Nasolabial folds, also called smile lines, run from the sides of the nose towards the mouth corners. Marionette lines extend from the mouth corners towards the chin. They are different facial concerns and need different assessments.
At MA360 in Chatswood and Hurstville, Sydney, consultations for nasolabial folds and marionette lines consider skin quality, facial support and movement. Discuss suitable treatment options, expected benefits, limitations, risks and costs, including whether treatment is appropriate for you.
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A published case exploring skin laxity and mid-face support. Read the complete case for context.
Read the complete case studyIndividual outcome: these images show one patient’s result. Other patients may experience different results.
These examples concern nasolabial folds and broader facial support. They are not presented as marionette line treatment results. A case may include more than one procedure and cannot predict another person's result.
A published case showing facial contour from the side. The full case study provides the treatment context.
Read the complete case studyIndividual outcome: these images show one patient’s result. Other patients may experience different results.
A front-view case showing a softer fold while maintaining the patient's recognisable expression.
Read the complete case studyIndividual outcome: these images show one patient’s result. Other patients may experience different results.
Case-study images are displayed without additional cropping. Individual results vary with anatomy, movement, treatment history and healing. See each case study for the information available about that patient’s treatment.
Nasolabial folds, often called smile lines or laugh lines, run from the sides of the nose towards the mouth corners. They form the boundary between the cheek and upper lip area and usually deepen when you smile. A fold is a change in facial contour, so it can involve more than the skin surface.
Marionette lines, also called labiomandibular folds, extend from the mouth corners down towards the chin. They are distinct from nasolabial folds. Related concerns include downturned mouth corners which describe the position of the corners themselves. Jowling affects the lower cheek and jawline. These changes can appear together, but each needs its own assessment.
Folds from the sides of the nose towards the mouth corners, often more visible when smiling.
Why facial folds deepenLines or shadows extending below the mouth corners towards the chin.
Explore marionette linesA downward resting position or pull at the mouth corners.
Understand the DAO muscleFullness or tissue descent that interrupts the jawline contour.
Explore jowlingFacial structure, age-related changes in support, skin elasticity and movement can affect both concerns. Nasolabial folds involve the cheek-to-mouth transition; marionette lines involve the lower face below the mouth corners. Their causes can overlap, but the anatomy is different.
Underlying bone structure influences facial contours. Age-related changes around the upper jaw can affect support beside the nose, while chin and jaw structure matter when assessing the lower face.
Changes in facial fat and support can make creases or shadows more noticeable. Cheek support is relevant to smile lines; chin and lower-face support also matter for marionette lines.
Changes in the position of cheek and lower-face tissues can create fullness beside a crease. This can contribute to a deeper smile line or a shadow near a marionette line and jowl.
Age-related collagen loss, sun damage and reduced elasticity can make lines around the mouth more visible or etched into the skin.
Smiling naturally deepens nasolabial folds. Mouth-corner movement is also assessed when lines below the mouth are a concern, although muscle movement alone does not explain every fold.
A deep fold does not always mean missing volume. If tissue has descended or the cheek is already full, adding more support in the wrong place can increase heaviness instead of improving it.
Marionette lines are the creases or shadows that run down from the corners of the mouth towards the chin. They may become more noticeable as skin loses elasticity and the support or position of the surrounding tissues changes.
A marionette line assessment considers the depth of the fold, chin and jawline support, tissue fullness and mouth-corner movement. The line can sit alongside jowling or a downward pull at the mouth corners, but these are separate features.
Marionette line treatment planning starts with what is creating the crease or shadow. Fine surface lines, reduced facial support and loose skin may need different approaches. Your clinician should explain the likely benefit and limits of each option. Where laxity is the main issue, skin tightening assessment may be relevant. More substantial tissue descent may warrant surgical advice.
Treating the nasolabial fold beside the nose and mouth does not automatically improve a marionette line below it.
The depressor anguli oris (DAO) is a facial muscle that helps pull the mouth corners down. Its activity can contribute to a downturned appearance, although skin laxity, facial structure and the balance of surrounding muscles also matter.
A downward mouth corner describes the corner’s position. A marionette line describes the crease beneath it. You can have one, both or neither, and a photograph alone cannot establish whether the DAO is the main contributor.
The clinician observes the corners at rest, while speaking and during facial expression. They also review symmetry, lip function, previous treatment and support from the chin and lower face before discussing whether any treatment is suitable.
A plan for mouth-corner movement does not remove excess skin or reliably lift jowls. Any proposed treatment needs its own discussion of risks, including possible changes to smile symmetry or lip function where muscle movement is affected.
Jowling is fullness or sagging at the lower cheeks that interrupts the outline of the jaw. Changes in skin elasticity, tissue position and underlying facial support can contribute. It may make the area beside the chin look heavier or deepen a nearby shadow.
Marionette lines and jowls often sit close together. The assessment looks at both the fold and the surrounding tissue, including the chin, jawline and neck. A DAO assessment addresses a different question: how muscle movement affects the mouth corners.
Selected non-surgical approaches may be discussed for mild laxity, but they have limits. Skin tightening options and a jawline assessment can help clarify what is realistic for your anatomy. Marked excess skin or tissue descent may be better assessed by a surgeon.
