Marionette Lines: Causes, Prevention, and Treatments

Marionette Lines

Marionette lines, also known as “sad lines”, can form around your mouth, especially at the corners of your mouth, which can give you a different look or show visible signs of aging. These lines can affect your smile, and as we age, these lines can begin to appear for many of us.

The good news is that there are ways you can slow or work around these facial changes. In this guide, we will cover all of the information on sad lines and how to get rid of them to revitalize your look and smile. 

What Are Marionette Lines?

The name: marionette lines originate from puppets. This is because a puppet has a jaw split that lets it move its mouth to create the impression that it is talking. The jaw split is why the lines that form around the corners of your mouth are called marionette lines. 

Marionette lines vary from person to person. Some people develop deep wrinkles that make them appear to have sagging skin on their jawline. On the other hand, some people have marionette wrinkles that just seem like fine lines. 

Marionette lines are often confused with nasolabial folds. So, what is the difference?

Nasolabial folds form from the nose to the mouth, whereas marionette lines form below the folds. In addition, nasolabial folds are called smile lines, whereas marionette lines are called sad lines. 

Who Gets These Lines?

The most notable factors associated with marionette lines appearing are age and genetics. Nevertheless, some people are susceptible to these lines due to staying for long hours in the sun or smoking. Marionette lines often begin as smoker lines and then develop gradually. 

When you age, you might notice marionette lines forming when you reach 40 years of age. However, the lines might begin to develop earlier in life, in your 30s and late 20s. The negative thing about these lines is that they make you look older. Other than age and smoking, there are other causes of these lines.   

Causes of Marionette Lines

Our genetics are the primary cause of marionette lines appearing when we age. If your parents have developed marionette lines, the likelihood is that you may also develop them later in life. 

Losing facial fat can also cause marionette lines. The loss of the fat causes lines to develop due to the extra skin sagging, causing the lines to form around your mouth. 

So, how does aging cause the marionette lines? This all has to do with gravity. As you continue living, gravity also continues exerting pressure on your face, leading to the stretching of the facial tissues. As a result, the skin begins to sag and recollect at the chin. The sagging effect causes the formation of lines at the sides of your mouth. 

Severe stress can also cause marionette lines. For example, if you frequently frown and sulk, lines form on your face and begin to deepen. Later in life, the sulk lines are what will lead to the marionette lines forming. 

The UV light from the sun causes marionette lines. People who enjoy sun tanning and those who don't apply sunscreen are more prone to developing these lines. Exposure to the sun causes your skin to lose its elasticity. When your skin loses its tightness, lines can form at the corners of your mouth. 

How To Treat Marionette lines

When you look in the mirror and notice these lines, we would recommend looking for a dermatologist or a cosmetic surgeon. These professionals will be able to diagnose whether or not you have the sad lines. The dermatologist will use a five-point rating scale to know how deep the sad lines are. Knowing the severity of the sad lines will assist in recommending the best treatment option. What are the treatment options that your dermatologist or cosmetic surgeon can suggest? 

Considerations For Treatment Options

Before your dermatologist recommends the best treatment option, there are factors that they have to consider. 

• Your current health. Your overall health is essential as there are various treatment options, some more invasive than others. 
• The severity of the sad lines. The cosmetic surgeon will have to look at how deep the sad lines have formed to determine the most effective treatment option. 
• Expectations and goals. Do you only want to get rid of the sad lines, or do you have other goals regarding your looks? You will have to discuss your goals and expectations before the dermatologist can start treating your sad lines. 

What Are the Treatment Options for Reducing Marionette Lines?

Various treatment options can minimize marionette lines. Some of them require surgery, while others are non-surgical. Let's get into some of these methods. 

• Surgical options For Dealing with Marionette Lines

The truth is, surgical treatment should be used as a last resort for marionette lines. Surgical treatment is more expensive and invasive compared to the other available treatment options. Any invasive treatment option implies that it will take some time before you recover from it. Do you have the money, and can your body undergo surgery with minimal complications? If the answer is yes, keep on reading to find out more. 

• Full Face Lift

One of the surgical options for treating these sad lines is a full-face lift. A full-face lift will ensure that there is no loose skin around your jawline and mouth. Moreover, the facelift surgery will let the cosmetic surgeon eliminate wrinkles, nasolabial folds, and marionette lines. 

On the downside, a full-face lift surgery is quite invasive as the surgeon will have to cut and move whole skin layers. So, you will be off your normal day-to-day activities for around 3 to 4 weeks. Also, it will be challenging to eat during this period as you will have stitches. 

• Laser Resurfacing

Another treatment option is laser resurfacing. Laser resurfacing involves deep skin treatment where fractional lasers like radiofrequency and Erbium are utilized to treat the damaged skin layers. The cosmetic surgeon will use a laser that emits radiation to heat the collagen layer in your face with water molecules. The heating will cause the skin to begin repairing itself. 

