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Anatomical Understanding of Marionette

Hello.
This is Chief Director Kim Ga-eul.
Nasolabial folds, Marionette lines
Why do they occur and how should we approach them?
Nasolabial folds are caused by
Loss of fat around the mouth
Drooping of nasolabial fat
Decrease in skin elasticity
These various factors simultaneously contribute to their formation.
So today, I will explain in the simplest way how to use
Sculptra for improving nasolabial folds and marionette lines alongside
lifting
to enhance understanding.
Step 1: First, we organize the drooping fat

When the jowl fat falls down
the lines around the mouth and the marionette lines
appear much deeper.

The most fundamental equipment at this time is
HIFU lifting.

🔸 Basic Principle of HIFU Lifting

Ultrasound creates a ‘thermal coagulation point’ in the deeper layers of the skin (SMAS)
to contract the tissues and lift elasticity.
Its definite effect is an advantage.
It is the most widely used
lifting equipment line in dermatology.
Ulthera: High intensity, verified effects
Shrink: Cost-effective option
It is designed according to the thickness of fat, skin, and line.

The key to HIFU is
‘where and how to shoot’
Many people think
“Is it okay to just target the jowl fat?” but
this is only partially correct.
If you continuously target only one area with lasers
some improvement is possible, but
“If the design is not appropriate,”
side effects occur immediately.
Especially the marionette lines
are HIFU prohibition zones
So the area just above the marionette lines should
avoid HIFU and combine with other procedures.
If you shoot according to the guidelines
there is a risk of hollowness in the cheeks.

So how should we design
to improve without side effects?
Asian faces often have
protruding cheekbones
and plump sides.
Therefore,
it’s essential to start with the cheekbone design so that the nasolabial folds and marionette lines
naturally blend in.
However, in practice,
the important cheekbone line is often omitted.
This can make the lower part look sunken or
the overall contour does not connect smoothly.
Cheekbones aren’t just bone,
but also comprised of fat layers, fascia, and skin
which together create structure, so precise design is very important.
Step 2: Directly fill the sunken cheeks and wrinkle lines
Just solving drooping
does not make the already deep marionette lines
disappear.
Now, volume reinforcement is needed.
This is where Sculptra shines.
Reasons for Sculptra's effectiveness
Sculptra is a typical collagen booster injection that does not provide immediate volume like filler,
but instead gradually creates collagen from within the skin
to naturally fill in volume.
🪄Sculptra Effect Timeline
🪄 6~9 weeks
Collagen generation begins
🪄 3 months
The nasolabial folds and marionette lines begin to fill
🪄 1~2 years maintenance
Newly formed collagen is maintained firmly
In other words,
the longer time passes, the more youthful changes occur,
natural volume that lasts long,
is the type of treatment best suited for those who want both.
Step 3: For wrinkles caused by muscles
use Botox to resolve them
If the DAO muscle pulling down the corners of the mouth
is strong,
the marionette lines become deeper.
Performing Botox on the corners of the mouth will
make the result more natural and tidy.
When getting expression Botox
it’s best to manage it with a feeling of ‘adding one area’.
⭐ Marionette line treatment must
address all three aspects simultaneously

☝️ Solve fat drooping
HIFU + complementary procedures in prohibition zones
✌️ Recover volume
Sculptra
👌 Control muscles
Botox for the corners of the mouth
This composition ensures
that the jawline is not heavy
and a natural youthful line is completed.
💡 Additional Q&A
Q. Will Sculptra make my face unnaturally big?
A. Sculptra does not provide immediate volume like fillers.
As collagen is gradually produced over time,
the face does not suddenly enlarge or appear artificial.
Q. Can Sculptra reduce the jowl fat itself?
A. Sculptra is not a treatment that reduces fat itself.
However, it can realign the volumetric structure around the jowl fat
to lift the collapsed line,
thus softening the impression of prominent jowl fat.
Q. When can I wear makeup after Sculptra?
A. You can apply makeup as soon as bruises or needle marks disappear.
Usually, it’s fine within 1 to 2 days.
However, it is advisable to avoid hard pressure, strong massages, and saunas
for the first 3 to 5 days.
Thank you for reading.
This is Kim Ga-eul.

















