Tweakment Finder TWEAKMENT



Marionette Lines

Written by: Alice Hart-Davis

Last Updated: 22 September 2023

What are marionette lines?

Marionette lines are lines that run down vertically from the corners of the mouth towards (or to) your chin. They get their name because if you imagine a wooden puppet or ventriloquist’s dummy, those are the lines where the mouth block would drop when it is ‘talking’. How can you soften them? Scroll down for all the FAQs.

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What causes marionette lines?

Marionette lines settle in for all the same reasons as any other lines;

. The fat underlying your skin helps to plump it up and keep your skin taut. As your face loses fat, the skin has less support, which contributes to it sagging. Practitioners call this ‘soft tissue volume loss’.

. As you age, the bones of your skull gradually lose volume. In your face, the effect of this bone loss is a gradual loss of support for the fat and skin. You’ll hear practitioners call this ‘bony resorption of the mandible’.

. As the ligaments that support the area around your chin and mouth grow looser with age, your chin gradually heads for the floor.

. As it gets older, your skin loses its elasticity, so it stretches and sags.

. As wrinkles develop, incipient lines become more obvious.

While the above five problems all contribute to lines elsewhere on your face, neck, and body, marionette lines are a particular menace, because once they become etched on your face, they give it a permanently grumpy look and drag the corners of your mouth downward.

Why do I have marionette lines?

Apart from the five factors explained in the following section, the following five habits and factors may contribute to you developing marionette lines:

  1. If you frequently pull faces in the wrong way, that may make the marionette lines worse. For example, if you habitually pull down the corners of your mouth, that action will deepen your marionette lines. Don’t laugh – it’s true. (Actually, do laugh – laughing stretches your skin in a different direction – but don’t grump or gurn.)
  2. You’re probably sick of reading about the ravages that sun exposure wreaks on your skin – but applying the SPF regularly remains one of the easiest things you can do to help keep lines and wrinkles at bay.
  3. It’s no secret that smoking is dreadful for the skin. Enough said.
  4. You don’t actually need to drink those much-ballyhooed eight glasses of water a day, but adequate hydration is vital to keeping your skin in good condition.
  5. Even if you can tick off the previous four points – you stay hydrated, you don’t smoke, you slather on the SPF automatically, and you avoid grimacing – you may have deep marionette lines programmed into your genes. If so, read on to explore your options for dealing with the lines.

Can I use toxins to treat marionette lines?

Yes, anti-wrinkle injections such as toxins can help — especially if pulling faces is contributing to your marionette lines. A touch of toxins in the muscles that pull down the corners of your mouth will damp down this expression, thus helping to reduce your marionette lines.

As usual with using neurotoxins in the face, you’ll want an experienced practitioner with a deft touch who can inject the right muscles with an appropriate dose to limit the muscles’ movements without freezing them fully. The toxin will take between one and two weeks to reach its full effect, so don’t expect instant results.

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What is the best treatment serum or cream for marionette lines?

Try a vitamin C serum in the morning, and a retinol product at night.

  • Vitamin C serum: As you know, collagen is the protein that gives your skin its structure and firmness. As you grow older, the fibroblast cells in your body that generate collagen slow down. This means that your skin doesn’t repair itself as fast or as well as it did before, so it becomes less resilient, and lines gradually become embedded in it. Adding a vitamin C serum into your regime, straight after cleansing in the morning, helps slow down the damage and stimulate the production of new collagen.
  • Retinol. Retinol is part of the retinoid family and is chemically related to vitamin A. Retinol can be transformative for the skin because it kick-starts collagen production and at the same time reduces the rate of collagen breakdown in the skin, so your existing collagen lasts longer, and new collagen is made faster.

There is an enormous number of these products available. Consult your practitioner for a specific recommendation of a cream or serum that will be suited to your skin or pick one of my recommendations, like:

Skinceuticals CE Ferulic

This serum, which combines vitamin C with vitamin E and Ferulic Acid, has become a skincare classic. If you have the cash to splash, it is a brilliant choice.

Medik8 Retinol 3TR

If you are new to retinol, this is a great product to start with. It’s a brilliant product, with a gentle formula that pretty much anyone should be able to use, and a time-release factor which slowly dispenses retinol into your skin.


