Marionette lines filler in Rotterdam

What are marionette lines?

The name comes from marionettes, puppets with a hinged jaw that hang on strings. In people these lines develop gradually, usually from around forty. At rest they quickly give the face a stern, tired or sad expression, even when you do not feel that way at all.

Several causes play a role. Volume around the mouth and chin decreases, the skin loses firmness and the cheeks descend slightly, adding weight next to the mouth corner. In addition, a small muscle below the mouth corner pulls the corners downwards. That is why marionette lines often go together with downturned mouth corners. Genetics, smoking, a lot of sun and weight loss also influence how early and how deep marionette lines develop.

How filler softens marionette lines

The doctor places a soft to medium-firm hyaluronic acid filler, for example from the Juvéderm or Restylane range, beneath the line and under the mouth corner. This fills the groove and supports the mouth corner from below, so it points down less. A small correction to the chin or jawline often helps to make the transition smooth.

Because the mouth moves a lot, the doctor works with small amounts here. Too much filler around the mouth quickly looks heavy. With pronounced marionette lines, two calm steps can be better than one session.

If the mouth corners droop mainly because of muscle action, combining filler with a muscle relaxant in that small muscle below the mouth corner can support the result. The doctor will discuss at the consultation whether this makes sense for you.

Marionette lines treatment is available from €250 per ml. The price is agreed with you beforehand at the free consultation.

Marionette lines before and after: what is realistic?

We do not publish before-and-after photos on the website; at the consultation the doctor can show you examples. A realistic result is that the lines are clearly softer at rest and the mouth corners sit more neutrally. Deep lines usually do not disappear completely, especially with lax skin. You look friendlier and fresher, without it being obvious that you have had something done.

Preventing marionette lines, and options other than filler

You cannot prevent marionette lines entirely, but you can limit how quickly they deepen: daily sun protection, not smoking and good skincare help keep the skin firm for longer. A cream cares for the skin but does not fill a fold. There is little evidence that facial exercises visibly reduce marionette lines.

Besides filler and a muscle relaxant, some treatments mainly improve skin quality and firmness, such as a skin booster (Profhilo) or a biostimulator (Radiesse or Sculptra) that stimulates your own collagen production. These add little immediate volume and are often combined with filler. If the whole face plays a role, for example the cheeks and jawline as well, a liquid facelift may be more suitable than filling the lines alone.

With a lot of skin laxity or pronounced jowls, surgery such as a facelift gives more result than injections. In that case we will tell you honestly and advise you to consult a plastic surgeon.

Who is it suitable for?

Suitable for women and men aged 18 or over. Not during pregnancy or breastfeeding and not with an active skin infection or cold sore around the mouth. With a lot of skin laxity or pronounced jowls, filler can only help to a limited extent; the doctor will tell you honestly. The treatment often suits:

• visible lines from the mouth corner to the chin at rest
• downturned mouth corners that give you a stern or sad expression
• volume loss around the mouth and chin

How does the treatment work?

1. 01

   Free consultation

   The doctor looks at your face at rest and while you talk, and explains whether filler, a muscle relaxant or a combination would help most. You receive a fixed price.

2. 02

   Preparation

   The skin is cleansed and disinfected. The filler contains a local anaesthetic; numbing cream can be used if needed.

3. 03

   Treatment

   The doctor places the filler with a fine needle or blunt cannula in small amounts. This takes about 30–45 minutes.

4. 04

   Free check-up after two weeks

   After two weeks the filler has settled. At the free check-up we assess together whether a small top-up would be worthwhile.

Aftercare and possible side effects

Mild swelling, tenderness and a bruise can occur and usually fade within a few days. You can reach the doctor via WhatsApp if you have questions. Serious complications are rare; very rarely, filler can block a blood vessel (vascular occlusion). The doctor knows the anatomy and knows how to act immediately. Contact us straight away if you notice increasing pain or pale, bluish or blotchy skin.

• for the first 24 hours: no exercise, sauna or alcohol
• no make-up on the injection points on the first day
• do not massage around the mouth in the first week
• cool the area during the first few hours with a cold compress wrapped in a cloth to reduce swelling
• no peel, laser or microneedling in the treated area for the first two weeks