Why do marionette lines appear? Exploring the anatomical perspectives and role of thread-based interventions

© 2024 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd..

The pathogenesis of marionette lines involves a complex interplay of anatomical, physiological, and age-related factors leading to the development of wrinkles around the oral commissures. This exploration delves into the distinct anatomical predispositions observed among different ethnicities, emphasizing the role of compact modiolus structures and muscle compositions. Notably, individuals of East Asian descent exhibit inherent facial structures that predispose them to pronounced sagging around the oral commissures during aging. The emergence of distinct facial lines, such as the commissural line and the melolabial fold, contributes to the formation of marionette lines. This specific wrinkle pattern, resembling a marionette puppet's mouth contours, is influenced by various factors like bone resorption, gravitational forces, fat compartment variations, muscle compression, ligament tethering, and skin aging. Treatment strategies for marionette lines encompass diverse interventions, including filler injections, botulinum neurotoxin, surgeries targeting fat reduction, thread lifting, and volumizing fillers. These approaches aim to address the underlying causes and mitigate the appearance of marionette lines. Botulinum neurotoxin injections, for instance, weaken specific facial muscles, reducing downward strain and aiding in tissue retraction. Anatomical considerations during procedures are crucial to avoid nerve or vascular damage. Delicate manipulation and precise entry points are essential to prevent inadvertent injuries, particularly concerning blood vessels like the facial artery and nerves like the mental nerve. Technical guidelines for procedures targeting marionette lines involve specific techniques like cogged thread reverse methods and volumizing thread placements. Attention to entry points, tissue engagement, and the direction of threads is crucial for effective treatment outcomes, minimizing complications, and ensuring patient safety.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:30

Enthalten in:

Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) - 30(2024), 4 vom: 04. Apr., Seite e13676

Sprache:

Englisch

Beteiligte Personen:

Hong, Gi-Woong [VerfasserIn]
Kim, Soo-Bin [VerfasserIn]
Park, Soo Yeon [VerfasserIn]
Wan, Jovian [VerfasserIn]
Yi, Kyu-Ho [VerfasserIn]

Links:

Volltext

Themen:

Aging factors
Botulinum Toxins
EC 3.4.24.69
Facial anatomy
Journal Article
Marionette lines
Review
Threads
Treatment strategies

Anmerkungen:

Date Completed 05.04.2024

Date Revised 06.04.2024

published: Print

Citation Status MEDLINE

doi:

10.1111/srt.13676

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370620135