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What?! Why do two lines appear when you smile? Are you already getting old? Impossible... Wrinkles in your 20s, so what is behind them? And how are marionette lines different from the nasolabial folds we hear about so often? Please, make these aging lines go away! If you want to say goodbye to them quickly, don't miss this article! It looks at how marionette lines form, how they differ from nasolabial folds, and how to prevent and improve them. Let's get started!
What Are Marionette Lines?
Marionette lines form for the same reason as nasolabial folds: they are part of the aging process, mainly due to the loss of tissue under the skin, combined with fat pressing down on the ligaments, which produces marionette lines. Besides natural skin aging, the following also contribute to marionette lines:
(1) Weakened expression muscles
People who are often expressionless use their facial expression muscles less, so their skin tends to loosen and age more easily.
(2) Dry skin
As skin ages, its water content decreases, which leaves the skin dry, leading to wrinkles and creases on the face.
(3) Loosened ligaments
Ligaments help keep the facial muscles elastic. But as we age, the ligaments gradually stiffen and loosen, so the skin starts to sag and wrinkles form.
(4) Irregular daily routine
Staying up late and chronic sleep deprivation slow down skin metabolism and speed up aging.
(5) Hollowing of the facial bones
As we age, the upper jaw bone and the zygomatic arch of the face gradually lose volume and shrink, and they lose their supporting function, so besides looking visibly hollow, the other subcutaneous tissues start to slide downward, eventually forming marionette lines on both sides of the mouth.
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Marionette Lines vs. Nasolabial Folds
Marionette lines and nasolabial folds are both signs of skin aging, and the main difference is location: nasolabial folds form on both sides of the nose, while marionette lines form on both sides of the mouth. The lines look like the two lines below the corners of a puppet's mouth, which is why they are called “marionette lines.”
Nasolabial folds and marionette lines look like two different kinds of lines, but as skin ages and muscle elasticity declines, nasolabial folds that are ignored can extend into marionette lines once aging becomes more severe.
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How to Prevent Marionette Lines
Marionette lines usually appear with age, so prevention is very important! Paying attention to daily skin care and massage while you are young, and choosing suitable skincare products, can help prevent marionette lines from forming!
(1) Choose anti-wrinkle skincare
Choose skincare products with anti-wrinkle ingredients such as collagen, retinol, and vitamins E and C, among others. These ingredients help improve skin elasticity and prevent fine lines and wrinkles from forming.
(2) Use moisturizing products
Moisturizing is part of every skincare routine. Choose products with hydrating ingredients, such as hyaluronic acid, glycerin, and ceramides, which help keep skin hydrated and reduce the appearance of fine lines.
(3) Gently massage the facial skin
Massage can boost blood circulation, clear metabolic waste, and strengthen skin elasticity, helping prevent marionette lines from appearing.
1. Use your fingertips to gently massage the skin around the corners of your mouth, pushing gently from the inside outward and lifting diagonally upward from the mouth corners, which helps relax the muscles and promote nutrient absorption.
2. Every day, lift the cheek tissue over a broad area: put your fingers together, or use the web of your hand, and lift from the area beside the mouth up to the temples, 10-20 times a day.
3. Using the part of the palm between the center of the palm and the wrist, draw circles outward from the inside at the corners of your mouth to relax and soothe the muscles and increase blood circulation.
(4) Avoid pulling the skin too much
Avoid pulling excessively on the skin around the corners of your mouth. When applying makeup in particular, choose a gentle approach and avoid using too much product or unsuitable techniques, to reduce pulling and pressure on the skin.
Ways to Get Rid of Marionette Lines
If your marionette lines are mild, you can improve them with self-massage:
Step 1. Lift the tissue beside the mouth: Put your four fingers together and use your palm to lift the tissue beside the mouth up to the temples, 10-20 times on each side every day.
Step 2. Relax the facial muscles: Again with your four fingers together, use the part of your palm near the wrist to draw circles outward over the facial muscles, which helps relieve muscle tension.
For more pronounced lines, a professional physician needs to evaluate you in person, one-on-one, and carefully sculpt the most natural lines and appropriate proportions, using radiofrequency, ultrasound, and collagen-stimulating injections to lift and firm the skin and improve sagging and aging:
(1) Collagen-stimulating injections
Among the many anti-aging approaches, the most popular are Sculptra and Ellansé, and both can stimulate the body's own collagen production, but they differ in ingredients, texture, results, and treatment areas:
- Sculptra
- Ellansé
Also known as the “baby-face injection” and the “liquid facelift,” its ingredient is poly-L-lactic acid (PLLA). Sculptra is watery when injected into the skin and suits broad-area firming and lifting. PLLA gradually stimulates collagen growth, so the real results take 3-6 months to appear slowly, an elegant, gradual improvement that lasts a long time through the body's own collagen production, improving wrinkles, filling in hollows, and providing firming and lifting effects.
After injection, Sculptra can be 100% absorbed and broken down by the body, with almost no side effects, making it a highly safe aesthetic treatment.
Its main components are a CMC gel carrier and PCL microspheres. After injection under the skin, the CMC gel carrier holds the PCL it encases precisely at the injection site and temporarily supports hollow areas of the face, so you can see a clear change right at the time of treatment. The PCL then stimulates new collagen at the injection site, and once the gel carrier is absorbed by the body, the collagen that grows on its own takes over, making the structural support more stable and the contour lines less prone to deformation, creating firm, smooth, three-dimensional facial lines.
Ellansé offers a dual treatment advantage: immediate filling, similar to hyaluronic acid, together with collagen stimulation.
(2) Thermage FLX
Thermage FLX uses monopolar radiofrequency to heat the whole area in a 3D volumetric manner, delivering heat “from the outside in” to the deeper dermis and subcutaneous tissue to stimulate more collagen remodeling and kick off the body's natural repair process, for improved marionette lines, a firmer contour, and restored skin elasticity results.
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(3) Ultrasound lifting (HIFU)
Ultrasound lifting works by point-focused heating, delivering heat deep into the skin to stimulate more new collagen. Using ultrasound principles, it creates thermal coagulation points “from the inside out,” acting from the dermis to the fascia layer and producing immediate contraction, so that the facial skin is lifted upward, which eases marionette lines.
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(4) Botulinum toxin (Botox)
Botulinum toxin is a natural, purified protein made by taking a bacterial secretion and, using advanced technology, extracting a highly purified “type A botulinum toxin.” It is a neurotransmission blocker used to treat overactive muscles. It relaxes the muscles that cause wrinkles, and the muscles then gradually shrink, achieving wrinkle reduction and smoothing of the skin.
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All four of these methods are suitable for treating marionette lines. Which treatment is right for you still depends on an in-person evaluation and your physician's recommendation and judgment.
This article is for general information only. Results vary from person to person; please consult a doctor in person before deciding on any treatment.
