The mouth and chin develop differently from the sides of the face and are bound on both sides by a retaining ligament.  Since ageing is the reverse of development we observe that the two areas behave differently. The chin and mouth area remains somewhat static whilst the sides of the face tend to slump on either side, creating mouth corners and ultimately marionette lines, demarcated by the ligaments and muscles either side of the mouth.

Any treatment has to address the sag of the sides of the face (due to volume loss) and the action of the llgament and the downward-pulling muscles. A combination of volumising fillers for the upper face, Silhouette soft for lifting and repositioning the upper face, botulinum toxin for the lower facial muscles and filler into the ligamentous area will all help to soften the look. Sometimes adding volume to the angle of the jaw will also help to pull back the tissue of the sides of the face and lessen the marionette lines.