Nasolabial Folds & Marionette Lines

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Best Filler Treatments For Marionette Lines & Nasolabial Folds

We lose volume in our faces every day simply by smiling and laughing. Over time, repetitive “folding” of the skin will cause a breakdown of collagen and a loss of volume and elasticity, resulting in fine lines, folds and, eventually, wrinkles. The skin between the nose and the chin is relatively thin, which is why many patients begin seeing lines forming here first. To help combat these initial signs of aging and stop the advancing of depth in these lines, Donaldson Plastic Surgery offers professional filler treatments for marionette lines and nasolabial folds!

What Are Nasolabial Folds and Marionette Lines?


Nasolabial Folds are cosmetic folds that form at what is called the nasolabial crease, the faint line that runs from underneath the nostril to the corner of the mouth. Nasolabial creases are a normal part of facial anatomy, but as we age, sagging skin causes this crease to look deeper. Some people refer to these as “deep laugh lines.” Marionette lines are the grooves that run from the corners of the mouth down to the jawline. They get their name from old-fashioned string marionette puppets and the vertical lines of their detachable lower jaws.

Benefits of Nasolabial Fold & Marionette Line Fillers

Facial “folds” are natural and they move dynamically when we smile, frown or get lost in thought. The goal of our treatments is not to eradicate these lines altogether, but to soften them for a naturally youthful look. The efficacy of these safe fillers is dependant on the depth of the fold and wrinkles on a patient’s face. We can say, with confidence, that we have the ability to lessen the appearance of Nasolabial Fold and Marionette Lines – but they’ll never fully be gone.

What's the Difference Between Wrinkles and Folds?

A “Fold Line” is a superficial crease that is left when your skin begins to sag and fold over itself. These occur naturally as the elastin and collagen beneath the skin’s surface begin to break down with age, with most patients noticing fold lines starting to form around their late 20s and early 30s. A fold line is similar to the crease left after you fold a piece of paper — it is the mark that is left on the paper when it becomes unfolded. We express emotion the same, but our skin doesn’t quite bounce back like it used to when we lost facial volume. Wrinkles are more superficial on the outermost layer of the skin, and are caused by repetitive muscular movement. 

What Causes Nasolabial Folds?

Some of the biggest causes of nasolabial fold lines are completely natural – volume loss due to age, learned speech behaviors and simple genetics. Environmental and lifestyle factors that play a major role include smoking, rapid changes in weight, exposure to pollutants and sun damage from unprotected exposure to UV rays.

What Causes Marionette Lines

The skin below our mouths and on our chin is very thin and, as collagen breaks down over time, telling signs of aging creep up. Causes of Marionette Lines typically include natural collagen loss, poor nutrition, long-term dehydration, stress and exposure to the sun.

Am I A Candidate for Nasolabial Fold/Marionette Line Filler?

It is important to know that not everyone who has nasolabial folds or marionette lines is a candidate for filler. It is also important to have realistic expectations about the outcomes. If your filler specialist suspects that filler will not help you achieve your goals, it is possible that they may recommend you not receive the treatment. In some cases, your injector may consult with you and recommend other options that would better treat nasolabial folds and marionette lines, such as laser resurfacing, Botox treatments or a surgical facelift.

What Should I Expect At My Filler Treatment?

Everything begins with that initial consultation with one of our specialists! We’ll discuss your goals and ensure that you’re a good candidate for this filler treatment. The procedure consists of a series of small, little pokes along the areas in question, with some stopping to check symmetry and how the filler responds to your natural facial movements.

Do These Treatments Hurt?

Patients can expect some minor discomfort during the procedure and slight swelling that may last anywhere from a couple of days and, in some cases, a couple of weeks. Some individuals experience bruising that lasts up to a week but can be covered by makeup.

How Long Does Nasolabial Fold and Marionette Line Filler Last?

The skin around the mouth is comparatively thinner when compared to other areas of the face, and it experiences much more dynamic movement. The constant movement of this area causes fillers to generally break down more quickly than more stagnant areas, such as the cheeks or nose. Different filler formulas also play a role in how long the actual molecular anatomy of the filler used also plays a role in how long the fillers last. Typically, a treatment will between 6 months to around two years. That’s quite the range, but it depends on how much of the filler was used, the amount of movement in the area and other factors, including your body’s natural metabolic rate.

What Type of Filler is Used for Nasolabial Folds & Marionette Lines?

The RHA® Collection is a unique hyaluronic acid filler designed specifically to combat dynamic wrinkles and folds. RHA uses longer branch chains of amino acids, which makes the filler much more flexible and pliable – meaning it won’t break down or degrade as quickly as fillers with shorter branch-chain amino acids. Some situations call for a filler with heavier viscosity to get the job done. If this is the case, we will discuss further options with you!

How Much Does the Filler Cost?

The cost of your nasolabial fold and marionette line filler treatment . Usually, we recommend you begin with two syringes of filler for your treatment, which may range anywhere from $1200 to $1800. The cost of your specific filler treatment will be given in a quote prior to your procedure. 

How Much Filler is Needed for Marionette Lines or Nasolabial Folds?

On average, our medspa specialists use 1-2 syringes to fill the overall need – the amount of filler depends on the technique of the injector and the depth of your lines/folds.

Why Choose Donaldson Plastic Surgery for Nasolabial & Marionette Line Filler?

At Donaldson Plastic Surgery, the end result of your treatment plays second fiddle only to your safety. Our skilled experts have been trained in facial aesthetics and truly understand the nuances of facial anatomy. If too much filler is placed in the wrinkle, you may be very smooth, but you may also look puffy – this can look odd around the mouth. We are very calculated and conservative with our approach. We take our time, let the filler settle, see how your lines move with your face and then decide if more filler is needed. Ready to start your journey toward greater self-confidence?

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We invite you to call us at 614-442-7610 to schedule your personal consultation with Dr. Jeffrey Donaldson or Dr. Michelle Sieffert. Read More about Dr. Donaldson and Dr. Sieffert’s plastic surgery specialties.

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