Plastic Surgery 101

Getting rid of marionette lines

Q. I am tired of people telling me I look sad or angry. My lower lip seems to be going down on the sides. I believe it’s the area that people call marionette lines. Is there something I can do that is not surgery? Please tell me so I can get rid of the Grinch before the holiday season.

The Grinch will be gone with a few easy steps. Marionette lines are the lines on the lateral side of your lower lip. They are there because of droopy skin and because of an active Depressor Anguli Oris muscle. The muscle tends to pull down the corners of the mouth, thereby accentuating the Grinch look. In general, this area may be treated with fillers such as Restylane, Perlane, Juvederm, Radiesse and Sculptra. While these fillers alone or in combination do a good job to improve this area, I have another little trick for patients who have a pronounced marionette area.

While fillers improve add volume, Botox and Dysport improve the look by diminishing the muscle movement. This procedure must be done by an experienced injector who knows the anatomy of the facial muscles integrally. In other words, don’t go for price and coupons on this procedure as your smile may end up crooked. A small amount of Botox or Dysport will reduce the muscle movement and direct your smile and lateral lips upward. Needless to say, this is an off-label procedure that, when done right, will enhance your holiday smile.

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