Precautions Discussed by a Plastic Surgery Clinic for Marionette Line Removal

Hello. We are ‘Re:本 Plastic Surgery,’ and we welcome you at Exit 1 of Sinsa Station.

Marionette lines refer to wrinkles that run downward starting from the corners of the mouth.

They are named “marionette lines” because their shape resembles a Western wooden puppet called a marionette.

When marionette lines appear, the corners of the mouth look droopy, and the face can appear much older.

Because they can make a person look older than even deep nasolabial folds, many people visit us to have them removed.

Cause

Marionette lines become especially deep when both cheeks sag and volume around the mouth is lost.

These wrinkles do not appear simply because the skin has loosened.

They occur due to multiple factors, such as weakening of the supporting ligaments, which causes the face to sag under the influence of gravity, as well as reduced collagen synthesis and insufficient skin moisture due to aging.

In addition, the area around the mouth has less moisture and fewer sebaceous glands than other areas, the skin is thinner, and it moves a lot while eating, making facial expressions, and speaking.

As a result, wrinkles tend to become deeper, and once they form, they are not easily removed.

Thread lifting

Marionette lines are not easy to improve with procedures that simply use devices.

In particular, deep wrinkles caused by sagging tissue require a physical method that lifts the drooping cheek skin.

If surgery feels burdensome, we recommend ‘thread lifting.’

Thread lifting is a procedure that induces an immediate lifting effect by inserting harmless threads under the skin and pulling them into place.

Unlike lifting that uses laser devices, it can physically pull up the area causing the issue, but because it does not involve surgical operations such as a facelift, downtime is relatively short.

Also, the threads used recently are mostly special medical products.

They naturally dissolve over time, and during the process of dissolving, they also stimulate surrounding tissue to help collagen production.

Thanks to this, you can expect not only an immediate lifting effect but also improvement in fine wrinkles around the area.

Types of lifting threads

The threads used for thread lifting differ in purpose depending on whether they have barbs and on their material.

First, to explain the materials: the most commonly used material is PDO, a safe thread that is even used as a suture in heart surgery.

After insertion, it gradually dissolves.

PLLA threads are collagen self-forming inducers that generate collagen on their own.

Compared to PDO threads, they are more suitable for increasing volume.

PDO threads are further divided into mono threads and cog threads.

Mono threads are smooth threads, and they are inserted into the dermal layer to help induce collagen regeneration.

Cog threads are threads with various types of “barbs,” and they are inserted into the dermal and subcutaneous fat layers to lift the skin by pulling it upward.

Most of the threads currently used for “lifting” are these cog threads.

Among PLLA threads, there are cone threads.

Represented by “Silhouette Soft,” this thread has round cone-shaped barbs surrounding the thread 360 degrees.

It is inserted into the dermal layer to lift the skin while also increasing volume.

It has the advantage of being more flexible than conventional threads, but the force for lifting and pulling the face is weaker.

The summary of the above is as follows.

Mono thread (PDO)	Smooth PDO (Polydioxanone) thread, inserted into the dermal layer to induce collagen regeneration
Cog thread (PDO)	PDO thread with various types of barbs, inserted into the dermis-subcutaneous fat layer and lifted by pulling, thereby lifting the skin
Cog thread and cone thread (PLLA)	PLLA (Poly L Lactic Acid) thread with a cone shape, inserted into the dermis and subcutaneous fat layer to lift the skin while also helping increase volume through its own collagen-forming properties

Which thread should be used and how it should be used must be decided after comprehensively evaluating the cause of the marionette lines and the degree of skin sagging.

Precautions for thread lifting

The threads commonly used for thread lifting are mostly short in length.

Because of this, depending on the force and direction used when inserting and pulling the threads, the force may be concentrated on the cheekbones.

In such cases, the cheekbones may appear larger, making the face look bigger, so special caution is needed.

Re:本 Plastic Surgery has developed and uses ‘Reborn Threads,’ which remove these shortcomings of conventional threads while enhancing their advantages.

Reborn Threads are long enough to effectively disperse the force that tends to concentrate on the cheekbones.

Also, thread lifting is a procedure in which the surgeon’s technical skill, sense, and know-how based on experience are more important than anything else.

Unlike other laser device procedures that can rely on the equipment itself, satisfaction can vary greatly depending on who performs the procedure and how carefully it is done.

It is also risky to approach marionette lines and sagging cheek fat with the assumption that thread lifting is always the answer.

At Re:本 Plastic Surgery, a board-certified plastic surgeon with more than 20 years of experience carefully diagnoses each person’s face and proceeds with the procedure only after 충분히 상담한 후 시술을 진행합니다.

We also do not standardize a specific procedure, but instead suggest the procedure that best suits each patient’s face.

If you are concerned about deepened marionette lines, please visit Re:本 Plastic Surgery.

We will kindly assist you with 1:1 customized consultation and diagnosis.

Thank you.