Why direct marionette line filler backfires
Why direct marionette line filler backfires
Why direct marionette line filler backfires
Filling marionette lines directly can backfire. Here's why chin and lip volume must come first.
Published -
Updated -

Author
Wi Young-jin · Chief director
Seoul National University College of Medicine · Seoul National University Hospital Specialist
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Lines under the corners of the mouth,
filled directly with filler,
why they looked even more obvious
Last Wednesday,
a woman in her late 40s came in.
At another clinic, she had received
1 cc of filler in the marionette lines,
"Instead, the area beside her mouth looked puffier
and made her look more saggy," she said, upset.
As we looked in the mirror together, I told her,
"The problem is that the wrinkle itself was filled."

They may look similar, but
the key is different
The marionette line runs from the corners of the mouth
downward toward the chin
as a vertical wrinkle line.
As the name suggests, it’s named because it looks like
the jawline of a ventriloquist dummy.
Many people confuse it with nasolabial folds,
but nasolabial folds run from the sides of the nose to the corners of the mouth,
while marionette lines run
from below the corners of the mouth to the chin.
The causes are a bit different too.
Nasolabial folds are mainly due to midface volume loss and sagging,
while marionette lines are driven largely by volume loss around the mouth and in front of the chin.
That plays the decisive role.
Director Wi Young-jin’s
Key Insight
Marionette lines are
wrinkles that run from the corners of the mouth to the chin.
Rather than filling the line itself,
correcting the volume loss under the lips and in front of the chin
first will naturally soften the line.
— Director Wi Young-jin (Beautystone Clinic, Hongdae)
Key Point
The marionette line runs from the corners of the mouth
to the chin.
Rather than filling the line itself,
correcting the volume loss under the lips and in front of the chin
first will naturally
soften the line.

This is something many people misunderstand,
marionette lines are not a "line" but
a "boundary line of hollowness."
As the fat and bone around the mouth and in front of the chin diminish,
a shadow forms at that boundary,
and if you fill only the line based on that shadow,
the surrounding hollowness remains, so only the filled part
looks oddly raised.
I placed deep in the layer over the bone in front of the chin,
0.6 cc of high-viscosity filler,
to the hollow right below the lips
about 0.2 cc of low-viscosity filler.
Because I didn’t fill the line directly
but instead supported the hollow areas above and below it,
the shadow disappeared.
Director Wi Young-jin’s Key Summary
When the marionette lines bother you,
rather than saying, "Please erase this line,"
it helps to think of it as "a hollowed feeling around the mouth."
Putting filler directly into the line
is usually only a second-best option.

This is how I break it down in the clinic
Type | Main Cause | First Approach |
Early to mid-30s, shallow line | Facial muscle activity, mild volume loss | Botox + skin booster |
Late 30s to 40s, moderate | Volume loss in front of the chin | Prejewel · filler under the lips |
Late 40s and older, deep wrinkles | Volume + reduced skin elasticity | Filler + lifting combined |
But it’s not all good.
Filler typically lasts about 9 to 12 months,
and depending on your body, some people are
absorbed in as little as 6 months.
Also, if too much is placed in front of the chin,
it can make the chin look longer,
so I don’t exceed 1 cc at a time
and prefer to build it up gradually.
If the right amount goes into the right layer,
even people who were told it wouldn’t work elsewhere
are often satisfied right away.
Three questions I get most often in the clinic
Q1. Between Botox and filler,
which should I do first?
For people with overdeveloped muscles that pull the corners of the mouth downward,
I recommend trying Botox first.
Once the muscle movement has quieted down,
the standard approach is to correct only the remaining hollowing
with filler.
Q2. How much does it cost and how long does it last?
It usually ends up around 0.5 to 1 cc,
and lasts about 9 to 12 months.
The exact cost should be given after seeing
the condition in person.
Q3. If it’s injected incorrectly, can it be dissolved?
HA-based fillers can be dissolved with a dissolving agent
.
But dissolving it doesn’t mean
it will 100% return to how it was before,
so where and how much is injected the first time is
the most important.
WhatsApp consultations before your visit are also available.
Also read
▶[Not AI] Beard hair-removal pain: this is manageable - Types of anesthesia
▶5 things to know before Hongdae exosome procedures
▶Shrink once every few months? Recommended intervals, honestly
▶[Beautystone Clinic] Director Wi Young-jin explains Juvelook Glam body procedure
Frequently asked questions
Q. Should I get Botox or filler first?
A. For those with well-developed muscles that pull down the corners of the mouth, I recommend trying Botox first.
Q. What are the costs and how long does it last?
A. Usually, it often ends up in the 0.5 to 1 cc range, and the duration lasts about 9 to 12 months.
Q. If it's injected incorrectly, can it be dissolved?
A. HA-based fillers can be dissolved with a dissolving agent.
Q. How long do bruising and swelling typically last after getting marionette line fillers?
A. It usually subsides within 3 to 5 days. However, if bruising occurs, it can last for up to 1 to 2 weeks, so we recommend scheduled treatments at least 2 weeks before any important events.

