Understanding the “Marionette Lines” The Overlooked Sign of Aging
While “marionette lines” may not be as easily noticeable early on compared to smile lines or under-eye wrinkles, they significantly affect facial balance and youthfulness—especially in those starting to notice drooping mouth corners or a tired expression, even when the face is relaxed.
Understanding marionette lines early on can help you manage and prevent premature facial aging before it becomes obvious.
What are marionette lines and where are they located?
What causes marionette lines?
Marionette lines are the deep creases that extend diagonally from the corners of the mouth down toward the jawline. These occur due to changes in the fat, muscle, and collagen layers under the skin around the mouth and jaw. As we age, the skin becomes thinner, muscles weaken, and fat either shifts or diminishes—leading to deeper creases in this area.
Typically, marionette lines begin to appear more noticeably in the late 30s to early 40s. However, some people may develop them earlier if their lifestyle accelerates skin deterioration, such as poor sleep, dehydration, smoking, or skipping sunscreen regularly.
How to identify marionette lines
The term “marionette lines” comes from the resemblance to the lines seen on marionette puppets — those vertical creases that run from the corners of the mouth down to the chin, mimicking the way a puppet’s mouth moves. In aesthetic medicine, the term is used to describe similar lines on the human face that can create a sad or aged appearance.
These lines become more apparent with age, especially when the face is at rest—not smiling—making the person look sad or moody. They often appear alongside other signs of aging, such as:
- drooping lip corners which make the face look sad and tired
- Fine lines around the mouth, which further add to the aged appearance
- Nasolabial folds (Smile lines) , or smile lines that run from the nose to the mouth corners, which often appear together with marionette lines after the age of 35
Why do marionette lines make you look older?
Even though marionette lines are not located at the center of the face, they can strongly affect how youthful you look:
- They create a “sad” expression
Lines extending downward from the mouth can make the face appear unhappy or displeased even when relaxed. - They affect facial symmetry
Uneven lines on both sides may make the face look slightly lopsided or unbalanced. - They age the appearance
Sagging skin and pronounced creases can make the face look older, even without wrinkles elsewhere. - They impact makeup application
They impact makeup application
Are marionette lines the same as smile lines?
People often confuse marionette lines with nasolabial folds (also known as smile lines) since they often appear together. Both are caused by similar factors—sagging skin and the degradation of fat and collagen in the lower face.
However, nasolabial folds are above the mouth corners, while marionette lines are below. When both lines appear together, they can make the face look significantly more tired and aged.
What can you do to fix marionette lines and sagging mouth corners?
Marionette lines can be directly addressed with treatments such as dermal filler injections or skin-tightening procedures. These help prevent skin from sagging and delay the development of deep wrinkles on the face in the future.
Fillers to treat deep facial lines
What Is Marionette Line Filler Injection and How Does It Help?
Marionette line filler is one of the most popular methods because they provide immediate results. This involves injecting hyaluronic acid (HA) fillers — a substance naturally found in the body — into the area below the corners of the mouth to smooth out deep creases, restore firmness, and rejuvenate a youthful look.
You can see visible improvement in the marionette lines right after the injection. The filler fully settles within one month, and the results typically last about 8–12 months before naturally dissolving.
Marionette line filler program reviews:
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[Marionette line filler program]
[Marionette line filler program]
One of the advantages of getting filler injections at MEGA CLINIC is the convenience — no downtime, fast and visible results, and you can go about your day right after the session. Our skilled doctors assess your condition and plan the treatment precisely. We also use only authentic products, which clients can verify before injection — ensuring both safety and effectiveness.
Skin tightening treatments for sagging skin
What Is Ultraformer III and How Does It Help with Marionette Lines?
Ultraformer III is a skin-tightening device that uses MMFU (Micro and Macro Focused Ultrasound) technology. It targets the SMAS layer — the same deep tissue layer that plastic surgeons lift during a facelift — to firm and lift the skin.
This treatment is ideal for those starting to notice sagging skin or those who want to prevent deep lines like marionette lines. It helps lift and support the skin structure around the mouth corners and jawline, improving overall facial firmness.
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After Ultraformer III , you’ll notice an immediate tightening effect of 10–20%, with continued improvement over the next 2–3 months as collagen production increases. The results last about 6–8 months, and follow-up sessions can be done to maintain the results.
Free consultation for marionette lines
If you’re starting to notice deep lines around your mouth or feel concerned about looking tired, aged, or less vibrant, it’s a good idea to consult with a specialist early on. A professional can help evaluate your facial condition and recommend suitable treatment options, whether it's filler injections or skin-tightening procedures, to address your concerns effectively.
MEGA CLINIC has multiple locations covering key areas in Bangkok and nearby provinces:
- MEGA CLINIC Siam Square (Bangkok)
BTS Siam, located at the open area near Inter Restaurant Parking available in front of the clinic - MEGA CLINIC Central WestGate (Nonthaburi)
MRT Talad Bang Yai, located on 2nd floor, Central Westgate (Central zone) - MEGA CLINIC Central Ladprao (Bangkok)
BTS Ha Yaek Lat Phrao / MRT Phahon Yothin Located on 9th floor, Central Ladprao (Use Entrance C elevator) - MEGA CLINIC Future Park Rangsit (Pathum Thani)
Located on G floor, Future Rangsit (Robinson zone, next to Watsons) - MEGA CLINIC Pak Nam BTS Srinagarindra (Samut Prakarn)
BTS Srinagarindra, next to Exit 4 staircase Parking available in front of the clinic
Our clinic is easy to reach (view maps) and offers a full range of beauty treatments, including filler programs, Botox programs, skincare, facial lifting programs, anti-aging solutions, and even weight-loss programs. We also provide free consultations with doctors before you decide on any treatment.
For more details or to book an appointment, message our admin team via LINE Official: @megaclinic (with @). Click the green “Add LINE” button at the bottom of the screen.