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FILLER FOR MARIONETTE LINES

Marionette lines are the lines that you get on the sides of your lips that extend down to the chin area. They can often give people a sad and tired appearance. These lines are very common as we age and start to lose collagen and volume from our face. 

If this is an issue for you, one of the first things we do is assess your lip volume. Often lack of support in the lips can lead to these lines.

We also assess the strength of the muscle pulling down the corners of the mouth (Depressor Angularis Oris) and we may combine filler with a small amount of wrinkle relaxing injections to relax this muscle.

It is advisable to combine fillers with suitable skin tightening machine based and home skin care treatments for the best results and to also slow down the ageing process.

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duration

30 mins

results

6-12 months

no. of sessions

1-2

downtime

very minimal

FAQs

Please see our most commonly asked questions below

What kind of results can be achieved?
Filler in the marionette lines will help to smoothen out the lines between the corner of the mouth and the chin. These lines can appear ageing and give people a sad appearance. Often it is not possible to remove this line entirely as it may end up giving you a full appearance if too much filler has been injected. When these lines are improved, it can help rejuvenate your whole face and give a more happy and well rested appearance.
Who is this suitable and not suitable for?
This treatment is best for mild to moderate marionette lines. If you have very heavy folds or significant skin laxity then it may not be a suitable treatment for you. In that case we recommend you do some skin tightening treatments with machine based treatments first and some lifting with PDO threads. If you have a history of anaphylaxis or allergy to wasp stings, fillers may not be suitable for you. This is because you are likely to be allergic to the filler dissolving enzyme. We always have to ensure we are able to dissolve the filler in an emergency (see below for risks and side effects).
How long does it last?
On average, filler in the marionette lines will last for 6-12 months. However, this is an average time and for some people, the filler may dissolve more quickly because of their metabolism and for some people it may last longer. We find that with subsequent treatments, the results often last longer. Wrinkle relaxing injections in the DAO muscle lasts 3 months.
What is the recovery/downtime?
The recovery and downtime for this treatment is minimal. Most people can go to work and social events the same day. It is also normal to have subtle bumps and irregularities when you first get fillers done, most of this is swelling and will resolve. If you only have wrinkle relaxing injections you will have very minimal downtime with redness that lasts a few hours only. We advise you not to wear makeup for the first 4 hours and avoid intense exercise for the first 5 days. Please see the aftercare section for more details.
What are the side effects and risks?
Like all medical treatments, there are side effects and risks. Swelling and bruising are to be expected, as is some discomfort. It is also normal to have subtle bumps and irregularities when you first get fillers done, most of this is swelling and will resolve. It is important to follow the aftercare to minimise migration risk and ensure the results last as long as possible. With wrinkle relaxing injections, there is a small risk that it may spread to other muscles and affect how you move your mouth. It is therefore important to follow the aftercare closely. If you have a history of cold sores, any needles to the face can trigger a breakout of it. So please inform us in advance if you have had any cold sores in the past year. There is a very small risk of filler entering a blood vessel and blocking off the blood supply to the skin. This is called a vascular occlusion. As a medical clinic, we have all the equipment and enzymes available to reverse this and dissolve the filler. It is a condition that either happens during the appointment or in the first 48 hours after. We give extensive aftercare advice and are available to get in touch within this period to dissolve it. We have also reviewed every single treatment we carry out in clinic to modify the techniques to minimise the risk.
How painful is the treatment?
There is very minimal pain for filler in the marionette lines. However, if you are apprehensive about pain or have a low threshold to pain, please ensure you take 1g of Paracetamol 1 hour before the procedure and inform the clinician so we can use numbing cream.
Duration
The appointment is 30 minutes long but the treatment itself takes 10-15 mins. If you have filler in multiple areas, the appointment will be longer. At No Filter Clinic we take our time assessing patients thoroughly, both at rest and with facial expressions so we can ensure the results integrate seamlessly with your features and your muscle movements. Our priority is to also ensure the treatment is safe and carried out to the highest standard.
No. of sessions
We are usually able to achieve the desired result in one session. We never like to inject more than what we think is suitable for your face and anatomy as this leads to a risk of it looking fake or migrating to other areas as there is only so much the skin can stretch. If you need further volume we normally recommend you come back after 1 month for a second treatment.
How will I look straight after?
You will be able to see the results of this treatment immediately. You may have some mild swelling but this will subside within 2 weeks. You can attend events the same day but must follow the aftercare rules.
How is it done?
We initially undertake a thorough assessment of your whole face to see if the treatment is suitable for you and explain the extent of the results that are possible. We then disinfect the area and mark out the areas for injection. There are two technique we use depending on each patient. We either use a needle or a cannula which is a blunt tip instrument that looks like a needle. It is inserted through a hole created by a needle near the corner of the mouth so there is just one entry point. As it is blunt there is minimal bruising or swelling.
Can it be reversed?
At No Filter Clinic London, we only use fully reversible fillers. This is because they are safer than permanent fillers and we can dissolve them in the case of an emergency, or if for whatever reason you are not happy with the result. This gives fillers a significant advantage over surgery as they are not permanent. However, this does not mean you should get fillers just to try them out as dissolving them is not a simple procedure. You should only get fillers done if you have researched them thoroughly, feel comfortable getting the procedure done and are happy to accept the small risks and side effects which are all manageable. If you have a history of anaphylaxis or allergy to wasp stings, fillers may not be suitable for you. This is because you are likely to be allergic to the filler dissolving enzyme (Hyaluronidase). We always have to ensure we are able to dissolve the filler in an emergency (see risks and side effects).
What is the aftercare?
We send a thorough aftercare email to all our patients but please find a summary below.

