When injecting filler into the marionette line, it is important to understand the positioning of the mental and inferior labial arteries.
A reduction in tissue elasticity as we age causes skin laxity – this, combined with loss of volume above and below the oral commissures, contribute to the development of marionette lines.
Before injecting dermal filler, the length and depths of the lines should be examined for superficial creases as well as loss of volume. The different features will need to be treated with different techniques.
The chin area will also suffer from a loss of volume contributing to the overall appearance of the line.
Desired Treatment Outcomes
Choice of filler
Medium or high viscosity fillers
Common site-specific effects
Superficial wrinkles at the corner of the mouth may only require less than 0.2ml of filler, whereas more severe folds may require up to 1ml.