How Botox Can Help Soften Marionette Lines

How Botox Can Help Soften Marionette Lines

Our facial expressions, skin elasticity, and volume loss begin to show up in various ways—one of the most common being marionette lines. These lines, which run vertically from the corners of the mouth to the chin, can create a downturned appearance, often making the face look sad or tired.

While dermal fillers are typically the go-to for treating marionette lines, Botox (botulinum toxin) is increasingly being used as a non-invasive solution to soften these lines and restore a more youthful, relaxed appearance. In this article, we’ll explore how Botox works for lines, who it's best suited for, and how it compares to other treatment options.

What Are Marionette Lines?

Marionette lines are named after marionette puppets, which have visible vertical lines near their mouths that create a hinged jaw effect. In humans, these lines:

Start at the corners of the mouth

Extend downward toward the chin and jawline

Become more pronounced with age, facial volume loss, gravity, and repetitive muscle movement

They are caused by a combination of factors:

Loss of collagen and elastin

Decreased facial fat and volume

Muscle pull from the depressor anguli oris (DAO) muscle, which pulls the corners of the mouth downward

Skin laxity

While not harmful, marionette lines can significantly affect facial aesthetics and self-confidence, leading many people to seek cosmetic treatments.

What Is Botox and How Does It Work?

Botox is a brand of botulinum toxin type A, a purified protein that temporarily relaxes targeted muscles. By doing so, Botox can reduce the movement that contributes to the formation of dynamic wrinkles—those caused by facial expressions and repetitive motion.

When injected into specific facial muscles, Botox:

Blocks nerve signals to the muscle

Reduces muscle contraction

Softens the overlying skin and reduces the appearance of wrinkles

For marionette, Botox is used to relax the muscles that pull the corners of the mouth downward, particularly the DAO muscle.

How Botox Treats Marionette Lines

Botox for lines is not about adding volume (that’s what fillers are for)—instead, it prevents or reduces the downward pull that deepens the lines and contributes to a frowning or sagging appearance.

Target Area: Depressor Anguli Oris (DAO) Muscle

The DAO muscle connects from the corners of the mouth to the jaw.

When this muscle contracts, it pulls the corners downward.

Botox injections into the DAO relax this pull, allowing the mouth corners to lift slightly, reducing the prominence of a marionette.

Benefits of Botox for Lines

Softens the lines by minimizing the muscle activity that worsens them

Lifts the mouth corners, restoring a more neutral or slightly upward expression

Creates a more youthful, approachable appearance

Can be done quickly, with no downtime

Often used in combination with dermal fillers for enhanced results

The Procedure: What to Expect

Botox treatment for lines is a quick, in-office procedure. Here’s what you can expect:

Consultation

A qualified provider will assess your facial anatomy, skin condition, and severity of the lines.

They’ll determine whether Botox, fillers, or a combination is the best approach.

Injection Process

The area is cleansed, and a numbing cream may be applied.

A small amount of Botox is injected into each side, targeting the DAO muscle.

The process takes about 10–15 minutes.

Aftercare

Avoid lying down for 4 hours post-treatment.

Refrain from strenuous exercise or rubbing the area for 24 hours.

You may experience mild swelling, redness, or bruising at the injection site.

Results: When and What to Expect

Botox results are not immediate—you’ll begin to see changes within 3 to 5 days, with full effects visible in 10 to 14 days.

Expected Results

Subtle lifting of the mouth corners

Softening of the lines

Improved facial expression (less “sad” or “angry” look)

Results typically last 3 to 4 months, after which repeat treatments are needed to maintain the effect

Is Botox Alone Enough?

For mild to moderate marionette, Botox may be sufficient on its own. However, in more advanced cases, a combination approach may be necessary.

Combining Botox with Dermal Fillers

Botox relaxes the DAO muscle to reduce the downward pull.

Hyaluronic acid fillers can add volume to the area around the lines, restoring lost support and smoothing deeper folds.

The combination offers both dynamic muscle relaxation and structural support, producing a more natural and comprehensive result.

Who Is a Good Candidate for Botox for Marionette Lines?

You may be a good candidate if you:

Have mild to moderate marionette caused primarily by muscle activity

Notice a persistent downward pull at the corners of your mouth

Want a non-surgical, temporary solution

Prefer minimal downtime

We are open to combining treatments for the best results

It may not be sufficient alone for individuals with significant aesthetic clinic skin laxity or very deep folds—these cases might benefit more from fillers, skin tightening treatments, or surgical options.

Risks and Considerations

Botox is generally safe when administered by an experienced professional, but as with any treatment, there are potential risks:

Temporary asymmetry if the injection isn’t balanced

Over-relaxation, causing an unnatural or “droopy” look

Bruising or swelling at the injection site

Rarely, diffusion of the toxin can affect surrounding muscles

Choosing a skilled injector is critical to achieving natural, balanced results.

Botox vs. Fillers for Marionette Lines: A Quick Comparison

Conclusion

Botox offers a subtle, elegant solution for softening marionette lines, especially when muscle movement is a contributing factor. While not a substitute for volume loss correction or surgical lifting, Botox can refresh your lower face and enhance your overall expression, without the need for invasive procedures or long recovery.

If you’re concerned about looking tired or downturned due to lines, consulting with a skilled aesthetic provider can help determine whether Botox, fillers, or a combined approach is right for your goals.