How to Get Rid of Marionette Lines Without Fillers – Useful Alternatives

Medically Reviewed
Medically Reviewed by Dr. Aurora Kalmanson on
Written by Fillers Editorial Team, plastic surgery specialists.

Marionette lines, the deep creases that can form around the mouth, often contribute to an aging appearance. Fortunately, there’s a range of natural strategies to mitigate these lines without resorting to fillers.

Strengthening facial muscles through specific exercises, improving skin blood flow and collagen production, and employing targeted skincare routines can all play crucial roles in reducing the visibility of marionette lines. Adopting these non-invasive measures and making appropriate lifestyle adjustments leads to a more youthful facial contour, diminishing the need for cosmetic fillers.

Professional Treatments for Marionette Lines (Non-Filler)

Even without fillers, professional treatments offer significant solutions for reducing the appearance of marionette lines. Exploring options such as Botox, laser resurfacing, or microneedling can achieve substantial improvements in skin texture and elasticity.

Botox and Neuromodulators

How Botox Works to Reduce Marionette Lines: Botox, a widely recognized neuromodulator, temporarily relaxes the muscles that contribute to marionette lines. By blocking the nerve signals that cause muscle contractions, Botox allows the skin above to remain smoother and less creased. This reduction in muscle activity eases the tension in the lower face, contributing to a noticeable decrease in the depth and visibility of marionette lines. The use of Botox is a strategic approach that, when precisely administered, provides a more relaxed and youthful facial appearance by softening the downward pull at the corners of the mouth.

Procedure Overview and Results: The Botox procedure for marionette lines is minimally invasive and quick, often completed within a lunch hour. Utilizing fine needles, the neuromodulator is injected into targeted areas, with minimal discomfort and no required downtime. Results typically manifest within a few days post-treatment, with optimal effects visible after about two weeks. These outcomes can last approximately three to four months, after which follow-up treatments are recommended to maintain results. Patients often report not just a decrease in marionette lines, but also an uplifted appearance as the skin around the mouth relaxes.

Laser Skin Resurfacing

Types of Laser Treatments (Ablative vs. Non-Ablative): Laser skin resurfacing is classified into ablative and non-ablative treatments. Ablative lasers work by removing the outer layers of skin, prompting substantial rejuvenation as the treated area heals. Non-ablative lasers, on the other hand, do not remove skin layers but instead heat the underlying skin tissue to stimulate collagen production, resulting in less intensive recovery. Both types can be effective for marionette lines; the choice depends on the severity of the lines, the desired results, and the patient’s willingness to undergo a longer recovery period for more dramatic outcomes.

Stimulating Collagen Production: Laser skin resurfacing stimulates the body’s natural collagen production process, which is central to the skin’s structural integrity. The heat from the laser promotes the body’s wound-healing response, leading to the formation of new, fresh collagen fibers. This regenerative process replenishes the skin’s diminished collagen levels due to age, helping to plump up and smooth out marionette lines. Regular treatments may be necessary for sustained collagen production, with the potential for long-term improvement in skin quality and elasticity.

Recovery and Downtime: Recovery time after laser skin resurfacing can vary widely, depending primarily on whether the treatment was ablative or non-ablative. Ablative treatments require more downtime, possibly involving several weeks, while non-ablative treatments have significantly shorter recovery times, often just a few days of mild redness and swelling. Aftercare is crucial for both types of resurfacing, including hydration, gentle skincare products, and rigorous sun protection to facilitate optimal healing and protect the skin during its more vulnerable recovery phase.


Collagen Induction Therapy: Microneedling, also known as collagen induction therapy, enhances the skin’s appearance by leveraging the body’s natural healing response. Fine needles create micro-injuries in the skin, which trigger collagen and elastin production as part of the healing process. This influx of natural proteins restructures and strengthens skin from within, reducing marionette lines’ prominence. For maximized effects, a series of treatments is typically recommended. As collagen builds over time, skin appears firmer and smoother, with a notable decrease in the depth of facial lines and creases.

Procedure Overview and Benefits: The microneedling procedure is straightforward and minimally invasive, with treatments usually completed within an hour. Patients describe the sensation as a light prickling as the device is moved across the target areas. Benefits of this treatment include improved skin texture and tone, reduction in pore size, and diminished appearance of lines, including marionette lines. There’s minimal downtime associated with microneedling, though slight redness may occur immediately after. As a versatile and less aggressive alternative to more intensive skin resurfacing methods, microneedling appeals to those seeking a maintenance-friendly approach to facial rejuvenation.

Chemical Peels

Types of Chemical Peels (Superficial, Medium, Deep): Chemical peels are categorized based on the depth of skin they affect: superficial, medium, and deep. Superficial peels, such as those containing glycolic or salicylic acid, address the topmost layer of skin and are suitable for mild discoloration and roughness. Medium peels penetrate further, often using trichloroacetic acid to treat deeper wrinkles and sun damage. Deep peels, involving phenol, reach the lower dermal layers and offer the most dramatic results in skin texture improvement, making them a powerful option for reducing marionette lines. Each type of peel has its specific indications and recovery times, with the depth of the peel directly influencing the intensity of the treatment and the subsequent healing process.

