The forgotten half of the face
Most clients walking into an aesthetic clinic ask about the forehead, the frown lines, or the crow's feet. Almost nobody comes in for the lower face — until they catch themselves in a side photograph one day and realise the jawline they had a decade ago isn't the jawline they have now.
The lower face — jawline, marionette lines, perioral area, chin — undergoes more visible structural change with ageing than the upper face. And it's the area the aesthetic industry talks about least, probably because the treatments that genuinely help are more nuanced than upper-face Botox.
What's actually happening to your lower face
Three layers shift with time. Bone: the jaw and chin lose volume, the lower face quietly recedes. Fat pads: the deep fat pads that supported your mid-face migrate downward, creating jowls and softening the jawline. Skin: collagen and elastin loss means skin no longer holds tension where it used to.
Marionette lines — the vertical lines from the corner of the mouth to the chin — are essentially the visible result of these three changes acting together.
What the marketing gets wrong
The common mistake is "let's fill the marionette lines." It almost always makes things worse. Filling a static line directly tends to look obvious, especially in animation. The line is a symptom; the cause is upstream.
The right approach treats the underlying structure: restoring mid-face support so the lower face isn't pulled down, defining the jawline so the jowl region has a frame, and softening the muscle (depressor anguli oris) that pulls the mouth corners downward.
What actually helps
Botox to the DAO (depressor anguli oris). A small dose to the muscle that pulls the mouth corners down often lifts the mouth corners and softens marionette lines without any filler at all. Underused, very effective.
Structural filler in the mid-face or chin/jawline. Restoring support upstream is often what actually softens the marionette area. This is a careful, conservative use of filler — never volumising for its own sake.
Profhilo or polynucleotides for skin quality. Better skin quality in the lower face area improves how light hits the area and how the skin holds tension.
Masseter Botox for a defined jawline. For clients with a square or heavy lower face from masseter hypertrophy (often grinding-related), masseter Botox redefines the jawline beautifully.
What I do not recommend
Direct filler into marionette lines as a stand-alone treatment. Volumising the chin and lower jaw with too much filler — it creates "shelf chin" that ages badly. Cheap thread lifts — the results are inconsistent and the recovery is significant.
A realistic plan
For most clients in their late 40s and 50s addressing the lower face, the first six months looks something like: assessment and photography, conservative mid-face filler to restore support, Botox to the DAO and possibly masseter, Profhilo for skin quality, review at three months, refinement at six.
The result, done well, is a jawline that reads younger without the face reading "treated." That distinction is everything.
Booking a consultation
If your lower face is bothering you and you're not sure where to start, a consultation is the right first step. I'll assess the underlying anatomy, talk through realistic options, and design a plan that respects the order things should be done in.
