To get rid of marionette lines with Botox, injections target the Depressor Anguli Oris (DAO) muscles, located at the corners of the mouth, to relax their downward pull, allowing the mouth corners to lift slightly and soften the lines, though fillers are often used alongside or instead for volume loss. A skilled injector places small doses into these muscles, often using multiple points on each side, to reduce the frown and create a more neutral or upturned look.
Where do you inject BOTOX for marionette lines? We inject BOTOX into the DAO (depressor anguli oris) muscle on each side of the mouth. This muscle attaches to the corner of the mouth and pulls downward. Relaxing this muscle stops one from frowning and deepening marionette lines.
These areas need supraperiosteal placement of a firm filler to replace the bone and fat loss in the deep tissues. “If the marionettes were still present, I'd then treat in layer two using a cannula to fan a medium product. I'd inject from the corner of the mouth to the mental crease to revolumise the subcutaneous fat.”
Can you put Botox in your marionette lines? They have proven Botox to be an effective treatment for marionette lines. The effects include an improved appearance in skin smoothness and a reduction in the appearance of wrinkles.
Here are four of the most popular options:
Dermal fillers containing hyaluronic acid are an ideal solution for adding volume to marionette lines and lips. By injecting fillers into the marionette lines, Dr. Alemi can smooth and soften these creases, restoring youthful contours to the lower face.
As the skin around the mouth is shallower and muscles in this area are complex, we typically recommend less than ten units of Botox to treat marionette lines, with average treatments ranging from 6-8 units per side (equivalent to 18-24 Dysport units or 6-8 Xeomin units).
Initial improvements from Botox® for marionette lines become visible within two to five days following treatment. Full effects develop gradually over two weeks as the Botox® completely blocks nerve signals to treated muscles.
The riskiest areas for Botox involve locations with crucial blood vessels and delicate muscles, primarily the glabella (between eyebrows) due to arteries that can cause blindness if blocked, the forehead/brow area risking eyelid droop (ptosis) or unnatural brow shapes, and the perioral region (mouth area), where poor placement can affect speech, smiles, or cause puckering. The masseter muscle (jaw) and neck (platysmal bands) are also sensitive, potentially causing chewing difficulty or swallowing issues with improper technique, requiring expertise to avoid complications like necrosis or paralysis.
If it's right for you, The Look of 3® is an opportunity to be treated in 3 areas, with 64 units, at least 3 times a year. For moderate to severe forehead lines, frown lines, and crow's feet in adults. *Treatments should be spaced 90 days apart.
A poorly done marionette line filler treatment can result in lumps, asymmetry, puffiness, or even make the lines look worse. This usually happens due to overfilling, incorrect injection techniques, or using the wrong type of filler.
“In the frontalis, a deep treatment is likely to cause pain if you manage to hit the periosteum. However it's unlikely to affect the aesthetic result”, she continues. When treating the orbicularis oculi area, Dr Lindsay notes that “a deep injection could diffuse to the zygomatic muscles causing smile asymmetry.
Dermal fillers in your 30's and 40's
Men and women in their thirties and forties rely on filler injections to smooth away smile lines and marionette lines as they start to appear. The goal at this stage is to slow the process and prevent deeper lines and folds to maintain a more youthful appearance.
The "Botox 4-hour rule" means you should stay upright and avoid pressure or lying down for at least four hours after injections to prevent the neurotoxin from migrating from the treated muscles to unintended areas, which can cause side effects like drooping or uneven results. This helps the Botox settle precisely where it's needed for optimal wrinkle-smoothing effects, so avoid bending, rubbing, or strenuous activity during this critical period.
The Best Areas to Inject Botox for Jowls
COMMON SIDE EFFECTS OF BOTOX
Gen Z is saying "no" or "not yet" to Botox due to a desire for natural beauty, individuality, and healthy aging, rejecting the overdone "Instagram Face," fearing irreversible damage, and prioritizing serious skincare and non-toxic alternatives over the costly, repetitive nature of injectables, despite social media pressure to do them. They're focused on "skinimalism," collagen support, and avoiding the potential for unnatural or frozen looks often seen online, opting for treatments that enhance rather than mask their natural features.
Botox Over 20 Years: What to Expect
With 20 years of Botox use, many people look younger than they would have without treatment. Muscle Atrophy and Adaptation: After long-term Botox use, some facial muscles may experience mild atrophy due to limited activity.
Botox Injection Danger Zones
Avoid injecting botulinum toxin into these frontalis muscles, which is the muscle that raises your eyebrows and arches your forehead. You should also try to not inject botox into several other facial muscles, such as those that allow you to smile or chew.
How can I prevent marionette lines or other signs of aging?
Most people start to see Botox results within 3 to 5 days, while full results typically appear between 7 and 14 days. The exact timing depends on factors like muscle strength, treatment area, and individual response.
Botox is useful for relaxing the muscles that pull down the corners of the mouth, while dermal fillers are the “go-to” treatment for erasing marionette lines because they are more effective in adding volume to the lower parts of the face. Doctors may also recommend combining both treatments to achieve the best results.
BOTOX typically follows the “rule of 3s”: you see an effect by day 3, the max effect is at 3 weeks, and the effect lasts approximately 3 months. At 3 months after injection, the previously interrupted communication is re-established via a process called sprouting.
It's very common for patients in their 30s to start considering Botox treatments, and they are extremely effective. You may want to consider the level of sun damage your skin faces, the amount of muscle movement in the face, and whether or not you have a genetic predisposition to getting wrinkles.