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GuideMarionette lines

Guide · Marionette lines

Marionette line fillers in Berlin

Marionette lines run from the corners of the mouth towards the lower jaw. If you would like to soften these lines, I assess the corners of your mouth together with your cheeks, chin and skin firmness. A single deep line alone does not tell us which treatment is right for you.

Understand your concernsCosts at a glance

With a personal perspective from Andrea CalettiSpecialist in Plastic and Aesthetic Surgery · Berlin

Adult woman with visible lines running from the corners of her mouth to her chin
Understanding your wishes and taking time to weigh up the options.

The short answer

When can hyaluronic acid help?

Hyaluronic acid can soften the transition below the corners of the mouth where there is suitable volume loss to address. If tissue has sagged significantly or there is excess skin, filling alone is often not enough. Muscle pull at the corner of the mouth can also play a part, but needs to be assessed separately.

  1. Identify the lines correctly

    Marionette lines lie below the corners of the mouth, while nasolabial folds lie above them.

  2. Look at the surrounding area

    Volume distribution and tissue position influence the visible course of the lines.

  3. Accept the limitations

    Adding more filler is not a substitute for a surgical lift.

From your wishes to a clearer understanding

Understanding marionette lines in more detail

The following distinctions can help you make sense of what you have noticed and prepare relevant questions for your consultation.

01Assessment

Marionette lines, ‘Merkel lines’ and the muscle that lowers the corners of the mouth

These informal names describe an appearance, not your mood.

Understanding the connections

Ageing and genetic predisposition change the skin, volume and support of the lower face. The muscle that lowers the corner of the mouth, also known as the DAO, can exert an additional downward pull. However, not every marionette line is primarily a muscular issue.

The horizontal crease between the chin and lower lip is anatomically different. I therefore look at the whole mobile area around the mouth, without drawing conclusions about your feelings from its shape.

02Treatment plan

Inject the lines directly or support volume in neighbouring areas?

A targeted correction is planned according to the findings, not a fixed amount per line.

Understanding the connections

Where there is localised volume loss, hyaluronic acid can support the contour. If neighbouring areas also lack volume, we discuss whether it makes sense to include them. A so-called liquid lift refers to this type of volume restoration with filler and is not surgery.

Treating the cheek does not reliably lift the corners of the mouth in the way a surgical lift does. Too much material can broaden the lower half of the face. I therefore explain the limits of a subtle correction and what alternatives are available.

03Limitations

When excess skin or muscle pull is the main factor

Not every pronounced line can be appropriately treated by adding volume.

Understanding the connections

If the degree of tissue sagging warrants it, a facelift consultation may be helpful. Surgery remains a voluntary choice, with its own scars, risks and recovery times. There is no obligation to have surgery instead of unsuitable filler injections.

Limited use of botulinum toxin in the muscle that lowers the corner of the mouth may be considered in selected cases. This is usually off-label and can alter your smile or mouth function. It does not replace volume restoration or a lift.

Comparing procedures

Which option suits which findings?

The choice is guided by the examination and your wishes. Benefits, limitations and recovery are discussed for the specific procedure.

Hyaluronic acid fillers

The aim
Restore volume where suitable.
The limitation
Cannot reliably lift significantly sagging tissue.
Recovery
Swelling and bruising are possible.

Muscle relaxation

The aim
Reduce the downward pull of the muscle at the corner of the mouth in selected cases.
The limitation
Off-label; risk of asymmetry and changes in function.
Recovery
The effect develops over several days.

Facelift

The aim
Reposition tissue where clinically appropriate.
The limitation
Surgery involving scars and its own risk profile.
Recovery
Longer recovery and aftercare.
Andrea Caletti during a personal consultation.A decision that fits your life

A closer look

A step-by-step approach to a softer contour

Before treatment, I examine the area around your mouth at rest and as you speak and smile. We discuss previous fillers, dental health, medication and expectations. You receive a plan in advance detailing the material, treatment areas and costs.

