Marionette lines
Marionette lines are folds extending from the corners of the mouth towards the chin or jaw. They may contribute to a downturned appearance at rest. The visible line can combine a true crease with shadow from nearby volume and early jowling.
What you may notice
- Folds below the mouth corners
- Shadow between the chin and lower cheek
- Downturned corners at rest
- Associated jowling or chin crease
Why it can happen
Lower-face movement, skin attachment points, changes in fat and bone support, chin shape and tissue descent can all contribute. Activity of muscles that pull the mouth corners downward may matter in some people, but anatomy and volume often play larger roles than the skin surface alone.
What may help
Skin care can improve texture but not reposition deeper tissues. Selected cases may be treated with filler, muscle-relaxing injections, fat transfer, resurfacing or lifting procedures. Correcting only the visible groove can add unwanted bulk; the mouth corners, chin, prejowl area and overall facial balance should be assessed together.
When to consult
Seek a qualified assessment to identify the dominant cause and realistic limits of treatment. Sudden lower-face asymmetry, weakness, speech change or numbness warrants urgent medical evaluation.
Evidence and sources
- DermNet. Facial lines and wrinkles [Internet]. Auckland: DermNet New Zealand Trust; 2004 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/facial-lines-and-wrinkles (new tab)
- DermNet. Ageing skin [Internet]. Auckland: DermNet New Zealand Trust; 2018 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/ageing-skin (new tab)
- American Society of Plastic Surgeons. Skin rejuvenation and resurfacing [Internet]. Arlington Heights (IL): American Society of Plastic Surgeons; [cited 2026 Nov 7]. Available from: https://www.plasticsurgery.org/cosmetic-procedures/skin-rejuvenation-and-resurfacing (new tab)
- US Food and Drug Administration. Wrinkle treatments and other anti-aging products [Internet]. Silver Spring (MD): FDA; 2024 [cited 2026 Nov 7]. Available from: https://www.fda.gov/cosmetics/cosmetic-products/wrinkle-treatments-and-other-anti-aging-products (new tab)