Facial Ageing
Lines running from the corners of the mouth toward the chin that can give the lower face a downturned or unhappy look.
Physician-led assessment · individualized care · Vancouver clinic
Understanding Marionette Lines & Downturned Mouth
Has anyone asked if you're upset when you were perfectly content? Or have you noticed in photos that the corners of your mouth seem to turn down, even when you're relaxed? Marionette lines run from the corners of the mouth toward the chin, and because of where they sit, they can make the whole lower face look sad or stern without you meaning it to.
They deepen gradually as the fat in the lower cheek settles, the small ligaments that hold tissue in place loosen, and bone support along the jaw and chin softens. A muscle that pulls the mouth corners down can add to the effect. The good news is that restoring support to the surrounding area, and sometimes relaxing that downward pull, can lift the corners of the mouth and bring back a softer, more approachable look.
Causes and Contributing Factors
Marionette lines form where mobile tissue around the mouth meets firmer tissue toward the chin and jaw, so they deepen with years of normal expression. Contributing changes include age-related loss of skin collagen and elasticity, reduced and downward-shifted fat in the lower cheek, loosening of facial ligaments, and loss of bone support along the jaw and chin. Muscle activity that pulls the mouth corners down, sun exposure, smoking, and weight change can add to the effect, and genetics strongly influence how early and how deeply they appear.
Signs and Symptoms
Assessment
At Anti-Aging Medical & Laser Clinic, injectable treatments are performed by our experienced physicians. Our cosmetic consultants may help with your initial assessment and planning, while the treating physician reviews your suitability, confirms the medical plan and performs your treatment. Together we look at your whole lower face: cheek position and volume, skin quality, support along your jawline and chin, the muscles that pull the mouth corners down, and how the lines change when you talk and smile. Your plan focuses on the expression you want to see in the mirror, with timing and a budget that work for you.
Cosmetic consultations are complimentary.
Prevention and Ongoing Care
Healthy skin around the mouth and chin makes any treatment look its best. Daily sunscreen protects collagen, a retinoid or peptide serum improves texture and firmness between visits, and a hydrating moisturizer keeps the skin smooth. Our team can suggest a routine, and our professional skincare is available in our online shop.
Treatment Options
These are some of the options connected to this concern. The appropriate plan depends on assessment, suitability, and your goals.
We look at the wider lower face, so the result blends naturally with your features. Our experienced physicians use Dermal Fillers & Facial Contouring to restore support to the cheek, chin and jawline, with hyaluronic acid fillers such as Juvéderm, Restylane, Belotero or Revanesse, or collagen-building Sculptra, Radiesse and HarmonyCa. A small dose of neuromodulator can relax the muscle that pulls the mouth corners down, and a Thread Lift with APTOS Threads or Silhouette InstaLift can lift settled tissue in selected cases. Emface, a needle-free muscle-toning treatment performed by our senior laser technicians under the medical direction of Dr. Gidon Frame, may also play a part. Each option has its own longevity and maintenance, explained on its technology page and in your personal plan.
Uses injectable fillers to restore or reshape facial volume and contour, selected for the structure and balance each area needs.
Uses botulinum toxin type A to temporarily relax selected muscles, softening dynamic lines and helping certain muscle- or sweat-related concerns.
Uses absorbable barbed threads to reposition and lift facial tissue, with a gradual collagen build as the threads absorb.
For the fuller picture, explore the treatment pages above or discuss the options during a consultation.
Many patients need only one of these. Your plan combines them only when a combination adds to your result.
Medical Assessment
See a doctor promptly if you notice sudden one-sided drooping or weakness of the face, difficulty moving part of the face, new asymmetry, or a lump or skin change near the mouth or jaw. These changes have causes other than ordinary aging and are best assessed first.
Frequently Asked Questions
A downturned resting look usually comes from a mix of deepening marionette lines, changing support in the lower cheek and jawline, and the pull of muscles that draw the mouth corners down. Each person's mix is different. At your consultation we'll show you which factors matter most for you.
Because they come from normal movement and lower-face structure, the aim is to soften them so your expression looks relaxed and natural. Individual results vary, and we'll give you a clear picture of what to expect for your face.
Marionette lines often reflect changes in the support around them. Restoring that support to the cheek, chin and jawline helps the result blend with your features and look like you. We'll talk through the approach that suits your anatomy.
Physician Assessment
An assessment can help clarify what may be contributing, which options may be appropriate, and what a reasonable next step could look like for you.
Visit Our Clinic
Anti-Aging Medical & Laser Clinic combines medical assessment, individualized planning, physician oversight, and a broad range of treatment options in its Vancouver clinic.
Bring your questions, treatment history, and goals. Your provider can help you understand appropriate options, expected recovery, and realistic outcomes.
Make an Appointment
Use our consultation form below and the clinic can guide you toward the appropriate starting point.