For filler injections, I choose a needle or cannula and the injection layer to suit your anatomy. Local pain relief is possible. Swelling affects the contour immediately after treatment; we decide on any further steps after a review.

  • The lines may be more pronounced on one side than the other.
  • Complete smoothing cannot be promised.
  • Any worries or a wish for time to think also have a place in the consultation.

Costs in Berlin

Costs and scope
for your planning

A small correction below one corner of the mouth and more extensive volume restoration involve different levels of treatment. The guide price below is not a fixed price for both sides. The quotation specifies the material, areas, preparatory treatments and further appointments.

Hyaluronic acid fillersHyaluronic acid treatment · depending on area and materialfrom €400

The treatment prices shown are guide prices for the scope described in each case. Before you decide, you receive a personalised cost plan detailing the scope of treatment, follow-up appointments and possible additional costs. Further areas or repeat treatments are not automatically included.

Discuss the scope of your treatment

Deciding together

Preparation, everyday life and aftercare

The advice for you personally depends on the findings, procedure and your progress.

  1. 01

    Preparation

    Tell me about any existing filler and prescribed medication; do not stop taking anything on your own initiative.

  2. 02

    Aftercare

    Allow for swelling and bruising, cool the area gently and avoid unnecessary pressure.

  3. 03

    Follow-up

    The result is assessed once the area has settled. Skincare and UV protection support the skin, but cannot prevent every further change.

Personal consultations in Berlin-Charlottenburg
Kurfürstendamm 200 · 10719 Berlin
c/o Vita Aesthetica

Contact & directions

An informed decision

Safety and risks
considered carefully

In the mobile area around the mouth, asymmetry, material that can be felt and unwanted changes in contour may become noticeable. Even a carefully performed injection cannot be guaranteed to be free of complications.

  • Swelling, bruising, tenderness or redness are possible.
  • Irregularities, nodules, infections and delayed inflammatory reactions can occur.
  • Rare vascular occlusions can cause tissue damage and serious consequences, including loss of vision.

When you need immediate helpSeek medical help immediately if you experience severe or increasing pain, unusually pale skin or a net-like pattern of skin discolouration. Any visual disturbances require immediate assessment by an emergency medical service or an ophthalmologist; do not wait until your follow-up appointment.

Dottore Andrea Caletti with a warm smile.

The doctor you will meet

Andrea Caletti

Specialist in Plastic and Aesthetic Surgery

I want you to recognise yourself in your appearance and feel comfortable with it.

My professional journey

Exploring the connections further

Lip lines

Fine vertical lines around the lip.

Nasolabial fold

The area between the nose and mouth.

Good to know

Frequently asked questions:
Marionette lines

A website can offer guidance. We will discuss your personal situation during a medical consultation.

Ask your question
01

How long do hyaluronic acid fillers last in marionette lines?

The effect usually lasts several months. The previously quoted guide of around eight to ten months is not a fixed duration. The product, amount used, movement and initial findings all influence how the results develop.

02

When will I see the result?

Volume changes immediately, although swelling may initially mask this. The result can be assessed properly once these reactions have settled; a follow-up appointment is arranged if needed.

03

Can I massage away marionette lines?

Massage and skincare can feel pleasant, but they cannot reliably provide a lasting correction of volume loss or sagging tissue. Recently injected areas should not be massaged unless you have been instructed to do so.

04

Do I need a facelift if I have deep lines?

No. I explain what filler injections can achieve and where their limitations lie. You decide for yourself whether to consider surgery or to have no treatment.

05

I am afraid of the treatment. What can help?

Please share your concerns during the consultation. We will take time to discuss the procedure, pain relief and possible complications. A consultation does not commit you to having injections.

Sources & medical background

Further medical information on the procedures described, their limitations and risks.

Dottore Andrea Caletti in a friendly conversationDottore Andrea Caletti

Let us begin with a conversation

Personal consultation
about your wishes

Tell me what matters to you.
I will take time for your questions.

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