Smile lines and marionette lines form when sagging and volume loss happen together. Lifting the sagging tissue first with a thread lift, then adding a small amount of filler only where volume has been lost, can give a natural result that doesn’t look overdone. The goal is to look the way you did five years ago.
Hello from DAYONE Clinic. “As I get older, everything seems to be sliding down, and my smile lines are really starting to bother me.” We hear this in consultations all the time. At some point, everyone catches their reflection and thinks, “Wait—I’m getting older.”
Here, we’ll explain why, when sagging and volume loss occur together, we recommend a thread lift before filler.
Two causes behind smile lines and marionette lines
Smile lines (nasolabial folds) and marionette lines don’t have a single cause. In most cases, volume loss and sagging are at work at the same time.
As the area just inside the smile line hollows out, the tissue around it bulges into a ridge, while the tissue above sinks with gravity. The difference between them grows, and the fold gets deeper over time. That’s why each cause needs to be addressed differently to get a natural-looking result.
Sagging—lift it with a thread lift or a device-based lifting treatment
Hollows—fill them with a collagen stimulator or filler
Why does filler alone end up looking overdone?
The problem comes when you focus only on the hollows and fill them while the sagging is still there. Trying to fill out the sagging volume as well takes more and more filler, and eventually the face looks puffy and overfilled.
But what if you lift the sagging tissue with a thread lift first? As the drooping tissue is lifted back up, the fold softens, so a small amount of filler in the hollows afterward can give a much better result. The threads and filler complement each other, and you naturally end up needing less filler.
Looking natural is the most important goal
This is worth emphasizing. Setting out to suddenly look like you’re in your 20s or 30s again tends to backfire and produce an unnatural result. Overdoing it can leave you very swollen or with an unnatural-looking face.
A realistic, natural goal is to look the way you did five years ago. With that as the target, lifting what has sagged and filling only the hollows with a small amount of product can give you a natural-looking improvement without obvious signs that you’ve had something done.
One more thing: for the jawline and marionette area, it’s more effective to start with a treatment that strengthens the ligaments. These days, filler can also be used to reinforce ligaments. As the ligaments are strengthened, the sagging tissue is naturally pulled up, and adding a thread lift lets the two work together to improve sagging far more effectively.
The bottom line
The key is to correctly identify both causes—sagging and volume loss—and treat each with the right approach. To find out which combination is right for your face now, we recommend visiting DAYONE Clinic near Gangnam Station for an in-person consultation with one of our physicians. If you have any questions, don’t hesitate to reach out.
This article is based on an interview from DAYONE Clinic’s YouTube channel, Face Design Lab.
This article is general information about the treatment and does not replace an individual diagnosis or treatment plan. Results and their duration vary from person to person.
Wondering what would suit you?
Whether a treatment suits you, and how to plan it, is best decided with a doctor.