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Woman undergoing marionette lines filler injections.

Dermal filler is a simple and effective way to treat the marionettes lines. The marionette lines are very aging on the face. They tend to make the person look more sad than they feel. Filling marionettes make a person look more positive and youthful.

What are Marionette Lines?

Marionette lines are the lines / folds which start at the mouth corners and go downwards ending at the jawline.

Aging of the Lower Face

Marionette line filler is used to address the signs of aging in the lower face, specifically the deep lines that run from the corners of the mouth down to the chin, resembling the strings of a marionette puppet. These lines become more prominent with age due to several reasons:

  1. Loss of Collagen and Elasticity: As people age, the skin loses collagen and elastin, which are essential for maintaining its firmness and elasticity. This leads to sagging and the formation of lines and wrinkles.
  2. Fat and Bone Changes: Changes in fat distribution and bone density in the face can affect the overall facial structure, making the marionette lines more noticeable.
  3. Muscle Activity: Repeated muscle movements, such as smiling and frowning, can contribute to the development of these lines over time.

Marionette line fillers, typically made of hyaluronic acid or other dermal fillers, are injected into these lines to restore volume, reduce the appearance of wrinkles, and improve the overall contour of the lower face. This treatment can help individuals look more youthful and refreshed by addressing one of the common signs of facial aging.

Choosing the Right Dose

The dose required for marionette folds varies. It depends on the anatomy and the desired result of the patient. Some patients will be satisfied with 1ml, others will need more to get the results that they want.

Dr. Maia will assess the face and decide on the best dose after taking a history and examining the patient.

Minimal Discomfort During Injections

A numbing cream may be applied to the area 30 minutes prior to the treatment. There is also local anesthetic in the dermal filler. After injection, ice is often used to decrease pain and to reduce the risk of bruising.

What to Expect

  • The patient will be numbed topically for 30 minutes prior
  • The face will be cleaned with alcohol.
  • Dr. Maia will inject using a very fine needle. Then pressure with gauze will be applied.
  • The patient will be given an ice pack to reduce the risk of bruising

Expert Injector in the Northern Virginia Area for Marionette Lines

Dr. Maia is an expert filler injector known for her natural-looking results. The results of injectables can be subtle and discreet, which makes them a popular non-surgical cosmetic treatment for men and women of all ages. At Maia Plastic Surgery, we offer a wide selection of dermal fillers and other cosmetic injectables that can be used in many areas to achieve stunning aesthetic results.

If you are interested in learning more about cosmetic injectables, come see us at Maia Plastic Surgery. Contact our Chevy Chase, MD, or Tysons Corner, VA, location to schedule your dermal filler and cosmetic injectables consultation.

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J. B.

Dr. Maia and her staff are incredibly professional and truly empathetic. They’ve done a beautiful job with the treatments that I’ve gotten and I look forward to coming to the office every single time.

Karli N.

Dr. Maia deserves more than 5-stars! I’m thrilled with my results and I’m less than 3 months post surgery. Dr. Maia is confident and kind, and not at all pushy like other plastic surgeons. I was overly impressed the morning of the procedure. The surgical and hospital staff know her well! They were ready for her and put me at ease while I was getting settled in the OR. I appreciate the team in Dr. Maia’s office for their patience and care. They are just as calm as Dr. Maia.

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Dr. Maia, Alana, and Kristina are talented, knowledgeable, and attentive. Great results, great support, and very responsive to any questions. Would recommend to anyone looking to improve their quality of life!

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Deise G.

I had a great experience with doctor Maia. Beyond my expectations.

Nate R.

Mid 40s male who’s always had nasal breathing issues and a dorsal bump. I finally decided to do something about it with a septoplasty/rhinoplasty combo. I met with a few doctors but Dr. Maia stood out. She instilled confidence, and I’m extremely pleased with the results. The surgery was straight forward, and the swelling was surprisingly light. A week later the cast was off and I was on the short road to recovery. Honestly, if I had known it was this easy I would have done it earlier. Thanks Dr. Maia!


I recently had Dysport injected by NP Kristina, and I could not be happier with the outcome. I can already see some of the results few days post-injections! I love how quickly Dysport softens the wrinkles, without giving you the "frozen look". Just in time for the upcoming holidays! Earlier this year, I did 3 Morpheus-8 treatments to my face and neck, and I am CONSTANTLY being complimented on how good my skin looks. Worth every penny! I also had fillers injected by Dr. Maia and Kristina. Dr. Maia did my under-eye, which I am obsessed about... what a change! Kristina injected my lips, chin, jawline, and cheeks. My face looks more proportional and guess what.... I FINALLY HAVE A CHIN :) Thank you, Dr. Maia, Kristina, and the Team. You're the best. I will surely be back for more.

R. H.

I had tummy tuck and muscle repair with Dr. Maia 3 months ago. I couldn't be happier. I am 44 and I got my 25 year old body back after tummy tuck with Dr. Maia. The initial consult was great. The surgery was fast. The post op care was excellent. Dr. Maia and team assured me that I had great post recovery and everything going okay. I had no complication whatsoever. The incission was very small and low which I love. She is amazing and caring surgeon. He teams are very responsive and wonderful. I am very happy with the result and everything.

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