Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)

Purpose Marionette lines, also known as static labiomandibular folds, are common age-related perioral wrinkles that impact facial aesthetics, particularly in Asian populations. This article aims to examine the anatomical basis, etiology, and filler injection techniques used for treating marionette l...

Full description

Saved in:
Bibliographic Details
Main Authors: Gi-Woong Hong, Sky Wong, Song-Eun Yoon, Jovian Wan, Kyu-Ho Yi
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Journal of Dermatological Treatment
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/09546634.2025.2452954
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832567765534244864
author Gi-Woong Hong
Sky Wong
Song-Eun Yoon
Jovian Wan
Kyu-Ho Yi
author_facet Gi-Woong Hong
Sky Wong
Song-Eun Yoon
Jovian Wan
Kyu-Ho Yi
author_sort Gi-Woong Hong
collection DOAJ
description Purpose Marionette lines, also known as static labiomandibular folds, are common age-related perioral wrinkles that impact facial aesthetics, particularly in Asian populations. This article aims to examine the anatomical basis, etiology, and filler injection techniques used for treating marionette lines.Materials and Methods The study reviews anatomical studies and clinical practices related to marionette lines. Anatomical observations focus on the position of the modiolus and its relationship to age-related changes. Treatment approaches are examined through a review of filler injection techniques, including supramuscular and submuscular fat layer targeting, as well as neurotoxin use for enhancing treatment outcomes.Results The review finds that the anatomical positioning of the modiolus in Asian populations predisposes them to increased susceptibility to commissural ptosis and wrinkle formation. Filler injections, particularly using a cannula for deeper layers, are effective for addressing volumetric loss in the supramuscular and submuscular layers. Neurotoxin injections into the depressor anguli oris muscle can enhance results by reducing downward force on the oral commissure.Conclusions Marionette lines are complex, multifactorial wrinkles that benefit from a multimodal treatment approach, combining dermal fillers and neurotoxins. Awareness of anatomical variations and proper injection techniques is crucial for achieving optimal aesthetic outcomes and minimizing risks.
format Article
id doaj-art-ea1378f8afda42f79826c779484e8d99
institution Kabale University
issn 0954-6634
1471-1753
language English
publishDate 2025-12-01
publisher Taylor & Francis Group
record_format Article
series Journal of Dermatological Treatment
spelling doaj-art-ea1378f8afda42f79826c779484e8d992025-02-03T01:00:44ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532025-12-0136110.1080/09546634.2025.2452954Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)Gi-Woong Hong0Sky Wong1Song-Eun Yoon2Jovian Wan3Kyu-Ho Yi4Samskin Plastic Surgery Clinic, Seoul, KoreaLeciel Medical Centre, Central, Hong KongBrandnew Aesthetic Surgery Clinic, Seoul, KoreaMedical Research Inc, Wonju, KoreaDivision in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Seoul, KoreaPurpose Marionette lines, also known as static labiomandibular folds, are common age-related perioral wrinkles that impact facial aesthetics, particularly in Asian populations. This article aims to examine the anatomical basis, etiology, and filler injection techniques used for treating marionette lines.Materials and Methods The study reviews anatomical studies and clinical practices related to marionette lines. Anatomical observations focus on the position of the modiolus and its relationship to age-related changes. Treatment approaches are examined through a review of filler injection techniques, including supramuscular and submuscular fat layer targeting, as well as neurotoxin use for enhancing treatment outcomes.Results The review finds that the anatomical positioning of the modiolus in Asian populations predisposes them to increased susceptibility to commissural ptosis and wrinkle formation. Filler injections, particularly using a cannula for deeper layers, are effective for addressing volumetric loss in the supramuscular and submuscular layers. Neurotoxin injections into the depressor anguli oris muscle can enhance results by reducing downward force on the oral commissure.Conclusions Marionette lines are complex, multifactorial wrinkles that benefit from a multimodal treatment approach, combining dermal fillers and neurotoxins. Awareness of anatomical variations and proper injection techniques is crucial for achieving optimal aesthetic outcomes and minimizing risks.https://www.tandfonline.com/doi/10.1080/09546634.2025.2452954Agingdermal fillersBotulinum toxinsfacial musclesanatomic landmarks
spellingShingle Gi-Woong Hong
Sky Wong
Song-Eun Yoon
Jovian Wan
Kyu-Ho Yi
Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)
Journal of Dermatological Treatment
Aging
dermal fillers
Botulinum toxins
facial muscles
anatomic landmarks
title Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)
title_full Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)
title_fullStr Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)
title_full_unstemmed Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)
title_short Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold)
title_sort anatomical based diagnosis and filler injection techniques marionette line static labiomandibular fold
topic Aging
dermal fillers
Botulinum toxins
facial muscles
anatomic landmarks
url https://www.tandfonline.com/doi/10.1080/09546634.2025.2452954
work_keys_str_mv AT giwoonghong anatomicalbaseddiagnosisandfillerinjectiontechniquesmarionettelinestaticlabiomandibularfold
AT skywong anatomicalbaseddiagnosisandfillerinjectiontechniquesmarionettelinestaticlabiomandibularfold
AT songeunyoon anatomicalbaseddiagnosisandfillerinjectiontechniquesmarionettelinestaticlabiomandibularfold
AT jovianwan anatomicalbaseddiagnosisandfillerinjectiontechniquesmarionettelinestaticlabiomandibularfold
AT kyuhoyi anatomicalbaseddiagnosisandfillerinjectiontechniquesmarionettelinestaticlabiomandibularfold