Oct 28 2014

A woman with youthful, attractive featuresFacial signs of aging are common complaints among our Orange County patients. Wrinkles, loose skin, and similar changes can not only make someone appear older, but they can also produce an expression of fatigue or anger, despite how someone truly feels or wishes to look. Marionette lines - creases that run downward from the corners of the mouth - are one such problem that our patients may wish to improve.

Luckily, there are multiple ways to address marionette lines, each with its own benefits. Depending on the severity of your lines and your preferences for treatment, anything from a facelift to non-surgical injections may be used to reverse this sign of aging. By familiarizing yourself with our treatment methods and consulting Dr. William Cohen, you can take your first steps toward a younger, more attractive look.   

Treatment via Facelift

A facelift is often the most direct and dramatic way to improve signs of aging in the lower portion of the face. Subcutaneous fat can be removed or redistributed, while the underlying musculature is repositioned and tightened. The skin is also trimmed and tightened, creating a smoother appearance that reverses the most common effects of aging from the mid to lower face. Due to the target treatment area, patients with marionette lines and other wrinkles around the nasolabial folds are particularly good candidates for a facelift.   

Is a Facelift Worth It?

Because a facelift requires surgery and addresses a relatively large area of the face, patients may wonder if a full facelift procedure is the best treatment option. If marionette lines are your primary concern, also consider the following factors:

  • Other signs of aging: A facelift is a fairly comprehensive procedure, designed to address multiple signs of aging from the middle of the face down to the upper neck. It is best reserved for patients looking to address a combination of problems, such as sagging skin, wrinkles, and creases.
  • Deepness of lines: If marionette lines are especially pronounced, a facelift may be the most preferable treatment option, as other methods may not reduce them satisfactorily. Alternatively, patients may wish to combine a facelift with other non-invasive follow-up treatments.
  • Ability to undergo surgery: Patients must be able to safely undergo and recover from surgery if a facelift is to be successful. Anyone with systemic disease, difficulty healing, bleeding complications, or uncontrolled diabetes may wish to consider a safer option. 

Laser Treatments

If patients wish to undergo a less invasive approach, our office provides a variety of laser treatments for skin and collagen renewal. The Cynosure® Affirm™ CO2 Laser, for example, may be used to stimulate superficial or deep collagen layers, thus promoting a smoother, more uniform appearance. Alternatively, Thermage® treatment utilizes radiofrequency technology to heat collagen under the skin, tightening it and stimulating new growth of cells.

Because laser treatments do not require incisions and typically achieve results gradually, through multiple sessions, patients can undergo treatment with very little worry or risk. These options are particularly well suited for patients who want to reduce their marionette lines subtly, while also rejuvenating their skin in the process. 

BOTOX® and Dermal Fillers

Like laser treatment, dermal fillers may also be used to correct individual signs of aging in a discrete area. However, whereas laser treatments promote the health of natural collagen, dermal fillers add additional volume under the skin, literally filling the areas where lines or winkles may have previously been. Depending on the nature of your marionette lines and your medical needs, your doctor can help you find a filler material that is safest and most effective for you.

Similarly, BOTOX® can provide extremely effective results for marionette lines. Since these lines are partially the result of relaxed ligaments near the mouth, BOTOX® can be used to temporarily tighten these ligaments once more, producing natural contours that are reminiscent of a young, healthy face. If you are satisfied with the results, additional injections may be given to further prolong the effects, with little risk to your health. 

Find the Right Treatment

It’s great to have a cursory understanding of your options, but it takes an experienced doctor to truly help you decide which treatment is best for you. Contact our office to schedule an appointment with Dr. Cohen, and arrive at a treatment plan that suits your individual cosmetic and medical needs. 

For medical issues, please call our office directly.

To: Advanced ENT and Facial Plastic Surgery


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