Nasolabial Fold and Marionette Line Filler: Softening the Lower Face

What are nasolabial folds and marionette lines?

Nasolabial folds are the creases that run from the sides of the nose down to the corners of the mouth, sometimes called smile lines. Marionette lines extend from the corners of the mouth down towards the jawline, named for their resemblance to the lines on a wooden puppet.

Both are a completely normal part of facial anatomy and are visible in people of all ages to some degree, particularly when smiling. They become more prominent over time as the face gradually loses volume and structural support.

Dermal filler treatment for these areas uses hyaluronic acid gel, injected beneath the skin, to restore lost volume and soften the appearance of these lines. It does not remove them entirely, since some degree of folding is a natural feature of facial movement, but it can noticeably reduce their depth and shadow.

Why do nasolabial folds and marionette lines form?

The main driver behind both nasolabial folds and marionette lines is volume loss in the deeper fat compartments of the midface and lower face. Research on facial ageing has found that as these deep fat pads shrink over time, the tissue above them loses its underlying support, which allows folds and shadows to deepen, including the nasolabial fold specifically.

At the same time, the skin's own collagen and elastin production slows with age, reducing its natural elasticity and firmness. Combined with the effects of gravity and years of repeated facial movement, this is what causes these lines to become more visible and persistent.

None of this reflects anything unusual or concerning about your skin. It is simply how the lower face changes with time, which is exactly why volume replacement, rather than skin tightening alone, is often the most effective approach.

When should you consider filler treatment?

There is no medical requirement to treat nasolabial folds or marionette lines, since they are not a health concern. It may be worth booking a consultation if:

• The lines are becoming more noticeable to you, even when your face is at rest
• You feel your expression looks tired, stern, or downturned even when you are not
• Previous fillers have worn off and you are considering a top-up
• You want a professional opinion on whether filler, another treatment, or a combination would suit your goals

A consultation does not commit you to treatment. It is simply a chance to discuss your face, your concerns, and what realistic results would look like for you.

How SABA Health Clinic can help

At SABA Health Clinic in Bishop's Stortford, our dermal filler service is designed around a natural, anatomy-first approach to softening the lower face.

• Doctor-led facial assessment to determine the right approach for your anatomy and goals
• Nasolabial fold and marionette line filler treatments, alongside cheek, jawline, and lip filler if needed
• Same-week appointments with no GP referral needed
• CE-marked hyaluronic acid fillers, which are reversible with hyaluronidase if required
• A judgement-free consultation with honest guidance on what filler can and cannot achieve