Bye-Bye Marionette Lines

Getting rid of vertical lines and wrinkles that run from the corners of the mouth down towards the chin (aka marionette lines) used to be something only ever achieved on the plastic surgeon’s table. And if surgery suits your needs, then we say go nuts. A good facelift, administered by the best in the business is pretty unbeatable, if truth be told.

However, if knives and serious downtime are not your jam, but you want to do something about those pesky puppet lines, the good news is there are plenty of other effective, less invasive options at your aesthetic physician’s office.

Herein our top three, tried and tested favorites…

Dermal Fillers

One of the most effective aesthetic options for marionette lines is undoubtedly fillers. With immediate results and minimal downtime, dermal fillers work by temporarily plumping up lost volume in the skin. They also help stimulate collagen production and attract moisture to the treatment area to further help fill in wrinkles, lines, folds and sagging skin. Great options for marionette lines are hyaluronic acid fillers such as Juvéderm Vollure and Restylane Refyne and Defyne. We also love Sculptra Aesthetic which offers more gradual, longer-lasting results.

Botulinum Toxin Injections

While Botox, Dysport, Xeomin and friends generally work better on horizontal than vertical lines, there are certain cases where Botox, or a cocktail of Botox and fillers, is exactly what the doctor ordered for your marionette lines. If droopy corners of the mouth are the main cause for those puppet lines, for example, Botox will work wonders. Just a couple of units per side will immediately help relax the depressor anguli oris (DAO) muscle, which is the muscle attached to the corners of the lips. Too much muscle tone in your DAO pulls the corners of the mouth down, so relaxing the muscle will really help… well… turn that frown upside down.


If your marionette lines are only just forming and are yet to really make their mark, microneedling is another great option. Also known as collagen induction therapy, microneedling works by creating tiny, controlled pinhole injuries in the skin. This damages the top layer of skin and forces it to go into repair mode to produce more collagen and elastin. Microneedling is more commonly used to help improve skin texture and tone, or to reduce the appearance of scars, but because collagen and elastin also help restore volume, a series of treatments will really help with vertical lines around the mouth. The number of sessions required will depend on the condition of your skin, but you’re typically looking at around four or five treatments at monthly, or six-weekly intervals.

One last thing: on top of seeking the right treatment for your specific concerns and treatment plan, there are many simple (and free!) lifestyle changes you can make to help soften newly formed marionette lines. The obvious one is not to smoke. Ever. Also, make sure you enjoy a diet rich in antioxidants; employ a top-of-the-class, medical-grade skincare plan that includes an AHA, antioxidant and sunscreen; and try the yawn facial exercise. It’s simple. Stretch your mouth as wide as possible, then slowly close it while counting to 20. Repeat this three or four times a day and you’ll be sure to notice a different in the tone and texture of your skin after a few weeks.