Marionette lines are creases or folds that extend from the corners of the mouth towards the jawline. They are named after the strings seen on traditional marionette puppets, which run from the mouth to the chin.
These lines can vary in severity and may become more noticeable as a person ages. While they are a natural part of the ageing process, several anatomical changes contribute to their development.
The lower face is supported by a complex network of structures that work together to maintain facial shape and contour. These include:
● Skin
● Subcutaneous fat pads
● Facial ligaments
● Facial muscles
● Facial bones
When these structures are youthful and well supported, the lower face appears smooth and balanced. As ageing occurs, changes within these tissues can alter facial contours and contribute to the formation of marionette lines.
Facial fat pads play a crucial role in maintaining facial volume and support. These specialised compartments of fat help create smooth transitions between facial structures and contribute to a youthful appearance.
Over time, facial fat pads may:
● Decrease in volume
● Shift position
● Descend due to gravity and tissue laxity
As volume is lost from the mid-face and lower face, the tissues around the mouth can begin to sag. This creates shadows and folds that contribute to the appearance of marionette lines.
Retaining ligaments help anchor facial tissues to the underlying skeleton. In younger individuals, these ligaments provide strong support and help maintain facial structure.
As ageing occurs, surrounding tissues lose elasticity and support. Although the ligaments themselves remain relatively stable, the tissues around them can descend, creating visible folds and changes in contour.
This process contributes to the deepening of marionette lines and other signs of facial ageing.
Many people are surprised to learn that facial bones change with age.
Bone resorption is a natural process in which bone density and volume gradually decrease over time. In the lower face, changes to the jawbone and chin can reduce structural support for the overlying soft tissues.
As support diminishes, the skin and soft tissues may begin to sag, increasing the prominence of marionette lines and contributing to changes in facial shape.
Several facial muscles influence the appearance of the lower face. Muscles responsible for facial expression constantly move the skin and soft tissues throughout life.
The depressor anguli oris muscle, for example, pulls the corners of the mouth downward. Over time, repetitive muscle movement combined with tissue laxity can contribute to the formation of folds around the mouth.
While muscle activity alone does not cause marionette lines, it can influence their appearance and progression.
The development of marionette lines varies between individuals. Factors that may influence their appearance include:
● Genetics
● Sun exposure
● Smoking
● Skin quality
● Collagen loss
● Facial structure
● Lifestyle factors
Some individuals may notice marionette lines developing relatively early, while others maintain smoother facial contours for longer.
Facial ageing is not simply a result of wrinkles forming in the skin. It is a multifactorial process involving changes in bone, muscle, fat, ligaments and skin.
For aesthetic practitioners, understanding these anatomical changes is essential for developing a comprehensive understanding of facial ageing. Knowledge of facial anatomy supports safer practice, improved assessment skills and a deeper appreciation of the complex processes that influence facial appearance over time.
Marionette lines develop as a result of numerous age-related changes occurring within the face. Volume loss, fat pad descent, ligament support changes, bone resorption and muscle activity all contribute to their formation.
By understanding the anatomy behind facial ageing, practitioners can gain valuable insight into the structures that influence facial appearance and develop a stronger foundation in aesthetic knowledge.
At Advanced Learning Academy, our accredited online
Facial Anatomy, Physiology and Pathophysiology courses provide learners with the knowledge needed to understand facial structures, the ageing process and the science that underpins safe and effective aesthetic practice.
