it. Filling only the line, without rebuilding the foundation, tends to look heavy. Restoring structure first gives a more natural result.
Marionette lines and nasolabial folds are the same.
They are different. Nasolabial folds run from the nose to the corners of the mouth, while marionette lines run from the corners of the mouth toward the chin. They often appear together but are treated as distinct areas.
More filler means a better result.
Overfilling the lower face is a common cause of an unnatural look. The goal is balanced support across the mid and lower face, not the most volume possible in one crease.
Only surgery can fix them.
Meaningful improvement is realistic without surgery. Building collagen, restoring targeted volume, and resurfacing the skin can soften marionette lines noticeably and refresh the lower face.
Marionette lines, answered
Let’s find the right approach for your lower face
Book a complimentary consultation and we will identify what is driving your marionette lines and build a plan to soften them, naturally and without surgery.
