Jowls are loose skin and flesh that hang beneath the lower jawline. Marionette lines or “puppet lines” are lines that run from the corners of the mouth to the chin. Both are a sign of ageing and volume loss in the face. One of the most commonly cited reasons for wanting to get rid of them is because they give the appearance of being grumpy or sad.
The main cause of both jowls and marionette lines is ageing. As we get older our skin becomes thinner and less pliable. This is due to loss of collagen and elastin. At the same time, we also lose volume in the face (particularly in the midface area) which provides scaffolding and shape. Both these processes result in sagging of the skin and tissues which gives rise to jowls and marionette lines in the lower face. Other factors which exacerbate skin ageing are smoking, sun-damage and genetics.
There are a number of treatment options for jowls and marionette lines. First of all, it is very important to ensure that you follow a regular skincare routine tailored to your skin type. Two highly effective and non-surgical options that we offer at City Skin Clinic are Botox® and hyaluronic acid dermal fillers. Which of these (if any) is suitable for you will depend on your expectations and the severity of the lines.
Botox® For Jowls & Marionette Lines
For moderate jowls, we offer jawline tightening with Botox® as part of our non-surgical neck lift. This treatment can soften the appearance of early jowling and provide a more defined jawline and sculpted neck. Whilst its possible to soften the appearance of marionette lines with Botox®, we do not think that this is the most effective treatment on its own. However, in some circumstances, we combine Botox with dermal fillers for treating marionette lines.
Dermal Fillers For Jowls & Marionette Lines
Since both Jowls and Marionette lines are caused by volume loss and sagging skin in the face, dermal fillers provide the opportunity to treat the underlying problem. For moderately severe lines, we can directly inject hyaluronic acid dermal filler into and around these creases to soften and minimise their appearance. For more severe jowling and marionette lines, we recommend hyaluronic acid dermal fillers to the cheeks to lift the face in addition to adding filler to the areas themselves.
If you have both jowls and marionette lines as well as other signs of ageing such as upper face wrinkles, then you can opt for a combination of Botox® and dermal fillers as part of our liquid facelift package.