Face and Body wrinkles are one of the many denotations of old age, however, some people are prone to wrinkles earlier than others due to several factors. Facial wrinkles at the corner of the mouth down the chin are called marionette lines.   

These lines typically travel down the chin from the corner of the mouth and constantly make you appear frowning. Although the marionette line is a sign of ageing, emerging commonly around 40 years of age. It may start becoming visible in some people around 20- 30 years. Thus, it can make you appear older than you are.  

This article will take you through various causes of marionette lines, how to get rid of it, prevent and conceal it. 

What are marionette lines?

Marionette lines are facial wrinkles characterised by folds of sagging skin around the corners of the mouth. These folds are vertical lines that run from the corners of the mouth to either side of the chin or jawline. Some facial features surface due to ageing, and the marionette line is one such. Overall, the face appears with the lower half sagging. 

The name marionette line was coined from the marionette string puppets known to have split jaws to facilitate talking as assisted by the puppeteer. The appearance of the wrinkle is similar to the split jaw seen on this puppet. The marionette line is also called the melomental fold. The mouth’s corners are the predilection site because the skin at this location is thinner than the rest of the face. 

Types of Marionette Lines

Types of marionette lines 

There are two types of marionette lines. It is crucial to figure out which one you have because their treatment options may differ. 

Shallow marionette lines 

Shallow marionette lines are just like fine lines. They do not cast shadows or form many creases. However, you shouldn’t lose your guard. If shallow marionette lines are not treated earlier, they can worsen gradually.

Deep marionette lines 

Deep marionette lines appear due to significant loss of facial fat and collagen. Consequently, the face may appear more sunken. Deep marionette lines are more severe than shallow marionette lines because the underlying cause is deep beneath the skin structure and not just the surface.

Causes of marionette lines


Collagen supports skin elements such as nerves, blood vessels, hair, oil, and sweat glands. On the other hand, elastin provides flexibility to the collagen matrix, thus improving the stretch and contraction of the skin. This is how the skin can hold its original shape. As you age, the skin naturally loses collagen and elastin, which cause skin sagging and wrinkles.

Sun exposure

Long-term exposure can lead to sun damage contributing to facial wrinkles by prematurely breaking down collagen and elastin. UV rays are strongest between early morning and late afternoon. Overexposing your skin to sunlight during this period without wearing SPF sunscreen will expose you to the increased risk of marionette lines and other types of wrinkles.


Dehydration increases the potency of numerous unwanted skin conditions. Skin dryness increases the risk of fine lines and wrinkles. 

Genetical inheritance

Genetics plays a role in an individual’s susceptibility to marionette lines. Check your grandparents and parents to see if they have marionette lines; if they do, it could mean you’re prone to getting it in the future.

Frequently pursing the lips.

Frequently pursing the lips creates lines on the face that become more prominent as you continuously fold the skin in the same pattern. This result is similar to when people raise their eyebrows to cause furrows that later become more pronounced on the forehead. 

Poor nutrition 

Nourishment plays a significant role in skin health. There are nutrient-filled foods that help promote the production of collagen and elastin. That being said, certain foods have poor or negative impacts on skin collagen and health. High consumption of foods such as caffeine, dairy, simple carbs and proceeded foods can contribute to the depletion of skin collagen. 

  • Smoking
  • Severe stress

How to get rid of marionette lines

Even though temporary, it’s possible to reduce the appearance of the lines on your face. There are no medical treatments that will permanently remove marionette lines besides Facelift surgery. However, medical advancements have given rise to a wide range of non-invasive facelift procedures that can effectively get rid of marionette lines. These procedures include;  Botox injections, dermal fillers, skin boosters, chemical peels, and PDO threads. You can also apply topical creams at an early stage(shallow) of marionette lines.

 Facelift Surgery 

This is the only treatment option that’s considered a permanent solution for wrinkles. After an initial consultation, your dermatologist may recommend a facelift (also known as a rhytidectomy) if you have significant wrinkles. This surgery involves incisions to remove or transfer fat while lifting underlying tissues upwards to tighten the face.

Due to medical advancement, specifically for the treatment of marionette lines, a minor scale surgery is recommended. Instead of a facelift, a mini facelift (partial rhytidectomy) is preferable.

You’ll need about one to two weeks off work during recovery. It’s essential to heed the doctor’s advice concerning post-operation activities and a healthy lifestyle. Excessive exposure to the sun and weight fluctuations could undo the results. 

Botox injection 

Botox (also known as Botulinum Toxin) injection improves the appearance of marionette lines by relaxing muscles that cause wrinkles around the mouth and eyes. It works best at the onset of observing the wrinkles.

Subsequently, after the injection, the skin becomes smoother with reduced wrinkles. It is better to repeat the botox treatment every three to four months to prevent the recurrence of the marionette lines. However, you might experience some bruising and irritation at the injection sites. As such, you should get it done by medical experts to minimise the side effects. 

Book a Treatment for Marionette Lines in London

Dermal Fillers Injections

Hyaluronic acid-based dermal fillers can be injected into the skin right below the corners of the mouth to lift the smile lines while filling out minor creases. These fillers replace the lost volume in the face by hydrating and treating wrinkles and folds. Post-injection, the skin appears healthy and youthful, along with having a natural look. 

How long do marionette fillers last?

How long do marionette fillers last?

