Marionette Lines are the vertical creases that run from the corners of the mouth towards the chin. They may first appear as fine lines but can later develop into deeper creases that mimic the look of a puppet’s mouth and even pull downwards further to accentuate jowls, the sagging skin underneath the chin and along the jawline.

Marionette lines may also present more visibly as a result of a drooping mouth. A drooping mouth is commonly characterised as a downward depressions at the corners of the mouth that drag facial expressions down, particularly when the face is at rest to give the impression of sadness, misery or disappointment. This persistent look can take its toll on your wellbeing and cause the face to look particularly aged and downcast.

Ageing predominantly forms the appearance of a downward-turned mouth and marionette lines, though some may be more genetically predisposed than others. The loss of collagen and elastin as we age is responsible for the depletion of volume, strength and structure in the skin and the tissue beneath it. What was once able to hold up the corners of the mouth and the skin around it, becomes weakened and so begins to sink and sag.

Marionette lines can be successfully treated using dermal fillers to fill and plump creases and specific areas of volume-loss to achieve a smooth and taut look to the face. They are also effectively alleviated with the use of PDO thread techniques whereby fine suture threads are carefully placed within the skin to create lift and promote collagen production for sustained firmness and restored definition.

A drooping mouth is commonly treated using anti-wrinkle injections whereby botulinum toxin A works to reduce movement in the depressor anguli orris – the muscle responsible for pulling the corners of the mouth down – so as to allow for the elevator muscles above the mouth to lift the corners successfully. This technique also eliminates fine lines and wrinkles in the area and prevents them from forming to achieve a youthfully bright and uplifted look.