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Can You Use Neurotoxins For Marionette Lines?

  • 6 min read


Marionette lines, also known as puppet lines, are the fine facial lines that go from the corners of the mouth to the lower part of the chin on each side of the face. In more severe cases, marionette lines may look like an extension of the nasolabial folds, which go from the bottom of the nose to the corners of the mouth.

Marionette lines usually become noticeable in your 40s and continue to become more pronounced, but some people notice these smile lines in their 30s. Your genetics, skin type, volume loss, the pace at which your collagen and elastin production reduces, and how often you make certain facial expressions will affect the age at which you will begin seeing your marionette line.

Marionette lines and nasolabial folds can cause people to appear sad or angry even when they are not, so many people feel unhappy with the effect these lines have on their appearance. Marionette lines can eventually develop into jowls, which can sag from the face down toward the neck and conceal the definition of the jawline.

Can Neuromodulators Remove Marionette Lines?

You may be able to reduce the appearance of your marionette lines with neuromodulators, also known as wrinkle relaxers, if you often use the muscles around your mouth to make facial expressions such as laughing, smiling, or frowning. These injections minimize the “frowny” appearance that lines around the mouth can create on the face.

By halting the movement of particular facial muscles like those causing marionette lines, neuromodulators temporarily smooth out deep-etched lines and prevent the formation of future lines. Botox is the most popular neurotoxin brand on the market, with Dysport and Xeomin not far behind.

When patients visit us with concerns over marionette lines, we typically recommend a combination of neuromodulators and dermal fillers to reduce their appearance. 

The lower portion of the face, particularly the area around the mouth, consists of many complex muscles, and our injectors here at HerSpace MedSpa use their aesthetic eye and attention to detail to precisely and strategically target the correct muscles during marionette lines Botox treatments.

Neurotoxins are best for mild to moderate marionette lines. But as they become more severe and form into jowls or blend with the nasolabial folds, we don’t believe it’s the most effective treatment for this area when used alone. Botox, Dysport, and Xeomin can soften marionette lines and create a slightly more defined jawline. However, we recommend combining the treatment with dermal fillers or radiofrequency microneedling with the Genius® RF device by Lutronic.

Dermal fillers can further reduce the appearance of marionette lines when combined with neurotoxins, while Genius® RF can tighten the jowls and further define the jawline when combined with them. 

Where Are Neuromodulators Injected For Marionette Lines?

Botox injections for marionette lines may be placed anywhere from the lower corners of the nose down to the bottom part of the chin along the jawline and are typically symmetrical on each side of the face.

Is There Any Downtime After Neurotoxin Injections for Marionette Lines?

Generally, Botox, Dysport, and Xeomin injections have very minimal side effects and have little to no recovery period. You may start seeing changes in the injected areas within a few days, but the final results can appear a week or two later.

How Many Units Of Botox Are Needed To Treat Marionette Lines?

As the skin around the mouth is shallower and muscles in this area are complex, we typically recommend less than ten units of Botox to treat marionette lines, with average treatments ranging from 6-8 units per side (equivalent to 18-24 Dysport units or 6-8 Xeomin units).

Neurotoxins vs. Dermal Fillers For Marionette Lines

Dermal fillers can reduce and soften deep marionette lines and other lines around the mouth. Juvederm, Restylane, and Belotero are some of the most popular filler brands for treating the area around the mouth.

Neuromodulators and dermal fillers both have their advantages when it comes to treating marionette lines. Fillers restore volume in the upper face to lift and smooth out the skin around the mouth and to fill in the lines, while Botox, Dysport, and Xeomin smooth out lines and prevent the formation of future lines by relaxing muscle movements.

We often use neurotoxins and dermal fillers to treat marionette lines, as combining the treatments produces more dramatic anti-aging results by reducing fine lines and volumizing the area around the mouth.

What Are Alternative Treatments For Reducing Marionette Lines?

While Botox is a widely used treatment for marionette lines, there are alternatives with minimal downtime. The treatments that we may recommend in place of neurotoxins, or in combination with them, to treat marionette lines include:

At a certain point, nonsurgical solutions such as Botox may no longer be sufficient for addressing the aging signs around the lower portion of the face. Surgical interventions such as facelifts eventually become the most viable option for treating loose skin and deep wrinkles in the lower facial area.

How Long Does Botox Last For Marionette Lines?

Depending on the amount of product used, whether it’s your first neuromodulator treatment or a maintenance treatment, and whether you combine it with others, your results may last anywhere from 3-12 months. Botox, Dysport, or Xeomin alone typically last 3-4 months but can last a year or longer when combined with hyaluronic acid fillers.

Considering Neuromodulators For Marionette Lines?

If you believe smoothing out the fine lines around your mouth will improve your overall appearance and boost your confidence, HerSpace MedSpa in Little Silver, New Jersey, is known for helping people to continue leading happy lives full of expression without worrying about facial lines forming from showing their emotions. Please contact us if you would like to book your consultation for Botox, Dysport, or Xeomin to address marionette lines.