Marionette fillers last ideally for about six to twelve months. The body gradually absorbs the filler products over time, returning the face to look as it did pre-treatment. However, the potency and length of service of the results depend on individual metabolism rate, lifestyle and amount of filler products used. Still, moderation is crucial as excessive derma fillers could give the face an unnatural appearance. 

You might have to revisit the clinic at about six months for another filler session to keep up appearances. 

Skin Boosters

Skin boosters are another treatment measure for marionette lines. These boosters gradually improve skin condition by doing the following;

  1. Stimulating collagen production
  2. Hydrating the skin layers
  3. Increasing elasticity and
  4. Reducing fine lines

While these boosters are injected into the skin like dermal fillers, the procedure is completely different. Skin boosters are injected directly into the dermal layer to improve skin quality while causing adequate hydration. These boosters are unlike the dermal fillers that are injected right underneath the skin to accentuate its health.

Nina of the Facial sculpting clinic uses Restylane Vital. This skin booster is made of liquid hyaluronic acid and is injected into the cheeks, mouth, chin, nose, neck, and décolletage areas. This stabilised hyaluronic acid-based skin booster plumps and hydrates the skin with results that boast a life span of up to six months. 

PDO threads

This is another non-surgical treatment method with minimal body invasion. This cosmetic process is designed to avoid scars, has minimal downtime and leaves the patient with a youthful appearance. PDO threads lift and tighten the skin of the face to remove marionette lines and saggy skin. 

Nina uses MINT PDO threads which are of recent innovation from South Korea. This PDO thread brand has been used in both pharmaceutical and biomedical fields for several years because of its safety profile. The material is both non-antigenic and non-allergic and totally biodegradable. As a result, the body easily absorbs the material over time. 

Chemical Peels

Chemical peel to get rid of marionette lines

Chemical peels work by removing the epidermis and part of the dermis. The procedure reduces the appearance of facial wrinkles as well as marionette lines by generating newer and stronger skin cells. The treatment lasts for about an hour, but the results can be seen instantly with superficial peels or within seven to ten days for deeper peels. The peel depth depends on which treatment is best for you. 

Topical treatment

Ideally, serums are best used at the earliest stages of facial wrinkles, but some use them even before getting wrinkles. It’s common to see anti-ageing serums incorporated into daily skincare routines. Certain ingredients must be considered part of an ideal serum for marionette lines. Some of these include the following. 

  1. Antioxidants such as vitamins E and C. These vitamins combat free radicals and oxidative stress, preventing skin ageing and wrinkling.
  2. Vitamin A derivatives. An example is a retinoid.
  3. Hyaluronic acid 
  4. Peptides
  5. Niacinamide (also known as nicotinamide) increases collagen production and improves elasticity. 


What is the best treatment for marionette lines?

The best treatment varies for individuals based on preferences. While some people do not mind going under the knife to get rid of marionette lines, some people would prefer a non-invasive remedy.
A private skin consultation session with Nina is the best way to begin the journey of achieving young and healthy skin. You can expect a detailed skin and facial assessment and a discussion about your desired results. With a variety of available treatments, a consultation session will choose the best suitable method for you. 

Does losing weight help with marionette lines?

Laxity or looseness of the facial skin could result in marionette lines. The increased subcutaneous fat volume exaggerates the skin’s slackness from being overweight. This means being overweight initially could stretch the skin. If, later on, one loses weight, there’s a possibility the loose skin collected at the chin forms marionette lines. 
Experiencing drastic changes or fluctuations in weight could significantly impact your skin over time. If you need to lose weight, perhaps for medical reasons, aim at gradually shedding off the weight so the body can keep up. It is also advisable to work with a professional to maintain your final size. 

How to prevent marionette lines

You can’t completely prevent marionette lines or facial wrinkles from appearing, as they are characteristic of old age. However, following some healthy lifestyle tips can prevent wrinkles from intensifying.

These include the following: 

Stay hydrated with water
Eat nutrient-filled food like vegetables and fruits. 
Manage your stress
Get adequate beauty sleep
Avoid smoking and alcohol consumption. 
Use a face moisturiser and wear sunscreen with SPF 30 or 30+ ratings daily. 
Minimise your caffeine intake
Use an anti-ageing serum
Manage your weight

Celebrities with marionette lines

There are several celebrities with marionette lines. Some have treated and concealed them well enough. To see how well an individual with the condition could look, check out videos online of “marionette lines before and after”. Examples of celebrities with marionette lines who unashamedly embrace their natural looks include Courteney Cox, Cameron Diaz and Renée Zellweger.

Concealing marionette lines

Concealing facial wrinkles like marionette folds with makeup is a great option to hide the lines temporarily. It does not involve surgery or dermatological treatment. Regular, old,  trusty layering and powdering will do the job. Here are some steps to follow. 

  1. First, apply your foundation. 
  2. Next, apply concealer.
  3. Then gently dab the concealer onto the face using a concealer brush. Avoid rubbing in the concealer and wait for the product to be absorbed.
  4. Apply setting powder to wrap it up. 

Sometimes focusing on eye makeup could divert attention away from wrinkles in the lower part of the face. 


Wrinkles such as marionette lines are naturally indicative of old age, and everyone eventually gets them. However, you may want to remove or conceal it if you are conscious of it or if it appeared at a younger age. Before you choose any treatment option, ensure you consult with a medical expert to know your skin condition and what is best for you.

Read also: Sagging jowls and best treatments

Skincare Steps for Glowing Skin


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