The lines running down from the corners of the mouth respond better when the support around them is restored rather than the line filled.
Marionette lines run downwards from the corners of the mouth towards the jaw. They are the change patients most often describe as making them look sad or stern at rest, regardless of mood, which is why they tend to bother people more than their depth alone would suggest.
They form from a combination of things: volume loss in the midface and around the mouth, descent of the tissue, loss of chin and jaw support beneath, and in some patients an overactive muscle pulling the mouth corners down. Which combination you have determines the treatment, and filling the line is rarely the whole answer.
At Dr Ellie Sateei’s London clinic the assessment covers all four. Results vary between individuals.
Where support is the issue, product is placed to rebuild the structure the mouth corner sits on, often at the chin and along the jaw as well as directly beside the line. Restoring that support lifts the corner and softens the line, using less product than filling the crease and holding better.
Where an overactive depressor muscle is pulling the corner down, botulinum toxin treats that directly and filler alone will not address it. That is assessed at consultation and treated separately.
Where the line itself remains after support has been restored, a softer product can be placed conservatively into it. The sequence matters, because filling first and assessing later is how the area around the mouth becomes heavy.
Treatment may suit you if you are looking to:
It is not the right treatment on its own where the dominant cause is a downward-pulling muscle, or where significant midface and chin support has been lost. In both cases filling the line without addressing the cause produces a poor result.
As an injectable treatment, it is not recommended during pregnancy or breastfeeding.
Treatment takes around 30 minutes, longer where the chin or jaw is treated alongside. Numbing cream is applied and most products contain lidocaine.
Mild swelling or bruising can occur and typically settles within a few days. Most patients return to normal activities immediately, and the result reads close to final within a week.
Duration depends on placement, generally nine to twelve months in the line itself and twelve to eighteen months where product is placed structurally at the chin or jaw.
| Treatment | London | Sevenoaks |
|---|---|---|
| Marionette lines | From £595 | From £555 |
| Chin filler | From £650 | From £595 |
| Anti-wrinkle injections | From £495 | From £395 |
New patient consultation, £195 at both clinics. If you go ahead with treatment on the day of your appointment, this fee is deducted from the cost of your treatment.Prices correct as published and subject to change.
“These lines bother patients out of proportion to how deep they are, because of what they do to a resting face. Somebody tells you that you look upset when you are perfectly content, and that stays with you. But the answer is rarely the line. It is usually the chin, the jaw and the corner of the mouth together, and sometimes a small amount of toxin in the muscle that is doing the pulling.”
Dr Ellie Sateei has over two decades of experience in dermatology and aesthetics.
From £595 in London. Your consultation is £195, deducted from the cost of treatment if you go ahead on the day.
Because they pull the visual line of the mouth corner downwards at rest. That is also why treating the muscle doing the pulling can help as much as filling the line.
Often, yes. The mouth corner sits on chin and jaw support, and restoring that support lifts the corner rather than only filling the crease above it.
Nine to twelve months in the line itself, and twelve to eighteen months where product is placed structurally at the chin or jaw.
Where an overactive muscle is pulling the mouth corner down, treating that muscle addresses what filler cannot. This is assessed at consultation.
Most patients return to normal activities immediately. Mild swelling or bruising can occur and typically settles within a few days.
Marionette line fillers are often planned alongside these.
Marionette lines have four possible causes and the line itself is rarely the most effective place to treat. The most useful next step is working out which combination applies to you, which may mean chin, jaw or muscle rather than the crease. Dr Ellie Sateei sees patients at her London.
Our London clinic is located at 91a New Cavendish Street, London, W1W 6XF
We serve patients from London, Kent and the home counties as well as from all over the world. Our London clinic sits in the heart of Marylebone, within easy reach of the West End by tube, while our Sevenoaks clinic in Ightham is moments from the M25 and M26 for patients across Kent.
