Marionette lines (Botox) - Image 1

Marionette lines (Botox)

from 190,00 €
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Dr. Thomas Ackermann’s Practice · Herzogenaurach

Botox for Marionette Lines –
the corner of the mouth that points upwards again.

Marionette lines are caused by two factors: volume loss — and muscle tension. The depressor anguli oris, the muscle that pulls down the corners of the mouth, actively pulls the mouth corners downwards. This makes the face appear sad or tired, even if one feels well. Botox specifically relaxes this muscle — the corner of the mouth lifts slightly, and the expression becomes friendlier and calmer.

The goal: a face that reflects how you feel.

Transparent billing according to GOÄ. Private practice standard in Herzogenaurach.

What you get from me:

  • Muscle diagnostics first: Botox or hyaluronic acid – or both? We clarify this before treatment
  • Targeted muscle application: Only the depressor anguli oris – no surrounding structures
  • Low pain: Finest Nanosoft needles – anesthesia standard
Your Treatment Experience

Description

Marionette Lines Botox: The muscle that pulls

Marionette lines – the vertical lines that run downwards from the corners of the mouth to the chin – have two causes that can be treated differently. Firstly: volume loss in the mid-face, which causes the tissue to sag downwards. Secondly: an overactive depressor anguli oris, the muscle that actively pulls the corners of the mouth downwards. Those who primarily suffer from muscle pull do not need filler — but Botox.

Patients from Erlangen and Nuremberg, who come to me in Herzogenaurach, often ask: “Do I need Botox or hyaluronic acid?” The answer depends on the cause — and sometimes both are useful, combined in one session. This is the difference between an individual analysis and a standard treatment.

How Marionette Line Botox Works

Botulinum toxin is precisely injected into the depressor anguli oris — the muscle that pulls the corner of the mouth downwards. By relaxing it, the corner of the mouth lifts slightly. The expression becomes friendlier, more rested, more open — without the face appearing frozen.

  • When Botox is appropriate: If the corner of the mouth is actively pulled downwards — identifiable by the wrinkle intensifying when speaking or tensing.
  • When hyaluronic acid is appropriate: If volume loss is the main cause — identifiable by a sunken mid-face and wrinkles that are deep even at rest.
  • Combination: Often, the best solution is a combination of both methods — Botox for muscle pull, hyaluronic acid for missing volume. We will discuss this in the preliminary consultation based on your individual anatomy.

Why the correct diagnosis before treatment is crucial

Anyone who treats marionette lines with hyaluronic acid, even though muscle pull is the main cause, does not solve the problem — they merely conceal it. Conversely, Botox offers little benefit if the main problem is a lack of volume. As a specialist in anesthesiology, I assess facial structures anatomically — I observe the dynamics at rest and in motion before making a recommendation. Therefore, every marionette line treatment in my practice in Herzogenaurach begins with this analysis — and not with a preconceived method.

Frequently Asked Questions about Marionette Line Botox

+ What is the difference between Botox and hyaluronic acid for marionette lines?
Botox relaxes the muscle that pulls the corner of the mouth downwards. Hyaluronic acid fills the volume loss that makes the wrinkle appear deep. Botox works against active muscle pull — hyaluronic acid works against missing volume. Often, a combination yields the best result. We will determine which method is appropriate for you based on a brief analysis of your facial expressions.
+ Does Botox at the corner of the mouth affect speech?
Not noticeably with correct dosage and placement. The depressor anguli oris is a small muscle — its relaxation does not alter speech motor skills. It is important that adjacent muscles — especially the depressor labii — are not unintentionally affected. Therefore, every treatment begins with a precise analysis of individual muscle anatomy.
+ How long does marionette line Botox last?
Typically 3 to 4 months. The mouth area is used intensively — which slightly shortens the duration of effect compared to the forehead. With regular treatments, the muscle can weaken in the long term, and the intervals extend.
+ When will I see the result?
The first changes appear after 3 to 5 days. The full result — the slightly lifted corner of the mouth and the friendlier overall expression — is visible after 10 to 14 days.

Personal consultation in Herzogenaurach – or by phone beforehand.

Erlangen · Nuremberg · Herzogenaurach

About brand
The Dr. Thomas Ackermann Brand Aesthetics with a medical foundation. This brand stands for a clear conviction: Beauty requires safety. As a specialist in anesthesiology, I combine precise craftsmanship in my private practice in Herzogenaurach with a deep understanding of low-pain treatments and natural proportions.
The goal: your personality in focus. Not short-lived trends, but a timeless, healthy radiance.
The pillars of my work: Safety & comfort: maximum pain reduction Natural look: focus on freshness and recovery Holistic approach: aesthetics meets inner health