Nasolabial & Marionette Lines

Book now

What Are Nasolabial and Marionette Lines?

Nasolabial lines

Nasolabial folds, often called smile lines or laugh lines, are the creases that run from the sides of your nose down to the corners of your mouth. Everyone has them to some degree, and they are a normal part of facial anatomy. It is when they deepen and become visible at rest that many people feel they look older or more tired than they are.

Marionette lines

Marionette lines run vertically from the corners of the mouth down towards the chin. They take their name from the mouth lines of a marionette puppet, and as they deepen they can pull the corners of the mouth into a downturned, sad or stern expression even when your face is relaxed.

What Causes These Lines?

These lines deepen for several reasons, and usually more than one is at work. As we age, the skin produces less collagen and elastin, so it loses firmness and springs back less readily. At the same time, the fat pads that support the midface gradually shrink and descend, which allows the skin above to fold at the nasolabial and marionette areas. Thousands of daily expressions, from smiling to speaking, etch these creases in over time. Sun exposure accelerates collagen breakdown, smoking and genetics play their part, and some people simply develop deeper lines earlier than others. Lines can start to appear from your thirties onwards, and the right time to treat them is when they begin to bother you, not at any particular age.

When Filler Is Not the Answer

Filler is not always the right treatment for these lines. In some faces, the fold is deep because the pad of fat above it is large and the skin has lost some of its firmness. Adding filler here only adds to the heaviness. In these cases, Endolift is often the better approach. It is a minimally invasive laser treatment that melts small pockets of fat and tightens the skin. After Endolift, a much smaller amount of filler is usually needed, if any, which gives a far more natural result.

How Dermal Filler Treats Nasolabial and Marionette Lines

Dermal filler is the most effective non-surgical treatment for these lines. We use premium hyaluronic acid fillers, which restore the volume the skin has lost beneath the crease, supporting the fold from below rather than simply plumping the surface. The improvement is visible straight away and continues to refine over the following two weeks as the product settles and integrates with your tissue. Hyaluronic acid also draws water into the skin and stimulates your own collagen production, so skin quality in the treated area often improves alongside the softening of the line itself. Every treatment is planned around your facial structure, so the result enhances your features without changing the way your face moves.

Why We Soften Rather Than Erase

We soften these lines rather than attempt to remove them completely. Nasolabial folds are part of normal facial anatomy, present even in children, and they allow the face to move naturally when you smile and speak. Erasing them entirely would look unnatural and would flatten the expressions that make your face yours. Our aim is a refreshed version of you, where the lines no longer dominate at rest but your face still moves and smiles as it always has.

Our Prices

  • £450

  • £850

  • £1200

FAQs

  • Most patients find treatment very comfortable. The fillers we use contain a local anaesthetic, and a topical numbing cream can be applied beforehand. Most people describe a brief pinch or a feeling of pressure rather than pain.

  • A natural softening of the lines, visible immediately and refining over around two weeks as the filler settles. Your face will still move and express normally, the lines simply stop dominating your appearance at rest.

  • Yes. The hyaluronic acid fillers we use can be dissolved with hyaluronidase if ever needed.

  • Most patients need 1 to 2ml across the nasolabial and marionette areas, though this depends on the depth of your lines and whether midface support is also needed. At your consultation, Dr Karwal will assess your face, agree a treatment plan with you, and confirm the amount of product and the price.

  • Needle entry points, redness, bruising, swelling and asymmetry around the injection sites immediately after treatment are normal due to the very nature of the treatment. There may also be some tenderness present as the bruising and inflammation sets in. These symptoms will resolve over the next 2-7 days, depending on your individual response to the treatment. It may take a full 2 weeks for all swelling to settle; until this time we cannot re-treat.

    For 24 hours avoid:
    Touching or pressing on the treated areas
    Applying makeup to the area
    Skincare with active ingredients such as retinol, acids or vitamin C

    For 48 hours avoid:
    Intense physical activity
    Sleeping on your side or front (sleeping on your back helps avoid pressure on the treated areas)
    Spas/saunas/steam rooms
    Massage/facials
    Touching/rubbing/massaging/applying pressure to the treated areas
    Alcohol

    For 2 weeks:
    Avoid dental work if possible, as keeping the mouth open wide for long periods can put pressure on the treated areas
    Be gentle when washing your face and avoid facial treatments or massages

  • Our clinic is in Mayfair, central London, at 2nd Floor, 15 Dover Street, W1S 4LP, a short walk from Green Park station. Please note the clinic is on the second floor with stair access only. All treatments begin with a consultation with Dr Karwal, which you can book online.

Book a consultation