They’re absolutely no laughing matter! Because they make your face look older and give you a sadder appearance. Did you know: Not all marionette lines appear only with age? Some people are prone to them early on, especially when they laugh. What are the first signs? What can you do about them, and how can you get targeted treatment for them in Vienna? Find the answers here.
A wrinkle with many names. One of them comes from former German Chancellor Angela Merkel. Take a look at a picture of yourself, and you’ll see why. Like a marionette, the marionette line separates the chin and mouth area from the rest of the face. In medical terminology, it’s also called the mentolabial fold, since it runs vertically from the corner of the mouth down to the chin. This means that the corners of the mouth droop, often forming a deep groove extending all the way to the chin. As a result, people with this condition are usually perceived as looking sad. This is often exacerbated by sagging cheeks, which develop naturally with age due to an increase in lower facial fat pads.
Interesting detail: at times, the nasolabial fold merges into the marionette fold, making the face look as if it were particularly exposed to gravity by pulling facial regions downward. This means that a very pronounced additional nasolabial fold can make your face look even older. But it can also make a problem in early years.
Strictly speaking, puppet wrinkles are not a problem of aging, but the foundation is laid already in the late 20s and early 30s. And how? As the muscle that pulls down the corner of the mouth gains increasing strength. In addition, its counterparts that move upward become weaker. That’s the way it is with most people. To make matters worse, this often causes fat deposits to build up on the muscle that pulls down. The result: Especially when laughing heartily, a deep wrinkle and a small cheek at the side of the corner of the mouth become visible in addition to fine lip wrinkles. The good thing is that, especially at a young age, there are simple ways to counteract this.
If we were to look for two culprits, they would be overactivity of a facial muscle on the one hand and the aging process on the other. Muscle overactivity is responsible, especially in young people, for the corners of the mouth being pulled down sharply or deep marionette folds appearing at the sides of them when laughing heartily. It is called the musculus depressor anguli oris. But in order for us to look happy, there are still counterparts on the face that pull up the corners of the mouth. These are several fine muscle groups with again long Latin names. If there is now unconscious overactivity of the depressor muscle, the antagonists cannot keep the wound angles in balance and a fold is formed.
On the other hand, facial fat pads migrate from the top to the bottom as we age. That is why the face often looks heavy in older people. As the upper half of the face looks rather bony especially in the temple and eye region and rather oily in the lower third. The consequences are an increase in static facial wr inkles such as nasolabial folds, marionette lines and sagging cheeks.
In your mid-20s, you’ll most likely first notice the signs when you smile—caused by overactivity of the chin muscle that pulls downward from the mouth. This creates deep vertical lines next to the corners of your mouth that extend toward your chin. Often, small fat deposits are located on either side of these lines, but they disappear completely when your facial expression is neutral. Since the marionette line is a rather deep furrow, you’ll notice the lines extending downward from both corners of your mouth very quickly. Unlike forehead or frown lines, they become permanent at an early age—regardless of your facial expression.
Ideally, as soon as they appear. This is because they produce a sad, bitter facial expression, which is why affected people usually suffer particularly from them. In your 20s and 30s, this is often barely noticeable and when exactly when you wouldn’t expect it. Namely, when laughing, where deep wrinkles and cheeks form next to the corners of the mouth. However, especially in the beginning, it is very easy to balance the volume gain in the lateral chin and lower cheek region. Why? Because the reason is the overactivity of a facial muscle. The older you get, the deeper the wrinkle digs into your skin and the greater the treatment effort becomes.
The good news: Marionette lines can be treated quickly and without surgery. The right method depends on the cause—an overactive muscle requires a different treatment than a lack of volume or reduced skin elasticity. That’s exactly why we take the time to carefully examine your face first.
If the wrinkle has already deepened into a furrow or if there is a loss of volume in the lower half of the face, hyaluronic acid injections are the first choice. The filler specifically fills in the furrow and supports the area around the corners of the mouth—your face immediately looks friendlier and fresher. The treatment takes about 20 minutes, and you’ll see the results right away. Depending on your skin type, the results last several months; with repeated treatments, they can last for years.
In cases of significant volume loss or a sagging jawline, we combine dermal fillers with Radiesse—which also stimulates collagen production—or with Ultherapy as needed: Ultrasound lifting firms sagging cheeks and the jawline, which can also visibly improve marionette lines.
If you’re still young and the wrinkle appears mainly when you laugh or speak, it’s almost always caused by overactivity of the musculus depressor anguli oris. This is the muscle that pulls the corners of your mouth downward. In this case, Botox treatment can help: It specifically relaxes this muscle, causing the corners of your mouth to lift while the opposing muscles gain strength. As a result, you often benefit from the treatment for longer than the Botox itself remains effective.
Let’s be honest: No cream or facial exercise can help with an existing marionette line. Good skincare and sun protection can slow down skin aging—but unfortunately, they won’t get rid of a line that’s already set in.
Last updated: October 6, 2026
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