Marionette or sad lines are the wrinkles that occur around the corner of the mouth. With agge this area can lose elasticity and can become gradually depressed over time. The depressing of the corners of the mouth in this area can often lead to an angry or stern appearance which can be undesirable in some patients. The marionette lines can extend vertically down toward the jaw giving the person a marionette like appearance.
In most cases the most effective non surgical treatment is an effective and appropriate use of dermal fillers. The fillers can help volumise wrinkles and push up areas of depression at the corners of the mouth. If the cause of the depression of the corners of the mouth is excessive muscular movement from facial expression BTX can be used to relax the offending muscles.