Katt122 in Florida   asks:

“Would a Lower Lift Help with Sagging in the Marionette Area?  Due to 30lb weight loss I have sagging in the marionette line area. Its not too bad but it bothers me that I look sad. I talked to a plastic surgeon about a lower lift. He said this would also help my jaw line. What would this entail. Is the recuperation difficult. I am 48. Would juvederm help to hold off the surgery for awhile? Can it help the neck? I have already had my eyes done and rhinoplasty so surgery isn’t new to me.”

Combination treatment facelift plus filler is best answer for sagging marionette lines. The marionette area sometimes is reasonably simple to treat, but other times is more difficult. A simple answer is to utilize simple, safe and less expensive techniques such as Juvéderm or Restylane for the marionette line area. This can be a potential six to nine month or even one year successful therapy in many instances, but not all. More permanent answer entails Sculptra or lipo injection to the area that can additionally soften the marionette line. These answers are safe and less expensive. Nonetheless a facelift provides an excellent improvement in marionette lines in most instances, but there are some instances where supplemental injection is needed. So at 48 years of age I would suggest trying fillers first and if this doesn’t resolve things to your satisfaction then strongly consider a mini-lift or facelift by an expert surgeon in the area who has done a lot of facelift procedures. And again even then, consider subsequent injections if this is not satisfactory. – Dr. Santos MD, FACS