GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Volume / Contour · Marionette line

HA filler crosslinked evidence for Marionette line

B 52.8 / 100 Supported 2 RCT/meta · 1 clinical/observational · 0 case · 20 total
Good evidence · positive conclusion

There is a relatively good level of clinical evidence, and a majority of papers support its effectiveness.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2021 Last 5 years 60% Positive results 45% Korea/Asia 5

Known in Korea as

필러라풀렌리쥬필리즈네미라콜쥬비덤뉴라미스레스틸렌리쥬비엘바디필러

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 The Depth of the Facial Artery, Meta-analysis. Aesthetic plastic surgery · 2025 · PMID 40164893

Abstract summary (English) INTRODUCTION: The depth of the facial artery (FA) probably is the most crucial factor while performing aesthetic procedures. The course of FA varies on different levels. The knowledge of exact depth can help physicians to locate the FA more accurately, thereby enhancing the safety of filler injections.

Journal Article, Meta-Analysis

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tier1 Multicenter, randomized, parallel-group study of the safety and effectiveness of onabotulinumtoxinA and hyaluronic acid dermal fillers (24-mg/ml smooth, cohesive gel) alone and in combination for lower facial rejuvenation. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2010 · PMID 21134044

Abstract summary (English) BACKGROUND: Combination treatment with toxins and fillers is the standard regimen in facial rejuvenation. Systematic studies of botulinum toxin alone and in combination with hyaluronic acid (HA) have not, however, been conducted in the lower face. OBJECTIVE: To evaluate safety and effectiveness and compare combination treatment with onabotulinumtoxinA and a 24-mg/mL smooth, cohesive HA gel filler with either...

Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't

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tier2 Nonsurgical correction of drooping mouth corners using monophasic hyaluronic acid and incobotulinumtoxinA. Journal of cosmetic dermatology · 2019 · PMID 31125173

Abstract summary (English) BACKGROUND: Nonsurgical correction of drooping of the corners of the mouth requires a multimodal approach combining botulinum toxin and soft tissue filler injections. OBJECTIVE: To validate a nonsurgical therapeutic approach for correcting a "saddened" appearance characterized by drooping mouth corners, oral commissures, and/or marionette lines. METHODS: In this prospective, evaluator-blinded study, monophasic...

Clinical Trial, Journal Article

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tier0_review Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold). The Journal of dermatological treatment · 2025 · PMID 39894451

Abstract summary (English) PURPOSE: Marionette lines, also known as static labiomandibular folds, are common age-related perioral wrinkles that impact facial aesthetics, particularly in Asian populations. This article aims to examine the anatomical basis, etiology, and filler injection techniques used for treating marionette lines. MATERIALS AND METHODS: The study reviews anatomical studies and clinical practices related to marionette lines.

Journal Article, Review

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tier0_review The Role of Toxins and Fillers in Optimizing Perioral Rejuvenation. Facial plastic surgery : FPS · 2025 · PMID 40550475

Abstract summary (English) Neurotoxins and fillers have become increasingly popular for restoring age-related changes in the perioral region. This review examines their roles in optimizing perioral rejuvenation.The perioral region composes the lower third and middle three-fifths of the face. It includes the lips, surrounding perioral skin, chin, muscles of facial expression, maxilla, and mandible.

Journal Article, Review

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tier_other The ARTIST Post-Market Study: Evaluating a High G' Hyaluronic Acid (HA) Injectable for Chin Combined With Midface HA Filler Treatments. Journal of cosmetic dermatology · 2026 · PMID 41919754

Abstract summary (English) BACKGROUND: A novel hyaluronic acid (HA) injectable (Restylane Shaype, HASHA) with high strength/firmness and enhanced HA concentration, optimized for lower face shaping has been developed. AIMS: This prospective, 8-week, multicenter, post-market study evaluated three treatment algorithms, i.e., the Shayping Technique, for subjects with multiple aesthetic needs, including HASHA for chin...

Journal Article, Multicenter Study

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tier_other An Evaluation of VYC-17.5L for the Treatment of Marionette Lines: A Prospective, Open-Label, Postmarketing Study. Journal of cosmetic dermatology · 2024 · PMID 39600229

Abstract summary (English) BACKGROUND: Marionette lines are a feature of the aging face, descending from the oral commissures towards the jaw. VYC-17.5 L is a dermal filler that contains 17.5 mg/mL of hyaluronic acid (HA) and lidocaine (3 mg/mL); it is intended for the treatment of skin depressions. VYC-17.5 L has been shown to be safe and effective in different conditions, but there is a lack of published literature on its effectiveness in...

Journal Article

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tier_other Three-Dimensional Computed Tomography Scanning Study of the Superior Labial Artery in Chinese Individuals for Assessing Filler Injection Safety. Aesthetic plastic surgery · 2024 · PMID 39048770

Abstract summary (English) BACKGROUND: Lip filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon. The aim of this study was to investigate the anatomy of the superior labial artery (SLA) and provide precise topographic information for dermal filler injection into the lips. METHODS: Computed tomography (CT) scans of 52 cadaveric heads injected with...

Journal Article

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tier_other Three-Dimensional Location of the Facial Artery in Relation to the Nasolabial Fold in Asian People: A Cadaveric CTA Study. Aesthetic plastic surgery · 2024 · PMID 38872060

Abstract summary (English) BACKGROUND: Injection cosmetics have become popular in recent years. The nasolabial fold is one of the most important and dangerous regions in the midface, and its three-dimensional relationship with the facial artery remains unclear. METHODS: Fifty-two cadavers infused with lead oxide contrast medium via the external carotid arteries were scanned by computed tomography (CT).

Journal Article

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tier_other Intralabial Lip Compartments and Their Potential Clinical Relevance. Plastic and reconstructive surgery · 2023 · PMID 37314374

Abstract summary (English) BACKGROUND: Aesthetic soft-tissue filler injections for lip enhancement are popular and performed throughout the world. When injecting lips with a cannula, as the cannula is advanced, resistance is perceived in consistent locations, potentially indicating boundaries between intralabial compartments. OBJECTIVE: We aimed to investigate whether intralabial compartments exist and, if so, to describe their volumes,...

Journal Article

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Suggested interpretation

Limited evidence

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