Although laser resurfacing sounds excellent and harmless, that is far from the truth. There are different kinds of lasers, and each has different energy outputs. The energy these lasers emit can cause pain and delay your recovery.

What's more, is that laser resurfacing is temporary. Because this treatment option is temporary, you will need additional treatments after a few months. In addition, hyperpigmentation is another risk of laser resurfacing. This is why you should look for a professional with years of experience performing the treatment procedure.  

Non-surgical Treatment Options for Marionette Lines

Many people prefer going for non-surgical treatments for dealing with sad lines. This is because the recovery period is short, and there is no scarring or hyperpigmentation. So, what are the non-surgical treatments that your dermatologist or cosmetic surgeon can recommend? 

• Dermal Fillers

Dermal fillers contain hyaluronic acid, a natural substance that helps trigger the body to produce collagen deep in your skin layers. This might be the best treatment for marionette lines, as the reduced collagen production causes the lines. 

Your cosmetic surgeon or dermatologist will inject the fillers under your skin. After the injection, you might notice the wrinkles have plumped up, and your face looks fuller. The good thing about this procedure is that it takes less than half an hour and the recovery period is short. On top of that, you will begin to notice the results immediately, and the effects of the fillers can last for months to years. The treatment's lasting effect depends on the injection location and type of filler used. 

The dermal fillers most frequently used by dermatologists and cosmetic surgeons are Restylane and Juvéderm. The latter is the most effective for deep wrinkles, resulting in a younger look. On the other hand, Restylane is effective when the sad lines are continually changing due to moving your mouth. 

However, you should be mindful to look for a professional who knows how to inject dermal fillers. This is because dermal fillers and facial cosmetics are relatively new in the market; therefore, you should source for someone with the know-how. Dr. Cat Begovic is a board-certified plastic surgeon and the founder of MD GLAM. She has developed special techniques to use fillers for various purposes, such as softening facial wrinkles.  

• Thread Lifting

Thread lifting, also called silhouette soft thread lifting, is becoming a common treatment option for marionette lines and other wrinkles. However, this procedure is more invasive than dermal fillers or Botox injections. 

The silhouette soft thread lifting procedure involves the dermatologist inserting a suture under the skin. The suture holds the wrinkled areas. An absorbable cone lets the skin move along with the mouth. However, the procedure is not permanent, but the good thing about it is that it does not leave any permanent scars on your skin tissues. 

• Chemical Peel

Chemical or skin peels are skincare products that exfoliate the outer layers of your skin, and nourish your skin at a deeper level. Chemical peels are applied on the outer layer of your skin, the epidermis, and the mid layer, known as the dermis. The chemical peel application reduces age spots and wrinkles as new skin cells emerge, making you look youthful. 

Before going for a chemical peel application, you should notify your dermatologist if you have used face acids or retinoids. Failure to inform them can cause skin sensitivity and irritation. In addition, you will have to go for a chemical peel treatment every month to maintain smooth and soft skin. 

• Botox Injection

Botox is another treatment that has become popular for people with wrinkles around the eyes and mouth. The injection relaxes the facial muscles, making your skin smoother as the wrinkles reduce. 

Dermatologists or cosmetic surgeons, such as Dr. Cat, may recommend Botox injections for people who have small marionette lines forming. 

Ways of Preventing Marionette Lines

Not everyone is a fan of injectables and other invasive treatments. The good news is that there are some more natural ways that can help reduce the formation of marionette lines: 

• Getting enough sleep. Sleep is vital in keeping diseases at bay and ensuring our brains can function well. Sleep also plays a significant role in ensuring we maintain healthy skin. But how? Lack of good quality sleep leads to premature skin aging. However, you should ensure you sleep on your back to prevent skin folding, which can cause wrinkles. 
• Consider sun protection. Although a bit of sunshine is suitable for your mood and skin, excessive exposure to UV light leads to the breakdown of the skin layers leading to marionette lines. If your occupation forces you to be exposed to the sun for prolonged periods, apply sunscreen whenever you go out. Sunscreen will prevent the structural breakdown of your skin layer. 
• Practice a proper skincare routine. There are a lot of companies that manufacture skin care products, and this means that some of the products are counterfeits. Ensure you buy your skin care products from established companies with proven results. Incorporate skin care products that contain hyaluronic acid, peptides, vitamin C and Niacinamide. These products help fight wrinkles and keep your skin elastic. 
• Maintain a healthy weight. One major drawback of losing significant amounts of weight in a short period is loose skin. When you lose a lot of weight, you lose fat, even on your face. However, this significant loss of weight can leave sagging facial skin, which can cause marionette lines. So, maintaining a healthy weight to curb weight fluctuations will prevent excess loose skin.