Facial Line Softening

Nasolabial and Marionette Line Softening

Topless Woman

Marionette lines (corner of the mouth) are long vertical wrinkles that traverse from the corners of the lips to the chin. They develop on each side of the chin as a result of the ageing process and other lifestyle factors. They get their name from marionette string puppets, which are known for having split jaws so puppeteers can open and close their mouths to make them give the appearance that they are talking. These creases often give the impression of a sad look to the face.

The skin around your mouth is thin, and as a result  it is particularly prone to wrinkling. These lines occur with age, smoking and genetics and can progress to form jowls later on in life. The combination of collagen breakdown and loss of elastin leads to the loosening of skin in the cheeks and lower part of the face.

People typically begin developing marionette lines in their late 30s or early 40s. Marionette lines are barely visible early on, but as time goes by these creases can become very deep and noticeable. 


Marionette lines can be treated with different non-surgical treatment options.


During the initial consultation, our Doctors at Hampstead Aesthetics will discuss these options with you and devise a bespoke treatment plan to achieve the best outcome.

Treatment options to get rid of marionette lines might include:

  • dermal filler injections

  • botulinum toxin injections

  • skin boosters

  • PDO Threads


Your treatment will start with an in-depth Medical Consultation with your Doctor. You will be able to discuss any concerns you may have about the procedure, and they will be able to suggest the most effective treatment strategy plan for your particular concerns.

It may be that Cheek Filler or Nasolabial folds could be treated prior to the marionettes.

The risks and benefits of any treatment will be discussed at length. 


If you are concerned about your Marionette Lines/ Nasolabial lines and would like a Consultation with one of our experts, they will be able to guide you and work out a treatment plan that effectively suits you.


The nasolabial fold is the deep crease running from either side of the nose down towards the corners of the mouth. Nasolabial folds are a normal part of human anatomy that everyone has. However, many people begin to notice them more significantly as they age. Over time, they can become deeper and may also sag.


With age, some people also develop fine lines next to the nasolabial folds. Still, others can develop lines that extend down even further to the chin. These are commonly known as marionette lines. Fat is lost from the cheeks, reducing skin volume and making the nasolabial  fold appear deeper. Repeated smiling or having a “big smile” may result in permanent, deep creases in this area.


Nasolabial folds become more noticeable due to a variety of factors. The factors include the following.

  • Loss of collagen. With age, the collagen in our skin diminishes. This makes the skin around the mouth and eyes look thinner and weaker than we are used to.

  • Loss of fat. As we age, we also lose some of the fat which is usually maintained in the cheeks. With this loss, parts of the face may appear saggy.

  • Sun exposure. Over time, constant and continuous exposure to the sun can cause skin damage. This may cause wrinkles and changes in the texture of the facial skin.


Due to the factors above, as the skin ages, facial expressions can cause deeper wrinkles. With less collagen and fat in the face, the skin is susceptible to more permanent changes. 


Other factors that play a role in skin ageing include the following.

  • Rapid weight loss or frequent weight fluctuations in weight

  • Smoking

  • Exposure to environmental pollutants


There are several treatment options for laugh or smile lines. The right treatment will depend on many personal factors, and what works for one person might not work for another. 


Dermal fillers

Often, dermal fillers are recommended as the first step toward diminishing the appearance of nasolabial folds. Deep nasolabial folds can be corrected through injections of dermal filler into the surrounding area, restoring the lost volume and softening the appearance of these creases. The goal of nasolabial fold injections is to even out the skin volume, leaving you with a smoother, refreshed-looking appearance


Our doctors can also inject fillers into the skin around the cheek, which adds volume to the area and lifts the skin. The treatment requires little to no recovery time. Some patients experience slight bruising. However, it is important to note that fillers are a short-term solution. Lasting six months to 2 years, with most lasting 6 to 9 months. 


PDO Threads

Correcting Nasolabial Fold lines using PDO threads is another non-surgical, minimally invasive cosmetic procedure designed to provide a more youthful facial appearance without leaving scars and with minimal downtime.

Procedure Time: 30 mins

Downtime: Nil

Onset of results: Straight away

Treatment Efficacy: 9-18 months

Side-effects: Possible swelling, bruising and mild tenderness

Anaesthetic: Topical Numbing Local anaesthetic cream

Technique: Needle or Microcannula


Before & After Results



Find the answers to your questions about facial line softening treatments with Hampstead Aesthetics.

If you would like to find out more, simply contact us for further information.

Treatment Option: Dermal Fillers Injections

Dermal fillers made with hyaluronic acid can be injected below the corners of the mouth to lift the smile and fill out minor creases. They replace the lost volume in your face by hydrating and treating deep wrinkles and folds, improving your skin’s health and youthfulness for a natural look. There is no downtime for this treatment and results are immediate, lasting 9 to 18 months.

Treatment Option: Botulinum Toxin Injections

Botulinum can be injected into the facial muscles to keep you from making the kinds of expressions that can cement marionette lines into place. In turn, your skin will become smoother with a reduced appearance in wrinkles. In order for botulinum injections to treat marionette lines, patients will need to repeat the treatment every 4 months.

Treatment Option: Skin Boosters

Skin boosters can help to gradually improve your skin’s condition, stimulating collagen production, hydrating the skin from the deeper layers, increasing elasticity, and reducing fine lines and imperfections. Unlike traditional dermal fillers, they are not injected beneath the skin to volumize or accentuate certain features of the face. Instead, they are injected directly into the dermis to hydrate and improve overall skin quality. At Hampstead Aesthetics we use STYLAGE HYDROMAX, a skin booster made of hyaluronic acid in a liquid form that gets injected in the cheeks, nose to mouth, chin, neck and décolletage areas. It contains a unique form of stabilized hyaluronic acid (HA) to plump and hydrate the skin, with results that have been proven to last up to 6 months. Skin boosters work best to prevent marionette lines, or to correct fine lines. They have a cumulative effect, so between 3 to 6 sessions every 2/4 weeks are recommended.

Treatment Option: PDO Threads

Correcting marionette lines using PDO threads is another non-surgical, minimally invasive cosmetic procedure designed to provide a more youthful facial appearance without leaving scars and with minimal downtime. PDO threads are used to lift and tighten the skin and the lower part of the face to remove deep lines and correct saggy cheeks. At Hampstead Aesthetics we use MINT PDO threads, the latest innovation from South Korea. They consist of a dissolvable suture made from a complex sugar called PDO (polydioxanone), which has been used in biomedical and pharmaceutical applications for many years because of its extremely safe profile. This material is non-allergic and non-antigenic and is also completely biodegradable, meaning the body completely absorbs the PDO material over time. This procedure consists in inserting the threads into the skin to lift it, providing an immediate rejuvenating effect. PDO threads also stimulates the production of collagen, which helps to regenerate the skin over time by increasing firmness, volume, and making the skin look younger. Before the treatment, a strong topical numbing cream is applied. After 30 minutes the treatment area is thoroughly cleansed and prepped. Local anaesthetic is injected into all the areas where the threads will be placed, so the patient does not feel any pain during the thread insertions. The PDO threads are inserted underneath the skin in the predetermined areas, and then lifted upwards to achieve an instant rejuvenating effect. Because the threads are dissolvable, the results will last about six months.