2026-09-03
Gangnam Plastic Surgery: Marionette Line Improvement Must Consider Cheek Sagging First
Marionette lines, often mistaken for simple mouth wrinkles, are frequently caused by sagging cheeks. Gangnam plastic surgery clinics emphasize a holistic approach, analyzing cheek sagging and overall facial balance for natural, lasting results.
※ This article is intended to provide medical information.
It is not subject to review under Article 56, Paragraph 2 and Article 57 of the Medical Act,
and is not an advertisement unrelated to the review content.
Hello,
I am Dr. Jung-Geun Park,
Director of Face Plus Plastic Surgery Clinic.
As we age, deep lines extending from the corners of the mouth downwards often make us look tired or angry.
These wrinkles are commonly called marionette lines,
and it’s easy to think they are simply wrinkles around the mouth.
However, in reality, it’s often not just a problem around the mouth,
but a change that occurs as the tissues supporting the cheeks move downwards.
Therefore, at Gangnam plastic surgery clinics,
when evaluating marionette lines,
it’s common to not only check the depth of the wrinkles
but also to consider cheek sagging and the overall balance of the face.
Today, we will delve into the reasons why marionette lines form
and why cheek sagging must be considered simultaneously.
Table of Contents | ||
1. Why do marionette lines form? 2. Why does cheek sagging deepen wrinkles? 3. Key points in treating marionette lines 4. Checkpoints for natural results |
1. Why do marionette lines form?
Marionette lines refer to the wrinkles that extend from the corners of the mouth towards the chin.
These wrinkles are not just a problem of the skin surface,
but a change that occurs as the skin, subcutaneous fat, retaining ligaments,
and SMAS layer all age together.
When young, the structures supporting the cheek fat are firm, so there are no significant contours around the mouth.
However, over time, collagen and elastin decrease,
and cheek fat moves downwards due to gravity.
As a result, hollow areas appear on both sides of the mouth,
and a folded boundary forms above the jawline,
making marionette lines appear more prominent.
Therefore, at Gangnam plastic surgery clinics,
it is explained that it’s important to analyze not just the mouth area in isolation,
but also the position of the cheek fat and the degree of overall facial sagging.
2. Why does cheek sagging deepen wrinkles?
Many people believe that marionette lines
are caused by the skin around the mouth folding.
However, the actual cause often arises from the downward movement of the cheeks’ weight.
In particular, when the fat pads of the midface descend, a continuous downward pressure is created on the mouth area.
This repeated pressure can create deep shadows below the corners of the mouth, and the jawline can also collapse, leading to an aged appearance.
Therefore, if the approach is only to fill marionette lines
or simply tighten the skin,
the fundamental cause may remain unaddressed.
For these reasons, Gangnam plastic surgery clinics often
first identify the direction of cheek sagging and the movement of facial tissues, then formulate a treatment plan tailored to the individual's condition.
3. Key points in treating marionette lines
The approach to treating marionette lines can vary
depending on the cause.
If reduced skin elasticity is the primary cause,
the plan may focus on improving elasticity; if cheek sagging is significant,
an approach involving repositioning the sagging tissues upwards and backwards
may be considered.
Additionally, if the mouth area appears hollow due to a lack of fat, volume restoration may also be considered.
The important thing is not to apply one method to everyone,
but to comprehensively evaluate skin thickness, fat volume, SMAS layer sagging, face shape,
and the degree of aging.
Therefore, at Gangnam plastic surgery clinics,
the process of first identifying the cause of marionette lines by examining not only the frontal but also the side profile of the face is crucial.
4. Checkpoints for natural results
Treating marionette lines is not simply about eliminating a single line.
Because the cheeks, mouth area,
and jawline are connected as a single structure,
the overall facial balance must be considered.
If wrinkles are overfilled,
the mouth area can appear heavy; conversely, if sagging tissues are not adequately addressed,
the lines may deepen again over time.
Therefore, it is important to comprehensively analyze skin condition, degree of sagging, elasticity, facial proportions,
and lifestyle habits.
In particular, since the pattern of aging differs for each person,
even for the same marionette lines, the necessary treatment approach can vary.
As such, at Gangnam plastic surgery clinics,
an approach that analyzes cheek sagging and the overall facial structure, rather than just focusing on the mouth area, can help in planning more natural results.
For marionette lines, understanding the cause of the lines
is more important than just the visible lines themselves.
Accurately identifying the cause and considering the overall facial balance
can help create a more natural and harmonious appearance.
-Operating Hours-
Weekdays 9:00 ~ 18:00 Saturdays 9:00 ~ 16:00 Public Holidays / Sundays Regular closure |
-Contact Us-
Face Plus Plastic Surgery Clinic | ||
Consultation Phone: 02-541-8500 Inquiries: KakaoTalk Inquiry |
-Directions-
Frequently Asked Questions
What are marionette lines?
Marionette lines refer to the wrinkles that extend downwards from the corners of the mouth towards the chin. These wrinkles are not merely a surface skin issue but a change that occurs as the skin, subcutaneous fat, retaining ligaments, and SMAS layer all age together.
Why do marionette lines form?
Marionette lines form as collagen and elastin decrease over time, and cheek fat moves downwards due to gravity. This causes the areas on both sides of the mouth to hollow and a boundary to form above the jawline, making the wrinkles more prominent.
Should cheek sagging be considered when treating marionette lines?
Yes, it should be considered. Marionette lines often arise from the downward movement of the cheeks’ weight. The descending midface fat pads can continuously press on the mouth area, creating deep shadows.
How are marionette lines treated?
The treatment approach for marionette lines varies depending on the cause. If reduced skin elasticity is the primary cause, treatment may focus on improving elasticity; if cheek sagging is significant, repositioning the sagging tissues may be considered; and if there is a lack of fat, volume restoration may be included.
What is important for natural marionette line improvement?
For natural results, it is crucial to consider the overall facial balance. Overfilling wrinkles or not adequately addressing sagging tissues can lead to an unnatural appearance or the lines deepening again over time. Therefore, a comprehensive analysis of skin condition, degree of sagging, elasticity, and other factors is essential.