Adding fullness beside a jowl is not automatically helpful. The aim of assessment is to understand whether the concern comes from a hollow, tissue descent, skin laxity or a combination.
There is no single treatment that suits every smile line or marionette line. Planning may involve skin quality, facial support or laxity, depending on the assessment. Downturned mouth corners and jowling may also be reviewed when relevant. The options below address different causes and are not interchangeable.
A consultation for nasolabial folds or marionette lines should explain why the fold is visible, what a proposed approach can change and what it cannot. Both concerns deserve their own assessment, even when they are discussed at the same appointment.
Assessment includes the fold at rest and during a smile, cheek and chin support, skin quality, tissue descent and previous treatment. A resting hollow differs from an etched surface line, a heavy cheek or a downward-moving mouth corner.
Where reduced cheek support contributes, the mid-face assessment may be relevant. A full cheek or significant laxity can call for a different approach.
A local crease and broader tissue descent are different problems. Direct treatment of a fold may be considered in selected circumstances, while other concerns require attention to the surrounding tissues.
Marionette lines, mouth-corner movement and jowling should each have a clear reason for inclusion in a plan. Treating every area is not necessarily useful.
Recovery depends on the procedure selected. Swelling, tenderness, redness, bruising or temporary asymmetry can affect early appearance. Your practitioner should explain aftercare, the review interval and symptoms that need prompt attention.
Read the safety and recovery guidance below before deciding.
There is no fixed duration that applies to everyone. Results depend on the procedure, the tissues addressed, facial movement, treatment history and ongoing ageing.
A review should consider whether further treatment is useful. Maintenance is not an automatic requirement.
The decision can be to wait or not treat. A suitable plan includes realistic benefits, limitations, risks, alternatives and costs. Normal facial folds and expression do not need correction.
A 2023 review of mid-face ageing describes interactions between skeletal change, fat compartments and soft tissues, with variation between studies. This supports looking beyond the visible nasolabial fold when assessing the face.
Research on lower-face anatomy also examines the relationships between skin, soft tissue and facial muscles. These findings help explain why marionette lines, mouth-corner position and jowling need separate consideration. Anatomy studies do not prove that a particular treatment will work for an individual.
A reasonable goal may be a softer resting shadow or a less pronounced contour change while retaining familiar facial movement. No procedure can guarantee a particular appearance.
At your Chatswood or Hurstville consultation, the face is assessed at rest, during speech and with expression. You can discuss smile lines beside the nose, marionette lines below the mouth, or related changes in mouth-corner position and the jawline.
You can explain whether the issue is a resting shadow, heaviness, an etched line, asymmetry or a broader change in facial balance.
Cheek and chin support, fold depth, skin quality, mouth-corner movement, jawline contour and previous treatment are reviewed together.
The clinician discusses expected benefit, limits, alternatives, recovery, costs and risks relevant to any proposed pathway.
If treatment is appropriate, a conservative or staged approach allows the result to settle before deciding whether more is useful.
Recovery from treatment for nasolabial folds or marionette lines depends on the procedure. Skin devices, needle-based procedures, lifting treatments and surgery have different risks and aftercare.
Depending on the procedure, swelling, bruising, redness, tenderness, firmness, temporary asymmetry or altered sensation may occur. Visible recovery can last longer than expected.
Possible problems include infection, nodules, contour irregularity, pigment change, burns, dimpling or prolonged swelling. Treatments that affect muscle movement can affect symmetry or lip function. Not every option is reversible.
With some procedures that place material under the skin, entry into or compression of a blood vessel can cause tissue injury and, very rarely, vision loss or stroke. The risks depend on the procedure; prompt recognition matters.
Seek urgent medical help after a facial procedure for severe or increasing pain, pale or mottled skin, dusky colour or unusually cool skin. Sudden visual changes, a severe headache, weakness, difficulty speaking, or breathing or swallowing difficulty need emergency care. Call 000 for an emergency and inform the treating practitioner.
Tell the clinician what was used, where it was placed, when it was performed and whether you experienced swelling, nodules or another complication. Unclear treatment history may change what can be recommended safely.
Active infection, inflamed skin, pregnancy or breastfeeding, certain medical conditions, allergies or medications may mean treatment should be postponed or avoided. Suitability must be confirmed for the specific option being considered.
These details depend on the treatment selected and your individual assessment. There is no single price, recovery time or expected duration for both concerns.
Some changes can be seen early, while collagen remodelling and skin tightening develop more gradually. Initial swelling can temporarily alter the appearance.
Duration varies with the procedure and your individual response. Review should guide whether any further treatment is appropriate.
Cost depends on the agreed pathway, complexity, number of areas, treatment staging and follow-up. A quote should be provided after assessment.
Answers to common questions about nasolabial folds (smile lines), marionette lines and related lower-face concerns, including treatment planning, recovery and Sydney clinic appointments.
Choose the clinic most convenient for you. Your appointment starts with an assessment of the concern, your medical history and any previous facial treatment.
On Sydney’s North Shore, near Chatswood Station and the Metro interchange.
Chatswood clinic details and directions
Call 1300 338 307
In Sydney’s St George area, near Hurstville Station and opposite Hurstville Library.
Hurstville clinic details and directions
Call 1300 338 307
