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Marionette lines take their name from the ventriloquists’ dummies or puppets of old who have a mouth which opens and closes as the performer speaks. The lines that run from the corners of your mouth down towards your chin are thus referred to as marionette lines. As we talk, eat and make facial expressions we move the area around our mouth and jaw and this dynamic movement causes the appearance of deep lines and folds at the sides of the lips. Many treatments are available to tighten the area, smooth wrinkles and replace lost volume to reduce the appearance of marionette lines.
Dermal fillers are made of various kinds of natural, man-made or synthetic materials that have been developed for injection into the skin and lips; including hyaluronic acid.
A face lift or rhytidectomy can reduce the appearance of loose skin and wrinkles around the cheeks and neck, by tightening the muscles and removing excess skin and fat, restoring a more youthful look.
Unlike dermal fillers which are aimed at mechanically filling wrinkles, folds and skin depressions, tissue stimulators are injectable products which cause a biological reaction in the tissue.
Plasma Sublimation or Soft Surgery allows the treatments of the signs of ageing and skin complaints, without actually cutting the skin. It can be used for non-surgical eyelid reconstruction (blepharoplasty), removing lines around the mouth, improvement in the appearance scars and treating a number of skin imperfections.
RF energy is able to penetrate deep into the skin and affect the deeper dermis and subcutaneous layers, causing tightening and improvements to the underlying tissue structure for facial rejuvenation.
Thread lift uses free floating cogged (barbed) or smooth sutures for lifting sagging tissue in the face and neck. It is marketed as APTOS Thread Lift, Contour Lift, Silhouette Soft, Scarless Suture Lift & Feather Lift.
Ultrasonic skin tightening, introduced with a device called Ultherapy, is a non-invasive, non-surgical cosmetic procedure that uses micro-focused ultrasound waves to stimulate collagen production, resulting in an uplifted effect to the face and neck.
The Accent system boasts dual handpieces – a bipolar one for volumetric dermal heating, aimed at skin tightening treatments; and a Unipolar one for for fat reduction and cellulite treatment.
Aliaxin® is a monophasic dermal filler product range containing a combination of well-defined molecular weights of hyaluronic acid for long-lasting results.
amalian is a range of mono-phasic and bi-phasic hyaluronic acid based dermal fillers manufactured in Germany.
Belotero ® is a new monophasic double crosslinked hyaluronic acid designed from biofermentation using Cohesive Polydensified Matrix (CPM) technology to increase facial volume and fill wrinkles.
DERMAFILL® is the first of a so-called ‘4th generation’ of safer, and more effective, pure, monophasic injectable hyaluronic acid based dermal fillers which exceed the stricter standards imposed by the American Food and Drug Administration (FDA) for very low levels of BDDE in filler products.
Ellansé is a new and unique non-animal, non-bacterial and non-human derived dermal filler family which are said by the manufacturer to be cost-effective by requiring less product, compared to others, for the same indications.
The use of 24 karat gold threads for skin rejuvenation is also marketed as gold filament rejuvenation. Brands of gold threads used in the UK, include SkinGold and GoldThread.
The INTRAcel Fractional Radiofrequency (RF) Micro-Needling system is comprised of a Fractional RF Microneedle™ (FRM) array that assists in skin rejuvenation and also treats acne, provides a non-surgical face lift, reduces large pores and acne scarring through a variable radiofrequency power
Intraline® is an innovative, cross-linked, hyaluronic acid based dermal filler used for wrinkle reduction, facial contouring, lip enhancement, and other facial imperfections. It is manufactured in Sweden by Bohus BioTech AB, using hyaluronic acid sourced from France.
Juvéderm® ULTRA and Juvéderm® ULTRA Smile is an advanced, cohesive, 3D hyaluronic acid matrix dermal filler with local anaesthetic, manufactured by Allergan; the makers of Botox® / Vistabel®.
Juvéderm® VOLUMA is a hyaluronic acid dermal filler used for recontouring and restoring the face in the case of age-releated volume loss in the cheek bone and chin regions. According to the makers, it delivers dramatic improvement in tissue quality, even in challenging areas, and is complementary to other aesthetic treatments and dermal filler procedures.
Juvéderm ® VOLIFT, VOLBELLA, VOLITE and VOLUMA are part of the Juvéderm VYCROSS ® Collection of hyaluronic acid-based fillers which are designed to add volume, restore contours, plus smooth out lines and wrinkles.
The Pellevé Wrinkle Reduction System precisely delivers energy to the dermal tissue using advanced radiowave technology to induce collagen contraction without damaging the epidermis. The result is noticeable improvement in skin quality and appearance.