Lines under the corners of the mouth,
filled directly with filler,
why they looked even more obvious
Last Wednesday,
a woman in her late 40s came in.
At another clinic, she had received
1 cc of filler in the marionette lines,
"Instead, the area beside her mouth looked puffier
and made her look more saggy," she said, upset.
As we looked in the mirror together, I told her,
"The problem is that the wrinkle itself was filled."

They may look similar, but
the key is different
The marionette line runs from the corners of the mouth
downward toward the chin
as a vertical wrinkle line.
As the name suggests, it’s named because it looks like
the jawline of a ventriloquist dummy.
Many people confuse it with nasolabial folds,
but nasolabial folds run from the sides of the nose to the corners of the mouth,
while marionette lines run
from below the corners of the mouth to the chin.
The causes are a bit different too.
Nasolabial folds are mainly due to midface volume loss and sagging,
while marionette lines are driven largely by volume loss around the mouth and in front of the chin.
That plays the decisive role.
Director Wi Young-jin’s
Key Insight
Marionette lines are
wrinkles that run from the corners of the mouth to the chin.
Rather than filling the line itself,
correcting the volume loss under the lips and in front of the chin
first will naturally soften the line.
— Director Wi Young-jin (Beautystone Clinic, Hongdae)
Key Point
The marionette line runs from the corners of the mouth
to the chin.
Rather than filling the line itself,
correcting the volume loss under the lips and in front of the chin
first will naturally
soften the line.

This is something many people misunderstand,
marionette lines are not a "line" but
a "boundary line of hollowness."
As the fat and bone around the mouth and in front of the chin diminish,
a shadow forms at that boundary,
and if you fill only the line based on that shadow,
the surrounding hollowness remains, so only the filled part
looks oddly raised.
I placed deep in the layer over the bone in front of the chin,
0.6 cc of high-viscosity filler,
to the hollow right below the lips
about 0.2 cc of low-viscosity filler.
Because I didn’t fill the line directly
but instead supported the hollow areas above and below it,
the shadow disappeared.
Director Wi Young-jin’s Key Summary
When the marionette lines bother you,
rather than saying, "Please erase this line,"
it helps to think of it as "a hollowed feeling around the mouth."
Putting filler directly into the line
is usually only a second-best option.

This is how I break it down in the clinic
Type | Main Cause | First Approach |
Early to mid-30s, shallow line | Facial muscle activity, mild volume loss | Botox + skin booster |
Late 30s to 40s, moderate | Volume loss in front of the chin | Prejewel · filler under the lips |
Late 40s and older, deep wrinkles | Volume + reduced skin elasticity | Filler + lifting combined |
But it’s not all good.
Filler typically lasts about 9 to 12 months,
and depending on your body, some people are
absorbed in as little as 6 months.
Also, if too much is placed in front of the chin,
it can make the chin look longer,
so I don’t exceed 1 cc at a time
and prefer to build it up gradually.
If the right amount goes into the right layer,
even people who were told it wouldn’t work elsewhere
are often satisfied right away.
Three questions I get most often in the clinic
Q1. Between Botox and filler,
which should I do first?
For people with overdeveloped muscles that pull the corners of the mouth downward,
I recommend trying Botox first.
Once the muscle movement has quieted down,
the standard approach is to correct only the remaining hollowing
with filler.
Q2. How much does it cost and how long does it last?
It usually ends up around 0.5 to 1 cc,
and lasts about 9 to 12 months.
The exact cost should be given after seeing
the condition in person.
Q3. If it’s injected incorrectly, can it be dissolved?
HA-based fillers can be dissolved with a dissolving agent
.
But dissolving it doesn’t mean
it will 100% return to how it was before,
so where and how much is injected the first time is
the most important.
WhatsApp consultations before your visit are also available.
Also read
▶[Not AI] Beard hair-removal pain: this is manageable - Types of anesthesia
▶5 things to know before Hongdae exosome procedures
▶Shrink once every few months? Recommended intervals, honestly
▶[Beautystone Clinic] Director Wi Young-jin explains Juvelook Glam body procedure
Frequently asked questions
Q. Should I get Botox or filler first?
A. For those with well-developed muscles that pull down the corners of the mouth, I recommend trying Botox first.
Q. What are the costs and how long does it last?
A. Usually, it often ends up in the 0.5 to 1 cc range, and the duration lasts about 9 to 12 months.
Q. If it's injected incorrectly, can it be dissolved?
A. HA-based fillers can be dissolved with a dissolving agent.
Q. How long do bruising and swelling typically last after getting marionette line fillers?
A. It usually subsides within 3 to 5 days. However, if bruising occurs, it can last for up to 1 to 2 weeks, so we recommend scheduled treatments at least 2 weeks before any important events.
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