Condition
Nasolabial Folds & Marionette Lines
These two features are often mentioned together, but they behave differently. The nasolabial fold is a natural anatomical boundary that deepens with mid-face change, while marionette lines run downward from the corners of the mouth and can make the expression look sadder at rest.
What is Nasolabial Folds & Marionette Lines?
Both are the result of volume redistribution and reduced support rather than the skin itself creasing. As the cheek loses projection and descends, tissue gathers along the nasolabial fold. Around the mouth, loss of chin and jaw support, combined with muscle pull downwards, deepens the marionette line.
Common signs and concerns
- A deeper groove from the side of the nose to the corner of the mouth
- Lines running from the mouth corners down toward the jaw
- Corners of the mouth turning slightly downward at rest
- Shadowing that photographs worse than it looks in person
- Cheek flattening noticed at the same time
Possible contributing factors
- Mid-face volume loss and descent
- Age-related bone and ligament change
- Weight loss
- Repeated expression and muscle pull
- Sun damage and smoking
- Dental changes affecting lower-face support
When to seek professional assessment
Ask for a professional assessment if the concern is persisting or progressing, if it is affecting how you feel day to day, or if home care has not changed it. Any new, changing, bleeding or painful lesion, or any symptom that could have a medical cause, should be assessed promptly by a doctor rather than treated cosmetically.
How Dr Farzana assesses this concern
Assessment is anatomical rather than product-led. Dr Farzana looks at facial proportion, skin quality, volume distribution and movement, then discusses what is contributing to the appearance you have noticed. Options are explained with their limits, alternatives and recovery, and nothing is treated on the day unless you are comfortable and suitable.
Treatments that may be considered
These are options offered by Dr Farzana that may be discussed for this concern. Which, if any, is appropriate for you is decided only after a private medical assessment.
Suitability and important information
This page is general information only and is not medical advice or a diagnosis. Suitability for any treatment is confirmed at a private medical consultation, including a review of your history, medication and goals. Risks, alternatives, aftercare and realistic outcomes are discussed openly. Results vary between individuals and no treatment is suitable for everyone.
Frequently asked questions
What is the difference between the two?+
The nasolabial fold is the natural boundary running from the side of the nose to the corner of the mouth, which deepens as the mid-face changes. Marionette lines run downward from the mouth corners toward the jaw and can make the expression look sadder at rest.
Why do they deepen?+
Both reflect volume redistribution and reduced support rather than the skin simply creasing. As the cheek loses projection and descends, tissue gathers along the fold, while loss of chin and jaw support deepens the marionette line.
Should the fold itself be filled?+
Often the better approach is to restore support in the cheek and around the mouth rather than filling the fold directly, which can look heavy. The plan is decided from your own anatomy.
Is this area higher risk than others?+
The mid-face contains important blood vessels, which is why treatment here should be doctor-led. Anatomy, risks and how any complication would be managed are all explained before you consent.
Can muscle-relaxing treatment help the mouth corners?+
For some patients a small amount can reduce the downward pull at the mouth corners, and it is sometimes combined with support elsewhere. Suitability is assessed individually.
How long do results last?+
Duration varies with the option chosen and with individual factors such as metabolism, movement and weight change. Expected longevity and review points are agreed before treatment.
Why do these folds look worse in photographs?+
Overhead and flat lighting exaggerates shadow, so folds often photograph more strongly than they appear in person. Dr Farzana assesses the area in good light and in movement rather than from photographs alone.
Where Dr Farzana practises
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