Mentolabial wrinkles – Merkel frown lines

Mentolabial - “Merkel”

The wrinkles which go down the corners of the mouth are known as mentolabial or marionette wrinkles. The forward and downward pulling of the mid-face compresses onto the “Merkel” area into deep wrinkles down the corners of your mouth, just as the nasolabial fold on the mid-face does during the aging process. Though the term mentolabial wrinkle is not familiar to many, the term Merkel frown line is with regards to the German Chancellor.

If the frown line along the Merkel area is not too deep it can be padded with hyaluronic acid-based filler. The sagging of the mid-face, however, cannot be halted, but the region can be plumped and stabilized. The initial filler treatment of the mentolabial wrinkle always provides satisfying results compared to follow-up treatments.

Improving the frown lines on the corners of the mouth

With a self-examination you can take your cheek between your fingers and stroke downward along to the corners of your mouth. While doing so you will notice a considerable difference in thickness towards the corners. This genetically predisposed breaking point of the mentolabial wrinkle can be filled and padded with a stable filler. While doing so, however, it is important not to overstep or exceed the given limits otherwise the filler will penetrate to the surface.

In addition to a filler treatment the muscles on either side of the mouth that are responsible for this downward pulling (depressor anguli oris) can be weakened with botulinum toxin. This improves the overall results and the filler will be less likely to wander into the neighboring compartment of excess skin of the marionette wrinkle pushing through to the surface. With our experience treating the cheek area also lets the face appear less saggy, thereby optimizing the treatment results of the Merkel frown lines.

Typical of treating marionette wrinkles

The marionette wrinkle area is rich in blood vessels. Therefore, special attention is required to perform a bloodless and hemostatic injection so that the patient is not hindered from being in public with hematoma longer than necessary. Depending on the severity, sharp and dull needles can be used.

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