Marionette lines (also sometimes known as ‘disappointment lines’) are the lines that extend from the outer corners of each side of the mouth all the way down towards the chin. Some people naturally have deeper marionette lines than others. Marionette lines form because of loss of the collagen that supports the skin and gives it integrity; they can also be exacerbated by smoking and sun exposure.

Such an appearance can be disconcerting to the patient as it creates a permanent look of anger and frustration.