How Can Sagging Skin Tissue Caused by Marionette Lines Be Improved?

As you get older, even when you are not angry, the corners of the mouth can droop downward for a long time, making your face look as if you are constantly displeased.

This is the phenomenon commonly called "marionette lines".

Loss of skin elasticity due to a decrease in collagen and elastin, changes in the position of the deep buccal fat pad, and repeated movement of facial muscles all combine to form marionette lines.

In particular, frequent smartphone use and frowning expressions caused by stress in modern life can accelerate these changes even more.

What is unfortunate is that the change in appearance caused by marionette lines can go beyond a simple cosmetic issue and affect interpersonal relationships and social life.

In fact, many patients who come in for consultations say,

"People say I look sulky and angry."

and share their concerns.

If this situation continues, self-confidence gradually declines.

So, how should marionette lines caused by sagging skin be managed?

Analyzing the root cause of marionette lines

The biggest cause of marionette lines is a change in the structure of the skin tissue.

The skin on our face is made up of the epidermis, dermis, and subcutaneous fat layer, and as we age, the changes that occur in each layer directly affect the formation of marionette lines.

The most important changes occur in the dermis.

The reduction of collagen and elastin fibers in this layer is the main reason skin elasticity decreases.

Collagen, which decreases by about 1% each year after age 25, plays a structural role in the skin, and when it decreases, skin elasticity gradually weakens.

Eventually, the skin begins to sag downward due to gravity.

In particular, the area around the corners of the mouth is where facial muscles move actively, so it loses elasticity faster than other areas.

When damage to elastin fibers is added to this, the skin that has once stretched out can no longer return to its original state.

Another important cause is the change in the position of the deep buccal fat pad.

When the deep buccal fat tissue located in the cheeks moves downward with age, it accumulates as a bulge beneath the cheeks.

As the skin gradually loosens over this accumulated area, marionette lines form.

Marionette line lifting

There are various lifting procedures to improve marionette lines, but among them, thread lifting shows relatively direct effects.

Thread lifting works by directly inserting medical absorbable threads (made of materials such as PDO, PLLA, and PCL) into the dermis and subcutaneous fat layer to physically lift the tissue.

This is fundamentally different from lifting procedures that create indirect effects using only thermal energy and chemical action.

In addition, as the threads gradually break down in the body afterward, collagen production is promoted through a foreign-body response, creating a more natural and firmer lifting effect over time.

One reason thread lifting is especially advantageous for improving marionette lines is that selective targeting is possible.

Marionette lines mainly appear concentrated in a specific area from the corners of the mouth to the jawline, and that area alone can be precisely targeted for focused improvement.

It is also possible to create a customized lift suited to each person’s facial structure by adjusting the direction and depth of thread insertion.

In particular, the medical threads used for thread lifting are made of biocompatible materials.

PDO threads, in particular, have excellent biocompatibility to the extent that they are used as sutures in heart surgery.

Types of thread lifting

Why choose the thread that is right for me?

There are many different types of threads used in thread lifting.

Depending on their characteristics, the effect on marionette line improvement and the duration of the results differ.

The most basic classification is based on the shape of the thread, which is divided into monothreads, cog threads, and volume threads.

Among them, the one that shows the most direct effect on improving marionette lines is the cog thread.

This is because cog threads have barbs along the thread’s direction, providing a direct lifting effect by strongly hooking into the tissue and pulling it upward.

PDO cog threads are the most widely used type of thread.

They are generally broken down over 6 to 8 months, and during the breakdown process, they continuously induce collagen production.

For improving marionette lines, they are relatively excellent in terms of immediate effect, but they also have the characteristic of lasting for a comparatively shorter time than other materials.

Because they offer good results for the price, they can be recommended for those considering their first thread lifting procedure.

PLLA threads are made from poly-L-lactic acid and can induce collagen production for a longer period of time.

Their breakdown period is relatively long at 12 to 18 months, and they are threads that focus more on elasticity and volume than on immediate lifting.

As such, the effects and advantages and disadvantages of threads vary depending on their ingredients and shape.

Do not choose on your own which thread is right for you; you must proceed only after a thorough diagnosis and consultation with medical professionals.

Marionette lines are a problem caused by more complex factors than commonly known.

Rather than giving up and leaving them untreated as an inevitable change caused by aging, first get a diagnosis and find out whether improvement is possible.

To do that, you need to choose a trustworthy medical professional.

Please compare carefully and check thoroughly.

Thank you for reading this long post.

| This post was written for informational purposes in compliance with Article 56, Paragraphs 1 to 15 of the Medical Service Act. All treatments carry the risk of side effects and complications depending on the individual. Before treatment, be sure to have sufficient consultation with a medical professional with extensive experience before making a decision. |