What It Is

A marionette fold fat graft is a cosmetic procedure that uses the patient’s own fat to fill and smooth the lines running downward from the corners of the mouth to the chin. These lines, called marionette folds, deepen with aging, skin laxity, and loss of volume, often giving the face a sad or tired look.

In Korea, marionette fold fat grafting is performed with microfat or nanofat injection techniques, allowing precise placement of fat to restore youthful facial contours while maintaining natural expressions.

Why It’s Done

Patients choose marionette fold fat grafting because:

• Deep folds make them look older or unhappy.
• They prefer a longer-lasting and natural alternative to dermal fillers.
• Fat grafting can also improve skin elasticity and texture due to regenerative stem cells in fat tissue.
• It provides subtle lifting and volume restoration around the lower face.

Good candidates include:

• Individuals with moderate to severe marionette folds.
• Patients with sufficient donor fat for transfer.
• Those in good general health with realistic expectations.

Alternatives

• Dermal fillers (hyaluronic acid, calcium hydroxylapatite, etc.): Temporary improvement (6–18 months).
• Thread lifting: Provides lifting effect but not volume restoration.
• Facelift or mini-lift: Surgically repositions tissues to smooth folds.
• No treatment: If folds are mild and not bothersome.

Preparation

Before marionette fold fat grafting in Korea, patients will:

• Undergo facial analysis and consultation.
• Stop smoking and alcohol 2–4 weeks before the procedure.
• Avoid blood-thinning medications and certain supplements.
• Plan for minor downtime due to swelling and bruising.

How It’s Done

• Anesthesia: Local anesthesia with sedation or general anesthesia if combined with other procedures.
• Harvesting: Fat is collected via liposuction from donor sites such as the abdomen, thighs, or flanks.
• Processing: Fat is purified through centrifugation or filtration.
• Injection: Fat is carefully injected into marionette folds using microcannulas for even distribution.
• Duration: 1–2 hours, outpatient procedure.

Recovery

• First week: Swelling, bruising, and mild tenderness in both donor and injection sites.
• Return to activities: Most patients resume light activities in 2–3 days.
• Final results: Folds appear softer and smoother within 1–2 months as swelling resolves; results are long-lasting, though touch-ups may be required.

Possible Complications

• Partial fat resorption leading to reduced correction.
• Asymmetry or uneven contour.
• Small lumps or nodules under the skin.
• Infection (rare with sterile procedure).
• Donor site contour irregularities.

Treatment Options in Korea

Diagnosis

Korean surgeons use 3D facial imaging, photography, and consultation to measure fold severity and plan fat graft volume.

Medical Treatments

• Dermal fillers for patients seeking a temporary, reversible solution.
• Skin tightening treatments to improve mild folds without surgery.

Surgical or Advanced Therapies

• Fat grafting for natural, long-term fold correction.
• Combination with facelift or thread lift for more advanced aging signs.
• Microfat or nanofat injections to improve both volume and skin quality.

Rehabilitation and Support

• Post-procedure care with swelling reduction methods.
• Scar care for donor sites (usually minimal).
• Follow-up visits to assess fat survival and refine results.
• International patients benefit from Korea’s expertise in precision fat grafting, advanced injection techniques, and natural-looking outcomes.