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FAQ ABOUT Marionette Lines

Can I use filler for marionette lines?

Yes, dermal fillers can help with marionette lines. This, too, is a subject about which you should consult your practitioner.

Depending on how deep your marionette lines are, your practitioner may choose to use a thicker, longer-lasting type of filler to treat them. The advantage of thicker fillers is that they last longer than thinner fillers, so you won’t need to have the treatment repeated as frequently. The disadvantage is that thicker fillers must be injected deeper into your skin to avoid lumpiness, whereas thinner fillers can be injected closer to the surface of the skin without producing lumpiness.

Which filler your practitioner will use is likely to depend on your facial anatomy and the depth of the marionette lines. The practitioner may also recommend using fillers to augment your cheekbones, which may sound like a bizarre strategy for treating the lower face, but actually it works a treat, by raising everything below the cheek a fraction – and that may be enough to soften the appearance of your marionette lines.

Can I use microneedling for marionette lines?

Yes, clinical microneedling is a great treatment for stimulating the growth of new collagen in the skin. The tiny wounds created by the puncture marks made by the needles prompt a cascade of wound-healing substances within the skin, which nudge the skin into regenerating itself from beneath the surface. More collagen means skin that is more firmly supported from the inside, and which is better hydrated which means that it is plumper, too, and both of those factors will soften the look of the marionette lines.

Can I use laser for marionette lines?

Yes, laser is another option for treating marionette lines. Different practitioners prefer different types of lasers, but typical treatment would be to use a fractional laser to remove the damaged layers of skin in the marionette lines.

Fractional lasering fires the laser beam through a grid to create micro-channels of damage in the skin, which stimulate the growth of new skin. The laser treatment also stimulates the production of collagen, which gives your skin another boost.

Many practitioners use laser resurfacing and then follow up with dermal fillers, which boost your lasered-fresh skin from the inside.

How can I hide marionette lines with makeup?

Here are two main ways of minimising your marionette lines with makeup:

  1. Invest in a thicker sort of make-up primer. This will act like a type of cosmetic filler paste, and will literally fill in the lines and wrinkles on the face, creating a much smoother base surface on which to apply your normal foundation. These primers usually have formulas that include light-reflective particles so that light landing on the skin is refracted, which creates a slightly blurred effect, which also makes lines and wrinkles less obvious.
  2. Apply a lighter concealer to your marionette lines. Get some concealer that’s a shade lighter than your foundation shade. Make your face up as usual, but then apply the lighter concealer to your marionette lines. Blend in the lighter concealer gently with your finger or a brush; you’re aiming to create an optical illusion to counteract the shadow of the lines, but not to end up with a white stripe on your face.


Alice answers your question. Want to ask Alice a question? Pop it in here and check back in a few days for the answer.

Do you have any information on Viscoderm Hydrobooster?

This is a good HA-based injectable moisturiser if your face is showing the sort of lines that look etched into the skin on your forehead, or around your eyes or mouth. It has a nice, 'stretchy' consistency in the skin and is manufactured by IBSA Derma – the people behind Profhilo, so you can be sure of its safety and efficacy.

Hello, I'm in my mid-40's with increasing sagging (mainly drooping upper eyelids, jowls and marionette lines). I've had three Ultherapy procedures at a highly-regarded clinic over the past five years to lift and tighten my face and neck. The last...

Hi, I'm sorry to hear that you had no improvement from your last Ultherapy treatment – surgeons are not keen on it as, in pursuit of the skin, it can (as one put it to me), 'mash up' the layers under the skin which makes it more difficult for surgeons to work on – not impossible but it makes their job trickier. They see the same result from treatments like radiofrequency microneedling (Morpheus8 et al) though many surgeons will still use RF microneedling for non-surgical tightening as it is a safe and effective treatment for the right candidate. Thread lifts can reposition sagging jowls, but if cosmetic surgeons don't like...

Hi Alice, I wanted to ask you about marine collagen VS bovine collagen. I take Skinade and I think it helps me, however I saw your post and you mentioned something about bovine collagen being closer to human collagen? Will it help things like very...

