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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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Our Patient Reviews

Maia Plastic Surgery

4.9 / 5.0

Based on 86 reviews

Caroline H.

Dr Maia truly loves what she does. She is invested in making you the version of yourself you want to be. She listens attentively to what you want and makes relevant suggestions. She did not try to introduce anything unnecessary into my treatment plan. The results I achieved during my first treatment keeps me coming back. Her staff is excellent and works to accommodate your schedule. I have recommended Dr. Maia several times and each time I get the same positive feedback.

Karen D.

Selecting a surgeon: After having two children and weight fluctuations over the years I was left with complete loss of volume in my breasts. I had four consultations with other surgeons but after comparing their photos to Dr Maia’s and meeting her in person, I knew she was my doctor. We talked about my lifestyle - being a mom and a professional, I didn’t want to be too big, but I’m curvy so I didn’t want to go too small for my frame either. She let me try on sizes and once I selected she agreed it was a good fit for my frame. Post op recovery: I was a smoker and had quit prior to surgery but she was very honest and adamant in telling me how important it was that I did not smoke. (I honestly needed the lecture and the transparency about what could happen if I did start smoking before surgery and post-op.) Because I was formerly a pretty heavy smoker, it did cause some issues after surgery with wound closing and she was SO diligent and on top of it seeing me once and week and squeezing me in for appointments between surgeries and patients. She prescribed different things to address the would closure issues before they really became a problem. Being able to have text message access to the office was great when I had questions and she even accommodated my schedule when I couldn’t be seen in person to send progress photos so that she could check on me. 3 months post op: I’m so happy with the results of my surgery and am so glad I waited to find the right doctor. She’s an artist! They look natural, fit my body shape and they haven’t even fully “dropped and fluffed” yet. Would highly recommend… comparing her patient photos to other surgeons will end your search. I feel so much better in my body thanks to Dr Maia.

Justine A.

This is my second time at Dr. Maia’s office and I am so pleased with my experience here. The staff is so friendly and caring. Dr. Maia is the best Dr in the DMV area, she knows exactly what she is doing and you will be happy with the results! I am so glad I found her! I recommend anyone who’s looking for a very personable doctor to come and see her! Thank you Dr. Maia & staff!

inhye k.

I’m not sure where to begin when attempting to explain the positive experience I had with Dr. Maia and her team. It was important for me to find a woman doctor and she comes with so much experience, an eye for detail and aesthetically on point! I felt so well taken care of, even after 2 months post op they still make me feel taken care of. Not only am I thrilled about the physical results, I am also blown away by their care and follow through. I follow Dr.Maia in IG and literally obsessed with her work!


Dr. Maia is truly amazing! She is an artist and somewhat of a magician! She takes the time to listen to you and walk you through the procedure every step of the way! I even texted after with questions and she and her team were very responsive! I was extremely impressed with the work she did around my eyes. Several people now tell me my 20 year old daughter looks just like me….I never heard that prior to the procedure!

Taylor H.

I had one of the most pleasant healthcare experiences I’ve ever had in my life! I came in for excessive underarm sweating and Dr. Maia recommended Botox. She carefully explained everything to me, which I really appreciated as it was my first time ever getting Botox treatment. Her medical assistants were very attentive to my additional questions and made me feel very comfortable while prepping for the treatment. Dr. Maia took her time with me, none of the 5-minute appointments you often get with doctors these days. Everyone was very welcoming and the office is bright and clean. Dr. Maia was referred to me by a family meme we and I’m so glad I went to see her. I absolutely recommend Dr. Maia to anyone and I plan to come back for additional future treatments.

Cynthia S.

I had a tummy tuck, lipo, and a prominent osteoma removed from my forehead. Although I was nervous about the procedures, Dr. Maia and her staff put my fears to rest. Even after the surgery, her professional staff called to check on me during my recovery, which helped put me mind at ease. Dr. Maia and her staff were always professional, responsive, and listened when I had concerns. After the procedures, I was back at work two weeks later and could not be happier with my results. I had a great experience and Dr. Maia will be my first call for any other procedures.

Wanda G.

Dr. Maia is great! She is very knowledgeable! I recommend her to anyone looking to do a cosmetic procedure, breast augmentation, facial lift, etc. Look her up on Instagram so you can see the amazing results from some of her patients!!!!

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