Marionette Lines: Botox or Filler? Which is Best?

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Marionette Lines: Botox or Filler? Which is Best? What’s the Difference?

So you’re sure of one thing: you’d like to get rid of Marionette Lines. But there’s something you’re not so sure of: What’s better for Marionette Lines: Botox or Filler? It’s a great question! After all, there are a few factors that go into choosing the best injectable for the lower face and around the mouth. Here’s all you need to know about Botox vs Filler for Marionette Lines:

How are Botox and Fillers Different? Which is Better for Marionette Lines?

Before we talk about the differences between Botox and Fillers, let’s talk about the similarities of cosmetic injectables. Both Botox and Face Filler:

  • Are top nonsurgical treatments to reduce wrinkles and fight aging
  • Offer minimal downtime, risk and recovery, unlike plastic surgery such as a lower facelift
  • Make use of an injection with a fine needle at predetermined points along the treatment area
  • Provide results quickly after treatment
  • Are temporary and require a treatment schedule to maintain results

What’s the Best Nonsurgical Treatment for Marionette Lines? 

If you’re considering Botox or Filler for Marionette Lines, here’s our general recommendation. In a nutshell, Botox is the treatment of choice when you want to stop the corners of the mouth from pulling down. On the other hand, a facial filler is appropriate when you’d like to restore volume to the area around the mouth.

But it bears repeating: this is solely our general recommendation. The real answer is that it depends on you. Put simply, a personalized treatment recommendation is extremely important for Marionette Lines. That’s because Marionette Lines are caused by different things. As a result, we recommend different approaches to treat them. In fact, sometimes, we might advise using Botox and filler together to address your concerns. Or we might suggest another treatment entirely. Let’s drill down further.

What Causes Marionette Lines? Which Treatment is Best for My Aging Concerns?

Also known as “Puppet Lines”, Marionette Lines extend vertically on each side of the bottom of the lips to the chin to form parentheses that frame the jawline. They typically appear in the 40’s and grow more static and deepen into creases and folds into the 50s and beyond. There causes include:

  1. Expression:  Everyone has an individual way of expressing themselves. On the mouth in particular, the depressor muscles cause us to frown. When this muscle group is activated over time, these expressions grow static. Add to that the one-two punch of gravity and aging, and the corners of the mouth become permanently downcast. If your concern is solely the corners of your mouth, we would typically recommend Botox placed in the depressor anguli oris (DAO) muscle.
  2. Facial Structure: Everyone has individual facial anatomy that contributes to how, why and the extent to which they develop Marionette Lines. As a result, there’s no one size fits all approach to diminishing them.
  3. Soft-tissue Volume Loss: As we age, skin grows thinner and we lose fatty tissue in the face. As a result, the skin no longer sits smoothly on the face and our skin sags and gets loose. This causes wrinkles, creases and folds on the lower face. When this happens, a dermal filler is a great volumizer, when placed around the mouth. However, it depends on the extent of aging on the face. Facial fillers are unlikely to correct extremely deep folds around the mouth that result from advanced aging. In this case, Ultherapy may be a more appropriate option. 
  4. Bone Loss: As we age, our bones become thinner, and the skin no longer has a sturdy structure underneath it to hold it in place. As a result, we develop skin laxity and volume loss. A dermal filler in the cheek area can rebuild this structure temporarily, as well as lift the jowls and smooth the skin.  Additionally, Ultherapy Lower Face Lift can restore the coveted V-Shaped contour of youth, and, thus, diminish the appearance of Marionette Lines.

Take an in-depth look at Ultherapy

Can Botox Fill in Marionette Lines? How Does Botox Work?

No. Botox by Allergan does not restore volume. It works by relaxing and softening the muscles around the mouth, so they can no longer pull down the mouth. Botox is an injectable form of the neurotoxin botulinum toxin. It was the first injectable to be approved by the FDA in the 1980’s. Other neurotoxin brands include:

  • Dysport (Galderma)
  • Xeomin (Merz)
  • Jeaveau (Evolus)

Take an in-depth look at Botox

What are the Different Types of Dermal Fillers?

While the world of Botox injectables is pretty straightforward, there’s a greater variety of dermal filler types. Different fillers for the face can be broadly separated by their brand and active ingredient:

Hyaluronic (HA) fillers (most commonly used):

  • Juvederm (Allergan): Juvederm Ultra Plus, Ultra, Voluma, Volbella, Vollure
  • Restylane (Galderma): Restylane Lyft, Defyne, Refyne, Silk, Kysse
  • Belotero (Merz): Belotero Intense, Volume, Balance and Soft

Calcium Hydroxylapatite Filler 

  • Radiesse (Merz) 

Polylactic Acid Filler 

  • Sculptra (Aventis) 

Take an in-depth look at Face Fillers

How Much Injectable Do You Need for Marionette Lines? How Many Botox Units? What’s the Filler Cost?

The amount of injectable and, thus, the cost, depends on each patient’s individual anatomy, as well as desired treatment outcomes. We always recommend determining Botox and/or Filler price in consultation with your physician. 

Where to Find a Botox Doctor in NYC? Where to Get Face Fillers Near Me?

As we said above, Marionette Lines require expert guidance to treat. Put simply, you get that at Smooth Synergy. Specifically, our Medical Director, Dr. George Liakeas, has close to 20 years experience administering cosmetic injectables on thousands of patients. He’s a trusted medical physician with a keen eye for aesthetics. He has a knack for understanding the face and knowing where to place injections to make you look your best. He can help you decide whether Botox or Facial Filler will help you achieve the results you’re looking for.

Why Choose Smooth Synergy Medical Spa in NYC?

Smooth Synergy Medical Spa & Laser Center in New York is a boutique cosmedical spa that opened in 2002. Conveniently located in Midtown East, we offer a comprehensive line of cosmetic injectables. To experience our expertise and to find out which cosmetic  injectable is right for you, please call us at 212-397-0111 to speak with an Expert in Beauty. We offer complimentary consultations for all your skincare needs.

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