Marionette lines: Why the corners of your mouth look grumpy and how to start fixing them

If you've started noticing shallow vertical lines running down from the corners of your mouth when you look in the mirror, those are **Marionette Lines**. These are vertical wrinkles that begin just outside the corners of the mouth (oral commissure) and descend toward the jawline. Clinically, they are referred to as melomental folds, and in Korean, they are commonly called 'mouth wrinkles' or 'grumpy wrinkles.' They are the lines that make the mouth look saggy even when you are not smiling, giving the face a somewhat grumpy expression.

These wrinkles are not caused by a single factor. They are formed by a combination of factors: the loss of collagen and elastin that support skin elasticity, the downward shifting of the mid-face fat pads, and the repetitive action of the depressor anguli oris (DAO) muscle. Therefore, it is more important to understand 'why they formed' rather than simply focusing on 'what to fill.' Gangnam Onlif Clinic approaches this concern not by changing the shape of your face, but by clearing away the signs of aging that obscure your natural texture.

🎭 What exactly are marionette lines?

The name marionette comes from the lines drawn around the mouths of ventriloquist dolls (marionettes). If you picture the vertical lines used to open and close a doll's mouth, you can visualize their exact location.

The key is the location. Marionette lines are vertical wrinkles that go from the corners of the mouth down toward the jaw. They have a different starting point than nasolabial folds, which run from the sides of the nose to the corners of the mouth. However, because the two often appear connected as a single line, it is easy to confuse them on your own face.

The oral commissure, where the wrinkle begins, is also an anatomical landmark used when planning treatments. When sagging becomes severe, they frequently appear alongside jowls along the jawline, so these two areas should be evaluated together.

📌 Key Summary: Marionette lines are vertical wrinkles running from the corners of the mouth to the jaw, whereas nasolabial folds are located from the sides of the nose to the corners of the mouth.

🔍 Why do they form? The many faces of aging

The changes occurring beneath the skin start earlier than you might think. Dermal collagen steadily decreases by about 1% every year after your mid-20s. Women, in particular, report a reduction of about 30% in skin collagen during the first five years after menopause, making the decline in elasticity noticeably faster during this period.

The causes can be broadly divided into four categories:

• Loss of Elasticity: The skin loses its structural support due to the decrease in collagen and elastin.

• Loss of Volume: Mid-face fat pads descend and skeletal changes occur, causing downward sagging.

• Muscle Action: The depressor anguli oris (DAO) muscle, which pulls the corners of the mouth downward, repeatedly exerts force.

• Lifestyle & External Factors: UV rays, smoking, rapid weight changes, etc., accelerate the process.

Interestingly, dental factors such as tooth loss, gum or alveolar bone resorption, and changes in bite can also weaken the supportive structure around the mouth, making wrinkles look deeper. That is why it is often hard to attribute them 'simply to losing weight.'

📌 Key Summary: A combination of collagen loss, volume loss, and muscle action creates marionette lines, and identifying the cause is the starting point for improvement.

📋 What stage are my wrinkles currently in?

You can estimate the condition of your wrinkles at home. If you gently lift your cheeks upward with your hands and the wrinkles noticeably diminish, it is a sign that sagging (volume/elasticity) is a major factor.

Since the approach varies depending on the stage, it is important not to look only at the visible creases but to understand the underlying causes together.

📌 Key Summary: If wrinkles diminish when the cheeks are lifted, sagging is a major factor, and the approach varies depending on whether it is mild, moderate, or severe.

💧 Filling lost volume while building collagen, ON Volassome

Marionette lines and nasolabial folds ultimately share a common denominator: they are 'areas that have lost support due to depleted collagen.' As facial expressions are repeated, the creases deepen, and once collagen decreases, it does not replenish on its own.

Onlif's signature ON Volassome addresses this issue directly. Biocompatible Calcium Hydroxylapatite (CaHA) particles immediately restore volume to sunken areas, while gradually decomposing within the body to stimulate collagen regeneration. Unlike methods that simply fill space, this approach restores the skin's natural 'texture' from within.

How does ON Volassome work?

The patented Lattice-pore structure is the key. The central core stably holds its place to maintain volume over a long period, while the outer layers are gradually absorbed layer by layer to promote collagen production.

• Immediate Volume: Closely supports sunken areas for visible improvement immediately after the procedure

• Collagen Regeneration: Calcium ions activate fibroblasts → stimulating self-collagen production

• Improved Elasticity & Dermal Thickness: Skin texture plumps up from within

How does it differ from other methods?

For reference, hyaluronic acid fillers last 6 to 18 months depending on the area and product, and can be dissolved with hyaluronidase if issues arise. ON Volassome is calcium-based, showing virtually no clumping or migration, and is specifically designed to minimize foreign body reactions.

📌 Key Summary: ON Volassome is a calcium collagen booster that simultaneously provides immediate volume and induces self-collagen regeneration, with expected results lasting from 6 months to over a year.

🕐 How is the procedure performed?

The entire process takes about 10 to 15 minutes. It is a highly manageable procedure.

1. Consultation & Design — Assessing the depth and type of wrinkles.

2. Numbing Cream Application — Applied to the treatment area and left for an adequate amount of time.

3. Procedure & Correction — ON Volassome is delicately injected to correct the sunken areas.

4. Finishing & Review — Comparing before and after results and providing aftercare instructions.

Since it contains lidocaine, pain is minimal, and local anesthesia can be administered if needed. Most patients can return to daily activities immediately after the procedure, but minor bruising or swelling may occur, so it is recommended to avoid irritating the treated area for about a week.

If you plan to take before-and-after photos for comparison, make sure to keep the lighting, distance, facial expression, and angle consistent to accurately track the changes.