What to do after treatment

Get some Arnica tablets from any pharmacy, this helps with bruising and swelling. Please do not wear make-up for 4 hours after treatment. In the evening of the treatment, you may gently wash your face and use your regular wash and lotions. Please skip any retinols or acids for the first night. Do not sleep with pressure on the face and try to sleep on your back for 1 week.

If you are uncomfortable with the swelling, please take Loratadine/Cetirizine (normally used for hayfever) to help decrease this. If there is excessive swelling you may contact the clinic to obtain a prescription for steroids to help resolve your inflammation more quickly; prescriptions drugs are not appropriate if the degree is swelling is within normal parameters. Aside from this, there is, unfortunately, no quicker way to resolve swelling as it is a normal bodily reaction to trauma. Wash your face very carefully, applying no pressure to areas treated for 4 weeks.

What NOT to do after treatment

- No strenuous exercise or gardening for at least 1 week.
- Do not massage the area treated for the first 4 weeks following treatment.
- No facials or waxing for the first 2 weeks.
- Do not take aspirin, ibuprofen or other anti-inflammatory medication for 24 hours after treatment as this may increase bruising. You may take paracetamol or codeine if you are uncomfortable.
- Do not consume alcohol for 24 hours after receiving treatment. This increases the risk of bruising.
- Do not have a sauna, hot tub or go in a tanning booth for 2 weeks after treatment.
- Do not have radiofrequency, IPL, laser or any other heat treatments near the treated area for 2 weeks.
How many mls do I need?
Most patients require 1 ml but some may require 2 mls.
Which fillers do you use?
We use all the premium brands available. We use a mixture of Teoxane, Stylage, Juvederm, Restylane and Aliaxin depending on the patient and their individual need. We only ever used hyaluronic acid based fillers as they are fully reversible. This is essential for your safety.
How do I prepare before the appt?
Before your Appointment

1. Please stop using topical Retinols, Glycolic Acid, Lactic Acids, Salicylic Acid and Tretinoin 5 days before your treatment. This will minimise pain and bruising. However, if you have been using these for a long time and your skin is likely to flare up without them, you do not need to stop them. If you are on Roaccutane, please get in touch before your appointment so we can discuss it and give individual advice.

2. Please stop using any Vitamin E supplements and Ibuprofen/Neurofen 5 days before your treatment. Please do not stop using any Aspirin (or any other medication) prescribed by your GP.

3. Laser treatments for the face, microneedling and chemical peels have to be avoided 1 week before and after the treatment.

4. Please do not drink alcohol 24 hours before and after the procedure.

5. Make sure you eat something before your appointment and are well hydrated. This prevents feeling lightheaded during the procedure.

6. It is advisable to take 1 g of Paracetamol (2 tablets) 30 mins - 1 hour before your appointment as it will significantly reduce any discomfort during the procedure.

7. Please attend the appointment alone. There is limited space in the clinic and anybody with you will be asked to wait outside the building.

8. Please come to the appointment with makeup removed and minimal jewellery.

9. Please note, we are not able to carry out any Dermal Filler treatments if you are due to fly in the next 3 days. This is because of the small risk of vascular occlusion in the first 48 hours. Wrinkle relaxing injections, Profhilo and Aqualyx are fine.
How does the pricing work?
There are different pricing structures. Please see price list for more information.

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