Dermal fillers are a safe procedure if basic safety is understood. When treating the marionette lines understand the position of inferior labial arteries.
As we age the reduction in tissue elasticity, increase in laxity and volume loss above and below the oral commissures all contribute to the key component of ageing in the lower face – the development of the marionette line.
Examine the length and depth of the line and for superficial creases as well as volume loss. Treat the two features with an appropriate technique. The line may start as a weak point at the oral commissures and with age extend all the way to the jaw line.
Be careful of over treating which can give the look of ‘something in the mouth’ when an imbalance in volume placement occurs.
Practice of marionette lines
Safety margins Most of the important structures lateral to the fold, such as the facial artery. There is also the mental artery more medial and the area has many branches of the facial vein. In practice you should assume there are arteries under every injection point- always check for a flash back before injecting
Desired treatment outcomes
Soften the jowl.
Lift corners of the mouth ‘eliminate sad look’
Soften or remove the pre-jowl sulcus.
Improve the jaw line.