Exfoliation and Skin Renewal: Chemical peels work by exfoliating the skin, prompting the removal of old, dead skin cells and stimulating the growth of new, healthy ones. This turnover process is vital for improving skin texture and reducing the appearance of marionette lines. By removing the outer layers of skin, peels unveil a smoother, more even complexion. Moreover, the removal process helps to kickstart the body’s healing response, which includes increased collagen production, essential in filling and firming the areas marked by marionette lines. Regular chemical peels can lead to sustained skin health by encouraging continuous regeneration and maintenance.

Recovery and Results: Post-peel recovery varies, with superficial peels often requiring minimal downtime. While the skin may look slightly red or feel tight, daily activities can typically resume immediately. Medium and deep peels may involve more intense side effects, like peeling or crusting, and require a longer healing time. The skin needs protection from the sun during this period and meticulous aftercare to optimize results. Once healed, results can be quite striking, with diminished marionette lines, improved skin tone, and a more youthful overall appearance.

PDO Thread Lift

How PDO Threads Work to Lift and Tighten Skin: PDO (polydioxanone) thread lifts employ biodegradable threads to provide an instant lift to sagging skin, thus directly affecting the appearance of marionette lines. The threads, introduced into the skin with small needles, act as a scaffolding that raise the skin upwards. Over time, the presence of these threads also stimulates the body’s collagen production around the threads, further strengthening the skin’s structure and firmness. As the skin tightens and new collagen matures, the appearance of marionette lines can be significantly diminished, resulting in a more contoured and youthful facial silhouette.

Procedure Overview and Results: The procedure for a PDO thread lift is relatively quick, minimally invasive, and can be performed under local anesthesia. It includes minimal downtime, with some patients experiencing mild swelling or bruising that subsides in a few days. The results are typically noticed immediately post-procedure and improve over the following weeks as collagen synthesis progresses. Results can last from 6 months to a couple of years, depending on the individual’s skin condition and lifestyle. The PDO thread lift is a less invasive alternative to a traditional facelift, offering a midway solution for those seeking visible, lasting improvements without extensive surgery.

Advantages Over Traditional Facelifts: PDO thread lifts provide a non-surgical alternative to traditional facelifts, offering several advantages. The procedure is less invasive, resulting in reduced risk of complications, and requiring local rather than general anesthesia. Recovery time is significantly shorter, with most patients able to return to normal activities within a week or less. The cost is also generally lower, and although the results aren’t as long-lasting as a traditional facelift, they provide a more immediate return to everyday life without the extensive downtime. Additionally, thread lifts stimulate natural collagen production, ensuring results that improve over time and benefit the overall health and texture of the skin.

Frequently Asked Questions

How long does it take to see results from non-filler treatments for marionette lines?

Results vary depending on the treatment, but some like chemical peels and micro-needling can show improvements within a few weeks, while others like facial exercises may take longer to see noticeable changes.

Are non-filler treatments for marionette lines painful?

Most non-filler treatments for marionette lines involve minimal pain. Numbing creams can be used during procedures like micro-needling or chemical peels, and facial exercises or massage are pain-free.

How much do non-filler treatments for marionette lines cost compared to fillers?

Generally, non-filler treatments have a wide cost range, often being more affordable than fillers, especially when considering the ongoing expense of filler maintenance over time.

What is the best non-filler treatment for deep marionette lines?

For deep marionette lines, laser resurfacing or a PDO thread lift can be effective, though consulting with a skincare professional is recommended to determine the most suitable treatment.

How often should I receive non-filler treatments to maintain results?

Maintenance frequency depends on the specific treatment; for example, chemical peels may be done monthly, while procedures like PDO thread lifts can last several months to years before needing a repeat.

Can I combine non-filler treatments with fillers for better results?

Yes, combining non-filler treatments with fillers can potentially lead to better results, with the non-filler option enhancing skin texture and health, and fillers providing volume.

Are there any risks or side effects associated with non-filler treatments for marionette lines?

Possible risks or side effects vary by treatment but can include temporary redness, swelling, and bruising. More invasive procedures may have additional risks which should be discussed with a healthcare provider.


The journey to reducing marionette lines without the use of fillers can refer to a variety of treatments and lifestyle adjustments. From at-home remedies like regular facial exercises and awarness of the importance of sun protection habits to professional treatments such as laser resurfacing or chemical peels, each option serves the goal of rejuvenating skin appearance. The ideal strategy often lies in an adapted, multifaceted approach that encompasses a dedicated skincare routine, informed lifestyle choices, and periodic professional treatments—all contributing to maintaining a smoother, more youthful complexion.

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Hong, G. W., Kim, S. B., Park, S. Y., Wan, J., & Yi, K. H. (2024). Why do marionette lines appear? Exploring the anatomical perspectives and role of thread-based interventions.

Dr. Aurora Kalmanson

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The information provided in this blog is for informational and educational purposes only and should not be interpreted as personalized medical advice. It's crucial to understand that while we are medical professionals, the insights and advice we provide are based on general research and studies. They are not tailored to individual health needs or conditions. Thus, it is essential to consult directly with a healthcare provider who can offer personalized medical advice relevant to your specific situation.