Marionette are the downturned corners and folds, that develop from the corners of the mouth down to the chin, resulting in a puppet-like appearance, hence the name ‘Marionettes’ after the puppet. They commonly appear after the age of 40, and some people have propensitiy to strongly use the pull-down muscles underneath when they are making expressions, pulling down on the area creating the fold or lines.
The development of lines and folds in the marionette area is multifactorial. Age, genetics, and lifestyle, such as smoking, can all influence how this area is affected. As we age, the skin and soft tissues of the face begin to lose elasticity and volume and can’t hold up the mouth corners.