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Best way to get rid of “marionette lines” ?

Question posted by MaryG. from Charlottetown

I have smile lines on either side of my mouth that I’m starting to notice more; I find they are making me look sad. Is there a way to fix that and what would the cost be?

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One thought on “Best way to get rid of “marionette lines” ?

  • Dear MaryG,

    The Marionette lines are the lines that form at the corner of the mouth down to the jawline are quite concerning and aesthetically displeasing for most patients.  They give patients a “mouth frown” or sad mouth appearance.  One could classify the treatments into non-invasive and invasive.  The simplest and non-invasive treatments, of course, would be the use of soft tissue fillers like Juvederm Voluma to add volume to the Marionette lines and support the corners of the mouth called the commissures.  Often they are very strong muscles that help pull down and assist in the downward descent of the corners of the mouth and this muscle is called the depressor angularis oris and a small amount of Botox used together with the filler can weaken this muscle to allow elevation of the cheeks.  Other techniques can be used by themselves or in combination with fillers and Botox that heat the skin non-invasively.&nbsp ; These skin heating devices include technology such as Forma, Exilis, Venus Freeze or fractional techniques such as Fractora, the Profound and Ulthera.  All these techniques heat and tighten the skin of the cheeks and jawline to pull back the Marionette line and minimize the appearance.  Minimally invasive techniques under local anesthesia can include a thread lift or suture suspension which can lift directly the droopy flesh over the Marionette line and then, of course, a mini facelift can result in a more permanent outcome.

    As you can see there are many options for your Marionette lines.  The simplest option use of soft tissue fillers, Botox with or without heating devices will cost somewhere between $750.00 and $2,000.00 depending on the clinic and the treatment professional.

    I hope this information has been of some assistance and best of luck.

    For more information, please review our soft tissue filler, botox and thread lift pages. If you’d like to find out more please call SpaMedica at (416)
    922-2868 or visit us at our website at

    R. Stephen Mulholland, M.D.

    Certified Plastic Surgeon

    Yorkville, Toronto 

Additional Information

Botulinum Toxin aka Botox

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