Marionette lines: causes and non-surgical treatment
What are marionette lines?
Marionette lines are the two creases that run downward from the corners of the mouth toward the chin and jaw. The name comes from a ventriloquist's puppet, whose hinged jaw is drawn with exactly those lines — which is a fair description of the effect people dislike about them.
They are distinct from the nasolabial folds, the lines running from the nose to the mouth corners, though the two often deepen together and are frequently treated in the same appointment. Marionette lines sit below the mouth corner; nasolabial folds sit above it.
Unlike a frown line, a marionette line is usually visible at rest. That is the practical test: if the crease is still there with your face completely relaxed, it is volume and support that have gone, not muscle movement causing it.
What causes them
The corner of the mouth sits on a small platform of fat and connective tissue. As that support thins and gravity pulls the cheek downward, the tissue slides past the mouth corner and a groove forms beneath it.
A muscle contributes too — the depressor anguli oris, which pulls the mouth corner down. In some people it is strong enough to be the dominant factor, which is why the corners of the mouth can sit low even on a full face.
The combined effect reads as a permanently downturned expression, which is what most people are actually asking about when they raise this.
Treatment options
| Option | How it works | Results appear | Lasts | Where |
|---|---|---|---|---|
Dermal filler along the line and mouth corner | Rebuilds the lost support so the tissue stops folding over the corner. | Immediate | 6 months – 2 years | At Beauty Factory SD |
Chin and jawline filler | Restores the framework the lower face hangs from. Often does more for the line than filling it directly. | Immediate | 6 months – 2 years | At Beauty Factory SD |
Wrinkle relaxer to the depressor anguli oris | Relaxes the muscle pulling the mouth corner down, lifting the corner slightly. | 2–10 days | 3–4 months | At Beauty Factory SD |
Microneedling | Improves skin quality in the area. Adjunct only. | Weeks, over a course | Maintained with repeat sessions | At Beauty Factory SD |
Lower facelift | Repositions descended tissue. Addresses laxity injectables cannot. | After healing | Years | Not offered here |
What we would recommend
Most marionette lines respond best to a combination rather than to one thing. Filler restores the lost platform under the mouth corner and along the groove; support at the chin and jaw rebuilds the structure the whole lower face is hanging from and does a surprising amount of the work.
Where the mouth corner is being actively pulled down by muscle, a small dose of a wrinkle relaxer to the depressor anguli oris lifts the corner and takes tension off the line — a genuinely useful addition, and one that costs very little product.
What the right mix is depends on whether your line is mostly volume or mostly muscle, and that is a consultation question, not a menu question.
What it won't fix
Filler will not lift jowls. If tissue has descended over the jawline, adding volume beneath it can improve the transition but will not reverse the descent, and past a certain point more filler makes the lower face heavier rather than younger.
It will not change bone structure or a naturally downturned mouth. Some mouth corners sit low as a matter of anatomy rather than aging, and treatment softens the groove without changing the shape.
It will not hold indefinitely. The lower face is a high-movement area, so filler here is often metabolised faster than in the mid-face, and maintenance is part of the plan rather than a failure of it.
What we use for marionette lines
Common questions
Is filler or Botox better for marionette lines?
Usually filler, because the primary cause is lost volume and tissue descent. A small dose of a wrinkle relaxer to the muscle that pulls the mouth corner down is a useful addition where that muscle is the dominant factor, but it is rarely the whole treatment.
Why would you treat my chin for a line beside my mouth?
The chin and jawline are the framework the lower face is supported by. Restoring that structure lifts and repositions the tissue above it, which often softens the marionette line more effectively than filling the line itself.
How long does treatment last?
Typically 6 months to 2 years for filler, depending on the product and individual skin. The lower face moves a great deal, so results here often sit at the shorter end of that range.
How much downtime is there?
Mild bruising or swelling may be present for up to a week, and minor swelling or bruising can persist up to ten days depending on the patient and the treatment.
Board-certified — American Board of Internal Medicine
Last reviewed August 7, 2026
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