“Marionette Lines” are the lines that run from the corners of the mouth vertically downwards towards the chin. They are named “marionette” because they can make you look like a marionette puppet if the creases are deep enough. They are caused by repeated movement of the mouth, coupled with the loss of fat and skin elasticity that occurs naturally as part of the aging process. Lost skin volume causes lines to turn into deeper creases. They tend to give the mouth a down-turned look as if you are frowning even when you are not. Many people feel these lines make them look sad, tired, or older than they truly are. The dose required for marionette folds is variable. It depends on the anatomy and the desired result.
The doctor will assess the face and decide on the best dose after taking a history and examining you.