Marionette Lines

What are marionette lines and folds?

Marionette lines and folds are the lines or folds that extend from the corners of the mouth towards the chin. They may become more noticeable over time and vary between individuals. These changes are a common part of facial ageing and are influenced by both facial anatomy and the supporting structures of the lower face.

What causes marionette lines?

Marionette lines usually become more noticeable as a result of several factors working together, including:

• Individual facial anatomy and genetics.
• Gradual changes in the fat and supporting tissues of the sides of the lower face.
• Ligament laxity higher or to the sides of the face.
• Transition line between two different types of fat structure.
• Changes in the underlying bone structure over time.
• Skin quality and elasticity.
• Repetitive movements of depressor muscles of the corner of the mouth or neck may contribute in some people.
• Natural facial movement and expression.

The underlying cause varies from person to person, making an individual assessment an important part of the consultation.

Assessment

During your consultation, we’ll assess the lower face as a whole, including the cheeks, jawline, chin, fat, skin quality and facial anatomy. We’ll also assess how the surrounding structures contribute to the appearance of the marionette lines. Understanding the underlying cause helps determine whether management is appropriate for you and what we recommend.

Why assessment is important

Marionette lines are not always the primary concern. In many people, changes in bone and fat and ligaments with age in the cheeks, jawline, chin or supporting tissues contribute to their appearance. Without a comprehensive assessment, management may not address the underlying cause of the concern or achieve an outcome that meets your expectations. A careful assessment helps guide appropriate, individualised management.

Individualised management

During your consultation, we’ll discuss whether management is appropriate for your individual concerns. If so, we’ll explain the available options, together with the expected benefits, limitations and potential risks, so you can make an informed decision about your care.

Prepared by
Dr Simone Doreian
Specialist General Practitioner
AHPRA Registration: MED0001163462