I have had bad experiences with several fillers. What can I use around my mouth?

I have marionette lines around my mouth. It is due to volume loss in my chin. I had a bad experience with Restylane, (massive swelling after the procedure that scared me into a visit to the ER). Would Artefill be a more permanent option? I also had fat put into this area but it only lasted about 3 months. Could a laser tighten the skin in this area to get rid of it. It is not to bad I am 50.

I wish I could say your situation is unusual but I’ve heard many similar stories!  Let’s start at the beginning and think through this.  I want you to go back to the mirror because most of the time marionette lines are caused by 2-3 things sometimes in combination.   You mention you have lost volume through the chin.  Have you also lost volume in your cheeks in front of your ears?  That fat pad often shrinks.  Also has your mid face (right under your eyes) lost volume?  You see where I’m going!!  These volume losses will contribute to the marionette lines.

I would not recommend Artefill.  I really do not recommend any permanent filler because there are reactions to these products that can occur, even after many years, that are disfiguring and not correctable.   Fat is very unpredictable as you discovered!

What about considering Sculptra?  Done well this could alleviate any volume loss in your cheeks and chin.  Also, Juvederm and Restylane are different.  The vast majority of people who have that extreme swelling with Restylane do not have that reaction with Juvederm.  Maybe a small test area to start?   Please see a good cosmetic dermatologist in your area.  Dr. I


Dr. Brandith Irwin, MD

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