Perfectha® from Laboratory ObvieLine (a Sinclair IS Pharma company) is a highly advanced hyaluronic acid gel dermal filler, cross-linked by E-brid® technology and developed to fill out wrinkles, hydrate the skin and add volume.
The Plasma IQ utilises the fourth state of matter: Plasma, used for a treatment method called plasma sublimation. It is used to improve lines and wrinkles, scars and stretch marks, as well as non-surgical blepharoplasty.
The Plexr soft surgery system uses the fourth state of matter, plasma, and is marketed for use as a non-surgical blepharoplasty, or soft eyelid surgery.
The Princess® range of dermal fillers are designed to combat the signs of ageing, with natural results. They are produced by the Austrian company Croma-Pharma GmbH, a company with a long history of creating hyaluronic acid (HA).
It is the first stabilised hyaluronic acid (HA) based product which is manufactured without the use of chemical cross-linking agents (BDDE) and is used for skin remodelling and treating skin laxity, not for just filling lines and wrinkles. According to the makers, it delivers dramatic improvement in tissue quality, even in challenging areas, and is complementary to other aesthetic treatments and dermal filler procedures.
Radiesse, launched in the US as Radiance FN, is a medical device designed for the correction of small and large soft tissue deficits, but can also be use for facial shaping and contouring.
The Restylane range consists of hyaluronic acid dermal fillers incorporating the EMERVEL collection (Lyft (Perlane), Refyne, Fynesse, Volyme, Kysse, Defyne), all specifically designed for injection into the face.
Revanesse and Redexis are two new monophasic, non-animal hyaluronic acid based dermal filler brands manufactured in Canada by Prollenium.
Sculptra (Formerly New-Fill) is a tissue stimulator and is used more as a sculpting and volumising agent rather than just a wrinkle filler. Sculptra contains Poly-L-lactic acid.
Silhouette Soft is marketed as a ‘non-surgical face lift’, a ‘one-stitch face lift’ or ‘puppet face lift’, the treatment is based on suture suspension with cones which are used in both reconstructive surgery and cosmetic surgery.
Manufactured by the French company Vivacy Laboratories, Stylage® is the first hyaluronic acid dermal filler with local anaesthetic lidocaine (lignocaine) and an antioxidant, in the form of mannitol, all within one product.
The Teosyal range consists of three monophasic hyaluronic acid based products of non-animal origin, which are highly biocompatible, offering patients immediate and long-lasting results.
The Thermage™ system is a mono-polar (one electrode) radiofrequency device that delivers radiofrequency energy deep into dermal tissues for facial skin tightening, body contouring and improvement in the appearance of cellulite.
TriPollar™ radio frequency (RF) technology is available via two devices, Apollo® and Regen®. The devices are marketed for cellulite reduction, body remodelling and skin tightening.
Ultherapy is marketed for ultrasonic skin tightening using high intensity focused ultrasound to tighten and tone loose skin on the face and neck.
ULTRAFORMER III is a HIFU device offering ultrasound skin tightening for the face and body.
Uma Jeunesse is a hyaluronic acid based dermal filler aimed at treating lines and wrinkles, naso-labial (nose to mouth) lines, marionette (mouth to chin) lines, sagging cheeks, as well as contouring lips, temples and noses.
Varioderm™ consists of a range of very highly cross-linked, pure non-animal hyaluronic acid fillers available in 4 concentrations for the treatment of lines, wrinkles and facial contouring.
Marionette lines are one of those aptly named wrinkles that conjure up a pretty clear visual. A marionette string-puppet, of course, has a split jaw so that puppeteers can easily open and close their mouths in order to make them look like they’re talking. Humans develop creases in the very same area over time, running from the outer corners of the lips to the outer corners of the chin. Because of their drooping quality, marionette lines can make a face look perpetually pouty. And, unfortunately, treating them professionally is not as straightforward as some other problem areas—which is why, as always, prevention is key.
Marionette lines, also known as oral commissure lines, occur when the depressor anguli oris muscle, or DAO muscle, pulls down the corners of the mouth, causing noticeable lines and a sad expression.
Marionette lines start to appear by the late 30's or early 40's, but the age when they become noticeable varies considerably by person. They are called marionette lines because they resemble similar lines seen on marionette puppets
Since marionette lines are caused by a combination of collagen breakdown and elastin in your skin due to aging and other lifestyle factors, the only way to fix them is to get to the source of the problem. The lines can be corrected through the injection of dermal fillers
While Juvederm, Radiesse and Restylane are generally used to treat marionette lines, you should consult with a professional to determine the most effective filler for your situation.