Hello, yes, bovine collagen is derived from cows. I like the brand that I've brought into the TTG shop, Totally Derma and yes, that is bovine collagen. Either marine or bovine collagen should help your skin and hair and nails, as well as your joints. Will it help your smile lines? Hard to say, because smile lines show up more as a result of your particular facial physiology and the kinds of expressions you make (nothing wrong with smiling, we could all do with more smiling in our lives). Smile lines often become more noticeable as we age because our faces lose volume, so the skin sags forwards and down, hence the smile lines....

Hello, I am 48 and really starting to look old, especially when I look at photos. What do you recommend as the most effective way to look fresher and better without toxin or filler? Is it HIFU or profound or another treatment? Or would I really need...

Hiya, TTG editor Georgia here. Dr Strawford will be best placed to answer all these questions for you once he's assessed your face and talked to you about your exact concerns. He is an expert practitioner with a great deal of experience. The tweakments you mention – HIFU, Profound (RF microneedling), toxin, and filler – all do different things that work towards making you look fresher and younger, but not in the same ways. Toxin for example won’t do anything about sagging skin but HIFU will, Profound will stimulate collagen production to tighten and plump the skin, but won’t replace lost volume in the ways filler will. So it all...

Hi Alice/Georgia, I hope you’re both well. Which is the best treatment for marionette lines and jowls between Morpheus8, HIFU and Forma? HIFU is much cheaper up here (Yorkshire) so I think I’m going to have to opt for that. It’s £500 for a...

Hiya, Georgia here. Generally, I’d say that you shouldn’t be solely driven by price when it comes to choosing a tweakment, because this could indicate that the practitioner isn’t well-trained or experienced enough to perform the treatment safely and effectively. But £500 for one session isn’t cheap enough to ring alarm bells. You’ll likely get a nice lifting and line-smoothing result on the area with HIFU thanks to the deep collagen stimulation, but your real best bet will be to find a fab practitioner near you who can properly assess the area and give you their opinion on what will work best for you – RF microneedling (such as...

Please can you tell me if there is a home device (or two) which might help with the lines I have either side of my chin? Also, I have a burst blood capillary between my cheek and my nose, and am wondering if there are any devices/treatments that...

I fear that no home use device is going to be much help with those lines – it sounds like you may need a bit of filler. And home-use devices can't help with thread veins or a burst blood vessel, but a session or two of IPL or laser would help you clear that. Take a look at our Practitioner Finder to locate a great clinician in your area who could talk you through the options....

Hi Alice, I've just watched your video on Secret RF. I'm having the treatment in a few weeks. Did you think it's worth the money for the results seen? Thank you.

I only had one round of Secret RF when filming it (at my age, I'd need about three sessions to see proper results) so I only saw a bit of skin-smoothing. But I know from practitioners who have the device that they absolutely love it for the results it gives, so yes, I'd recommend it.

Monthly Hydrafacial or monthly Caci? I’m 43 with skin in reasonably good condition but starting to notice some signs of ageing, so planning to treat myself to a monthly facial.

Hiya, editor Georgia here. In an ideal world, budget permitting, you'd do both! HydraFacials are more geared towards extractions and hydrating the skin, improving surface issues like breakouts or dry skin. You do get some collagen stimulation from the LED light element but if your main concern is signs of ageing then I’d go for monthly CACI treatments instead. CACI is specifically for combatting signs of ageing by stimulating the facial muscles using electrical microcurrent. If you're new to CACI, you'll be advised to book a course of treatment and to have the first few treatments a fortnight apart. Find out more here....

Filler or toxin for marionette lines? I lost weight after cancer treatment which has left pronounced marionette lines.

Possibly a bit of both? Glad to hear that you are the other side of cancer treatment. Toxin helps by softening the muscles that exaggerate the marionette lines, and filler can prop up the areas around the mouth and chin that have lost bone (which just happens, over time) as well as fat. Find a great practitioner and ask their advice, they will know what's best for your particular face.

Which is better, the sensica or the nu face for marionette and crows feet?

Hi, they do rather different things. I'm a big fan of the NuFace devices for keeping up the tone and tautness of facial muscles. Sensica uses radiofrequency energy to heat and tighten the surface of the skin and smooth wrinkles that way - though if you're up for trying that I'd suggest the new Dermadeep RF Pro from Orlaya which is a lot more powerful albeit more expensive at £499.


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