Managing the Marionette Lines – Fillers or Botox?

Even those among us who aren’t dummies can get confused about when one should use Botox versus fillers, (Juvederm) in the nasolabial folds AKA marionette lines. It’s one of the signs of aging that make you look the oldest, even more so than wrinkles. Weirdly, weight gain in the face can help lessen the look of nasolabial folds, calling to mind French actress Catherine Deneuve’s famous quote that “after a certain age, a woman has to choose between her fanny and her face.” Weight distribution differs dramatically from person to person, of course, and if you’re looking to take care of those uninvited vertical meridians, injectables may be right for you. Should you opt for Botox? When would a filler like Juvederm do the job? When does a combination of the two make sense? Here’s what you need to know:
In case you’re not well-versed in the realm of neurotoxins, Botox is a drug prepared from the bacterial toxin botulin, used medically to treat certain muscular conditions and cosmetically to remove wrinkles by temporarily paralyzing facial muscles. While Botox can help with some of the vertical upper and lower lip lines, it will not soften very deep folds in that area. It’s best relegated to the upper portion of the face and can even provide a bit of lift to the brows when used on the forehead. Bonus! A Botox-filler combo platter might be the ticket, specifically if a downward turn on the corners of the mouth is a concern.
As far as fillers go,  Juvederm is typically used for the cheeks, lower face and lips. Depending on the type of filler you get, the amount injected and where geographically on the face you’re treating, the results will last anywhere from 8 months to two years. Juvederm is a smooth consistency gel made of hyaluronic acid, which naturally occurs in your skin, which helps to add volume and hydration.   Juvederm is priced by the syringe, about $700-750. Botox is about $18 per unit, but it may take up to 60 units depending on how much your doctor determines you need.
So the main takeaway is that fillers like Juvederm work well for lines that are vertical on the face, whereas Botox tends to be administered to horizontal ones. In certain instances, a Botox-Juvederm cocktail may take the “edge” off of a permanent pouty expression. Now that we’ve demystified when to use Botox versus when to use Juvederm, let us know your experience with either of these in the comments!

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Information provided by Smart Beauty Guide


  1. Jackie says

    I read the Doctor’s thorough description.
    I think botox would be my choice and if it did not work I’d add the juvederm next month. .I suffer turned down left corner and bad marionettelines.

    • Meghan says

      Hi Jackie,

      We emailed you some information! Call our office at 203-790-5700 and we can schedule a consultation!!
      -Baroody Plastic Surgery

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