Why are the lines from the mouth to the chin (“marionette lines”) so hard to fix?

Hi, My chin area from the corner of my mouth on the bottom lip down has wrinkles. They have used juvederm, that didn’t help, had micro needling and that didn’t help... help I need suggestions.. thanks

I love the story, told in Jeff Kober’s meditation blog, about a friend who comes upon a friend busily searching for her keys under a streetlamp.  She asks, “Oh no, did you lose something? Can I help?”  The friend gratefully accepts help. They search but nothing …..and finally, the friend asks, “Where the keys were lost exactly”?  Her reply is “They were lost down the street, but this is where the light is.”

The problem of wrinkles can be a little like that.  We are all looking at the line when the problem is actually elsewhere!  To prove that to yourself, try picking different spots on your cheeks and pull up or out a little?  What happens to that line?

Some ways to think about solutions for marionette lines:

  • If the skin on your cheeks has lost elasticity from sun or health problems, consider doing a skin tightening procedure like fractionated CO2 or a radiofrequency procedure like Thermage, Ultherapy or Profound to tighten the skin some.
  • If the fat pads in your face are shrinking, you may want to consider volume replacement with filler to lift your cheeks back into position.
  • Because the fat pads in the chin can shrink also, volume replacement with filler may be needed.
  • There is a muscle that pulls down on the corner of the mouth (depressor anguli ori) that may need to be treated with Botox/Dysport.
  • A too-large fat pad just above the jowl area may be contributing.
  • Some of us need all of the above to correct marionette lines.

Bottom line:  Go slowly, and try to figure out what’s causing the marionette lines first, and then prioritize!

Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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