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Posted 11th Mar 2024

Managing Marionette Lines with Skin Treatments

How to Treat Sagging Jowls

Did you know there are ways to manage marionette lines with skin treatments?

Marionette “folds” develop due to volume loss in the layers of the face associated with ageing. Skin quality changes in this area can also cause marionette lines.

It’s worth considering both skin treatments and injectables to build holistic treatment plans, depending on the patient’s context.

Clinical trainers and aesthetics specialists, Dr Lindsay Jones and Dr Janine Rothburn discuss topical skincare and skin treatments for managing marionette lines.

How to Treat Sagging Jowls

Managing patient’s expectations

Dr Lindsay tells us that, following a consultation and examination, she would discuss various options with each patient.

She stresses that, “Skincare alone cannot resolve the specific concerns of marionette lines. Based on their severity, a single modality is unlikely to be the cure.”

Injectable treatments for marionette lines

Botulinum toxin

These mouth-to-chin lines can be treated in a variety of ways. Dr Janine explains, “Toxin can be used around the corners of the mouth to reduce the downward pull of the depressor anguli oris muscle (DAO). This reduces their appearance significantly.”

Fillers or polynucleotides

“Dermal fillers and polynucleotides can be used to treat marionette lines. They provide structural support and volumise the surrounding tissues,” Dr Janine notes.

Chin Microneedling for Skin Quality Facial Anatomy Harley Academy Aesthetics Training Courses London UK

Ways to address marionette lines using skin treatments

Topical skincare

Regardless of the aesthetics treatment or target, Dr Lindsay emphasises, “It’s vital to convey the importance of good skincare to all patients. We age in all layers of the skin and to age well we need to target all of them.”

“Daily broad spectrum sun protection factor (SPF) is a non-negotiable basic requirement. I’d also advise vitamin A products, as they can stimulate long-term dermal collagen production.

“Retinol is a fantastic topical skincare option for many patients and can help to smooth the appearance of fine marionette lines.”


One treatment Dr Lindsay would advise patients to consider is Profhilo. “Injectables such as Profhilo are designed to treat skin laxity and dermal atrophy through the stimulation of dermal fibroblasts,” she explains.

Dr Janine adds that while Profhilo won’t target marionette lines specifically, “it may soften the appearance by stimulating collagen and remodelling the skin. Polynucleotides can also be used similarly.”

Energy-based skin treatment devices

An alternative way to treat marionette lines is through energy-based treatments. “Devices such as Morpheus 8 combine radio frequency and microneedling to treat tissue laxity,” Dr Lindsay comments.

Microneedling and laser resurfacing

For finer lines, Dr Janine states, “Microneedling and laser resurfacing are additional treatments that can reduce the appearance of marionette lines, by stimulating collagen production.”

Microneedling is likewise a great treatment for skin textural concerns and atrophic acne scars. This is something to consider when creating your patient’s treatment plan if they have multiple skin concerns.

Chemical peels

Dr Janine recommends, “You can use topical treatments to improve marionette lines, such as chemical peels. These can increase cell turnover, improve the quality of the skin and, therefore, soften the appearance of marionette lines.”

Chemical peels can treat a wide range of concerns, including wrinkles, acne and pigmentation. They combine well with injectables like toxins and fillers. If a patient is looking for a more holistic approach, this may be a useful addition to their long-term treatment plan.

Chemical Peel for Marionette Lines Cosmetic Dermatology Training Course Facial Anatomy

Broaden your aesthetic medicine treatment offering

Having the relevant knowledge of skin, skin treatments and injectables will enable you to offer holistic treatment plans and care. Combining skincare advice and non-injectable treatments with filler and botox will ensure you can address multiple aesthetic concerns. Skin treatments are also great starters if a patient isn't ready for injectables. This means you’ll be able to develop a solid rapport and patient base that keeps on returning.

Make the most out of your medical aesthetics training with our Combined Level 7 Diploma & Cosmetic Dermatology course. The course is open to doctors, dentists, nurses and clinical pharmacists. It’s the perfect way to start your career and develop your knowledge of popular treatments including microneedling, chemical peels, botox, fillers and skin boosters. It’s particularly relevant if you intend to start your own small business, as you'll have options for most facial aesthetic concerns.

If a concentrated focus on skin is what you’re looking for, then our Cosmetic Dermatology course may be for you. It’ll provide you with in-depth knowledge and training on how to tackle various skin concerns for different skin types. You’ll expand your knowledge of all treatments, techniques and contraindications while learning to consult patients.

To find out which aesthetics training course would be the best option with your goals in mind, book a call with one of our course advisors.

All information correct at the time of publication

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