Marionette lines are the vertical lines that run downward from the corners of your mouth toward your chin. Filler in this area lifts the corner of the mouth, supports the surrounding tissue, and softens the line itself. Most clients need around 1ml of filler total for a first treatment. Results last 12 to 18 months. The visual change is often more impactful than the same dose used in the nasolabial folds, because the marionette area carries so much of how rested or tired a face looks.
I am Cristina Pardo, an NMC-registered aesthetic nurse practitioner in Norwich. This post explains what marionette lines are, why filler works so well for them, and the small technical detail that determines whether the result looks natural or strange.
What marionette lines are and why they form
Marionette lines are named after the strings on a marionette puppet. The lines drop down from the corner of the mouth toward the jaw, framing the lower face. As we age, the lines tend to deepen because of two simultaneous changes: tissue volume loss in the lower cheek, and a downward pull from the muscles around the mouth.
Most people start to notice them in their late 30s or 40s. They tend to deepen unevenly. The dominant side of the face usually shows the line first.
The visual effect is often described as looking tired or sad even when the person feels neither. The line creates a downturn at the corner of the mouth that the brain reads as a slight frown.
Why filler works so well in this area
Marionette lines respond to filler for a slightly different reason than nasolabial folds do. The filler does not just fill the line. It lifts the corner of the mouth back to a neutral position. Once the corner is supported, the line itself becomes less visible because the downward pull is reduced.
This is why small amounts of filler in the marionette area can give dramatic visual change. The mechanical lift matters more than the volume.
Compared to the nasolabial folds, the marionette area requires less product. 0.5ml to 1ml is often enough for a first treatment. Anything more than 1ml usually starts to over-volume the lower face.
Who suits marionette filler
Clients with visible downturn at the corner of the mouth. The classic candidate is someone who looks slightly sad in repose, even when their mood is fine.
Clients with moderate volume loss in the lower face. The filler integrates with surrounding tissue and provides support.
Clients who have considered Botox but found it did not address this area. Botox to the downturning muscles (the depressor anguli oris) can complement filler beautifully, but it does not address the volume component on its own.
The combination that works best
Marionette filler often pairs with a small amount of Botox to the depressor anguli oris (DAO) muscle, the muscle that pulls the mouth corner downward. The filler supports the corner from below, the Botox relaxes the muscle pulling it down.
For most clients, the combination gives a more complete result than either treatment alone. The recommended timing is to start with the filler, assess at 2 weeks, and add a small dose of Botox if the downward muscle pull is still visible.
Anti-wrinkle injections at Pardo Medical Aesthetics launch in September 2026, so combination treatments will be available from that date.
What the appointment looks like
Free video consultation first. We assess the area on camera, talk through the realistic outcome, and plan the volume.
In-person appointment runs around 45 minutes. Numbing cream for 15 minutes, careful marking, then the treatment itself. Most marionette filler uses a cannula rather than a needle. The cannula enters through a single small puncture near each mouth corner and distributes product into the area beneath the line.
You see the result immediately. Mild swelling for 24 to 48 hours is normal. Final result at day 7. Photo review at 14 days.
Frequently Asked Questions
Most clients need 0.5ml to 1ml total across both sides. Anything more than 1ml in a first treatment is usually too much.
12 to 18 months for most clients. The area moves less than the lips, so the product holds longer than lip filler does.
Mild discomfort. Numbing cream and lidocaine in the product make it easy for most clients. Bruising risk is low with cannula technique.
Not at conservative dose. Over-volume in this area is the most common error and it does create a heavy lower-face look. I will not place more than 1ml in a first treatment and most clients never need more.
Yes, frequently. The two combine well because the lip and marionette areas relate to each other anatomically. We plan the doses together.
Marionette lines filler is £240 per ml at Pardo Medical Aesthetics. Mobile within the 15-mile Norwich service zone, no travel charge.
Related treatments at Pardo Medical Aesthetics
Written by Cristina Pardo, NMC-registered aesthetic nurse practitioner at Pardo Medical Aesthetics. Mobile aesthetics across Norwich and Norfolk. Read more at JCCP guidance on dermal fillers for further reading.
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