Marionette Lines: Why They Form and How to Care for Them — From Mechanism to Recovery Care

If you notice a pronounced shadow forming a figure-eight shape running from the corners of your mouth down to your jawline when looking in the mirror, this is commonly called a 'marionette line.' The name comes from its resemblance to the jointed lines around the mouth of a marionette puppet, and it's described as one of the representative static wrinkles that appear around the mouth as aging progresses.

This article will cover, in order, the structural mechanism behind the formation of marionette lines, procedural approaches to addressing them, and recovery and home care during the downtime period following treatment. All content is presented neutrally within the scope of the reference materials, and whether to undergo any procedure, as well as the specific method, should always be decided through consultation with a specialist.

Why Do Marionette Lines Form — Structural Causes

In academic reviews, marionette lines are also explained under the term 'static labiomandibular fold,' and are reported as an aging-related wrinkle around the mouth that is relatively commonly observed in Asians. As the term 'static' suggests, a defining feature is that the fold remains visible even when the face is at rest.

The formation of this fold is explained as involving more than simple skin sagging. Anatomically, a positional shift in the 'modiolus'—the point where muscles near the corner of the mouth converge—is observed to occur alongside aging, and this fold is understood as a multifactorial wrinkle in which the fascia, ligaments, fat layers, and other structures are jointly involved.

In other words, marionette lines can be seen as less a surface-level skin issue and more a result produced jointly by the supporting structures of the lower face and the pulling force of the muscles.

Procedural Approach — Combining Filler and Botulinum Toxin

Since multiple structural factors are involved, academic reviews mention that a multi-pronged approach combining dermal filler and neurotoxin (botulinum toxin) may be helpful. However, it should be understood accurately as an approach aimed at easing structural factors, not one that completely eliminates the wrinkle itself.

Filler injection using a cannula is described as working by supplementing volume-deficient areas in the supra-muscular or sub-muscular layers. This can be understood as an approach that fills in the sunken-looking area below the corner of the mouth.

Meanwhile, injecting botulinum toxin into the depressor anguli oris (DAO) is described as being able to complement results by reducing the pulling force of the muscle that draws the corner of the mouth downward. While filler is an approach that supplements volume, toxin can be described as an approach that adjusts the downward pulling force itself.

However, some descriptions of this combined approach are presented in the form of individual clinical blog posts or interviews, and in some cases lack sufficient quantitative evidence. The academic reviews themselves also focus mainly on explaining mechanisms, without confirmed high-level evidence such as randomized controlled trials. Therefore, it should be noted that effects and duration can vary significantly by individual.

What to Know About Perceived Effects and Downtime

The perceived degree of effect and duration from filler and botulinum toxin approaches can differ depending on individual facial structure, wrinkle severity, and skin condition. Before any procedure, an accurate diagnosis of one's own facial structure and consultation with a specialist about which method is suitable should come first.

Given the nature of injection procedures, swelling, mild bruising, and temporary sensitivity in the treated area may occur immediately afterward, and recovery time can vary by individual. Since reference materials do not provide verified specific figures on side effects or downtime, it's advisable to receive direct guidance on the expected course and precautions from your physician before the procedure.

Why Skin Condition Care Matters During Post-Procedure Recovery

After an injection procedure, the treated area's skin barrier may go through a period of temporary sensitivity. During this period, it's said that avoiding irritating ingredients and focusing home care on maintaining stable skin hydration and barrier function can be helpful.

Of course, home care does not replace or guarantee the effect of the procedure itself; it should be accurately understood only as a supportive role in managing skin condition during recovery.

Home Care Can Make a Difference in Post-Procedure Recovery

From immediately after the procedure through the early recovery period, skin can be more sensitive than usual, so many people incorporate skincare focused on soothing and barrier care during this time. For example, within the 2-STEP regimen of the Abzu cream line, STEP1 Ultra Cera-Rich can be used to target soothing and barrier care for skin that has become sensitive right after the procedure, while STEP2 Hydro Re-Boosting can be used to continue deep hydration care during the recovery period as swelling subsides. However, this kind of home care does not guarantee or replace the effect of the procedure itself—it is only a supportive means of managing skin condition during recovery. The suitability and method of the procedure itself should always be discussed with a specialist at a medical institution.

Medically reviewed by 아비쥬의원 의료진. (September 10, 2026)