📌 Key Summary: The ON Volassome procedure takes about 10–15 minutes, allows an immediate return to daily activities, and requires minimizing irritation to the area for one week.

🙋 Ideal candidates for this treatment

• Those who have prominent mouth and nasolabial wrinkles even when not smiling

• Those who feel wrinkles make them look older

• Those who find traditional fillers burdensome and want natural-looking changes

• Those who want to improve both wrinkles and skin elasticity simultaneously

• Those looking for long-lasting results

Under the philosophy that 'no single doctor can excel at everything,' Onlif operates by assigning doctors to perform only the procedures they are most skilled in. Rather than changing the shape of the eyes, nose, or mouth, clearing away the signs of aging that overshadow your natural beauty is the direction Onlif pursues.

📌 Key Summary: If you want natural, long-lasting improvement around the mouth, ON Volassome is suitable, and an in-person assessment of your condition is the first step.

🌿 Good daily habits to practice

Just as important as the procedure itself, daily care helps maintain the results longer. Since UV rays are a major cause of collagen damage, make applying sunscreen a daily habit. SPF 30 blocks theoretically about 97% of UVB rays, while SPF 50 blocks about 98%.

• No Smoking & Hydration: The basics of maintaining skin elasticity.

• Retinoids: Helps with collagen synthesis, but consistency for 3 to 6 months or more is usually required to notice visible effects.

• Avoid Rapid Weight Changes: Loss of volume can make wrinkles appear deeper.

While creams alone cannot eliminate deep creases that have already set in, they certainly help slow down progression and maintain treatment results longer.

📌 Key Summary: Sun protection, quitting smoking, hydration, and retinoids are key habits for preventing and managing marionette lines.

❓ Frequently Asked Questions

How are marionette lines different from nasolabial folds?

Nasolabial folds are wrinkles running from the sides of the nose to the corners of the mouth, while marionette lines are vertical wrinkles running from the corners of the mouth down toward the jaw. Though their locations differ, they often look connected, so it is best to evaluate them together.

At what age do marionette lines start to form?

Since dermal collagen decreases by about 1% annually after the mid-20s, individual differences vary greatly, but they often begin to appear faintly starting in the mid-30s. For women, collagen decreases by about 30% during the first five years after menopause, which can make them more pronounced during this time.

How is ON Volassome different from regular fillers?

While regular HA fillers only physically fill volume, ON Volassome uses Calcium Hydroxylapatite (CaHA) particles to immediately replenish volume while simultaneously stimulating self-collagen regeneration. It is characterized by virtually no clumping or migration and is designed to minimize foreign body reactions.

Can I return to daily life immediately after the procedure?

Yes, most patients can return to daily activities immediately after the procedure. However, minor bruising or swelling may occur, so it is best to minimize unnecessary irritation to the treated area for about a week.

When do the effects appear, and how long do they last?

You can see volume improvement immediately after the procedure, and since self-collagen is continuously generated afterward, results last on average from 6 months to over a year. This can vary depending on individual skin conditions.

Are dental conditions or bite alignment related to marionette lines?

Yes. Tooth loss, gum or alveolar bone resorption, and changes in bite alignment can weaken the support structures around the mouth, making wrinkles appear deeper. Therefore, these factors are also considered when identifying the cause.

Because marionette lines are the result of multiple overlapping causes, they cannot be resolved simply by filling visible creases. An accurate assessment of your mouth's current state and the right approach can only be determined through an in-person evaluation. At Gangnam Onlif Clinic, we will carefully walk through this process with you.

Marionette Lines: What to check before choosing a clinic

Even for the same procedure, the results and recovery process vary depending on where, by whom, and how it is performed.

Asking these questions during your consultation will help you make an informed decision.

• Does the clinic perform this procedure frequently? — Every clinic has different core procedures. Check if they regularly treat marionette lines.

• Can I verify the products and equipment used? — Ask if you can verify the product name and authenticity (whether it is an approved import and if there is an unboxing verification process) during the consultation.

• Do they explain the cost breakdown? — Rather than just hearing the total amount, you need to understand what product is used, how much of it, and in what areas to make a proper decision.

• Do they design the treatment looking at the entire face? — The injection points and dosage for the same procedure will vary based on face shape, skin condition, and facial asymmetry.

• Do they explain side effects and the recovery process beforehand? — A consultation that explains potential adverse reactions and coping methods is better than one that only promises desired results.

• Is there a post-procedure follow-up channel? — Check if there is a scheduled follow-up time, a way to contact them in case of issues, and set criteria for follow-up visits.

How Onlif Clinic approaches marionette lines

• We divide responsibilities — Operating on the belief that a single doctor cannot cover every procedure, Onlif assigns specialized doctors to different fields of treatment.

• We verify products and equipment during the consultation — We guide you through the products used and the unboxing verification process during your consultation.

• We explain costs along with the treatment plan after diagnosis — Since the treatment area, volume, and scope differ for each person, we explain exactly what costs are involved and why.

• We design treatments looking at overall facial harmony — We view the face through three axes—texture, symmetry, and youthfulness—planning to clear away elements overshadowing your natural impression rather than changing your features.

• We discuss side effects and recovery first — Along with expected improvements, we explain individual variances, possible side effects, and management steps before the procedure.

• We monitor progress after the procedure — If verification is needed during the recovery period, we provide guidance on follow-up visits and contact channels.

If you are concerned about marionette lines, it is best to first find out what is possible and what is difficult given your current condition.

An accurate diagnosis and treatment plan can only be made through an in-person consultation. Find out more through a consultation at Gangnam Onlif Clinic.