Marionette Lines

What are marionette lines?

Marionette lines, also called melomental folds, are creases that extend from the corners of your mouth to your chin. The name comes from marionette string puppets, which have pronounced vertical lines in the same place.

Marionette lines may be mild, moderate or severe.

What is the difference between marionette lines vs. nasolabial folds?

Marionette lines and nasolabial folds are in different locations on your face. Nasolabial folds are known as smile lines and extend from the nose to the mouth. Marionette lines appear below nasolabial folds.

Who typically gets marionette lines?

Most people will get marionette lines as they age. However, some people may be more prone to developing these lines sooner or have more visible, deeper lines. For example, people who smoke and don’t use sun protection may form marionette lines early or have more prominent wrinkles.

What age do marionette lines appear?

Marionette lines typically appear around age 40. But you may see faint or subtle lines at the corners of your mouth in your 20s and 30s.

Do marionette lines make you look older?

Yes, marionette lines are a sign of aging. These wrinkles can make you look older than you are.

What causes marionette lines?

Marionette lines may develop due to:

• Aging and naturally losing collagen and elastin in your skin.
• Having parents or grandparents with marionette lines.
• Not wearing sunscreen on your face.
• Pursing your lips frequently.
• Severe stress.
• Smoking.
• Sun exposure, which can lead to sun damage.

What do marionette lines look like?

Marionette lines can be subtle or deep lines, traveling from your mouth’s outer corners to your chin. They can make you look like you’re constantly frowning.

How are marionette lines diagnosed?

Your dermatologist or cosmetic surgeon may use a five-point rating scale to diagnose the severity of the marionette lines. The rating scale can help your surgeon determine the best treatment option.

What is the best treatment for marionette lines?

The best way to treat marionette lines differs for each person. Together with your healthcare provider, you’ll decide which option is best for you based on your:

• Current health.
• Desire for any additional skin changes.
• Goals and expectations.
• Severity of marionette lines.

What are the treatment options for minimizing marionette lines?

You can minimize marionette lines with various cosmetic procedures and treatments. Most of these options don’t require surgery or incisions.

Instead, healthcare providers use injections, peels, lasers and threads to minimize marionette lines. But these cosmetic treatments are temporary. The effects will wear off, and you’ll require additional sessions.

Treatment options include:

• Botox.
• Chemical peels.
• Dermal fillers.
• Laser skin resurfacing.
• Microneedling (collagen induction therapy), which increases the production of collagen to add volume and improve lines.
• Thread lift.

What is the best filler for marionette lines?

Dermal fillers temporarily add volume to your face to smooth out lines and wrinkles. There isn’t one filler that’s best for marionette lines. In general, dermal fillers may help with mild to moderate marionette lines. But they might also create an unnatural look.

Can surgery get rid of marionette lines?

If you have deeper marionette lines, your healthcare provider may recommend a full or mini-facelift (rhytidectomy). During a full or mini-facelift, your surgeon makes incisions to remove and lift your skin. This surgery requires a longer recovery than the other options for marionette lines, such as fillers or injections.

How can I prevent marionette lines or other signs of aging?

You can’t completely prevent marionette lines from forming, as they naturally occur with age.

However, you can prevent marionette lines and other wrinkles from worsening by following healthy living tips:

• Drink water to stay hydrated.
• Eat foods with nutrients, such as fruits and vegetables.
• Get enough sleep.
• Quit smoking.
• Manage stress.
• Minimize caffeine.
• Use a face moisturizer.
• Wear sunscreen with SPF 30 daily.

What can I expect if I have marionette lines?

Various cosmetic treatments can reduce the severity of marionette lines and improve the look of your skin. Surgery is the only long-lasting solution for marionette lines.

How long do marionette lines last?

Marionette lines last forever. These lines become deeper as you age. With treatment, you can temporarily minimize the appearance of marionette lines.

What questions should I ask my healthcare provider about marionette lines?

If you have marionette lines, ask your healthcare provider:

• Are my marionette lines mild, moderate or severe?
• What are the best treatments for the type of marionette lines I have?
• Am I a candidate for surgery to treat marionette lines?
• What skin creams can minimize marionette lines?

A note from Cleveland Clinic

Marionette lines are wrinkles that extend from the corners of your mouth to your chin. Cosmetic treatments, such as dermal fillers, cosmetic peels and laser resurfacing, may temporarily get rid of or minimize marionette lines. Healthy habits can prevent these lines from worsening. Talk to your dermatologist or cosmetic surgeon about the best treatment and prevention options for you.