Marionette Lines with Hyaluronic Acid - Image 1

Marionette Lines with Hyaluronic Acid

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Dr. Thomas Ackermann Practice · Herzogenaurach

Marionette Lines Hyaluron –
Volume restored, contour back.

Marionette lines appear when the face loses volume in the middle and lower third — the tissue sags, and the corners of the mouth pull downwards. Hyaluronic acid can specifically compensate for this loss. The result is not an altered face, but the face you know — in its former balance.

Analyze the cause — then treat.

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

What you get from me:

  • Facial analysis first: Volume loss or muscle pull — the cause determines the method
  • Layer-specific injection: Strengthen the foundation, restore contour
  • Immediately presentable: Result directly visible, no downtime

What hyaluronic acid really does for marionette lines

Marionette lines — the vertical lines from the corners of the mouth to the chin — appear when the lower third of the face loses its structural support. Bones and fat pads deplete, the tissue follows gravity, and the corners of the mouth droop. The face looks sadder or more tired than one feels — not because something has changed, but because something is missing.

Patients from Erlangen and Nuremberg, who come to me in Herzogenaurach, often ask: "What can be done?" The answer depends on the cause — and that's precisely the difference between a good and a less effective treatment.

Hyaluronic acid for marionette lines: what it does

If volume loss is the main cause, hyaluronic acid can specifically restore the missing foundation. The goal is not to fill the wrinkle directly — but to support the tissue in the areas that cause the wrinkle to form.

  • At the cheek-corner-of-mouth transition: This is where the face first loses its support. Targeted volume application gently lifts the corner of the mouth — without direct intervention at the corner of the mouth itself.
  • Directly in the wrinkle zone: If the wrinkle itself is deep, hyaluronic acid can be precisely injected layer by layer — using a product developed for this zone.
  • Combination with botulinum toxin type A: For pronounced marionette lines, a combination of volume application and botulinum toxin type A on the muscle yields the most harmonious result. We will discuss this during the initial consultation.

From the inside out — the principle that creates natural results

The face consists of several layers — and a lasting natural result is achieved when these layers are treated in the correct order. Those who immediately focus on the surface treat the symptom. Those who strengthen the foundation treat the cause. Therefore, in my practice in Herzogenaurach, I first analyze where the loss is occurring — before choosing a product. More on this approach can be found on the Treatment Concepts page.

Frequent Questions about Marionette Line Treatment with Hyaluronic Acid

+ When is hyaluronic acid better than botulinum toxin type A?
Hyaluronic acid is the right choice when volume loss is the main cause — the tissue is missing, the corner of the mouth no longer has support. botulinum toxin type A is better when the depressor anguli oris muscle actively pulls downwards. In practice, both causes are often combined — in which case a combination of both methods is also advisable.
+ How long do the results last?
In the lower third of the face, hyaluronic acid typically lasts 9 to 14 months — depending on the product, metabolism, and treated area. Deeper layers generally last longer. With regular touch-ups, the results remain consistently maintained.
+ Will I look "overfilled" afterwards?
Only with too much material or incorrect placement. With conservative dosing and an approach that strengthens the foundation rather than plumping up the surface, the result looks natural — a face that resembles itself, just more rested.
+ Is the treatment part of a larger concept?
It can be — but doesn't have to be. Some patients come for a single, targeted treatment. Others benefit from a coordinated treatment conceptcombining foundation, tightening, and skin quality over months. We will clarify what makes sense for you in a personal consultation — without any sales pressure.

Personal consultation in Herzogenaurach – or by phone beforehand.

Erlangen · Nuremberg · Herzogenaurach

Same fold, different method: If the depressor anguli oris muscle actively pulls the mouth corners down, relaxing it with botulinum toxin type A addresses the cause — see Marionette Lines with Botulinum Toxin. Often a combination of both is the most sensible plan.