Why Do Smile Lines and Marionette Lines Deepen, and What Can You Do About It in Hamden, Connecticut?
If you have noticed the creases running from the sides of your nose down to your mouth becoming more defined, or the lines framing your chin looking a little heavier than they used to, you are not imagining it. Nasolabial folds and marionette lines are some of the most common concerns people bring up when they start thinking seriously about their skin. They tend to sneak up gradually, showing up first in photos or under certain lighting before becoming something you notice every time you look in the mirror.
The good news is that these lines have well understood causes, and there are effective ways to address them. At Dolce Vida Med Spa in Hamden, Connecticut, many clients who are dealing with this exact concern find that PDO threads offer a way to lift and refresh the lower face without surgery. Before we get into the treatment itself, it helps to understand why these folds and lines form in the first place.
What Causes Nasolabial Folds and Marionette Lines to Deepen?
Nasolabial folds (often called smile lines or parentheses lines) and marionette lines (which run from the corners of the mouth toward the chin) are a natural part of how the face ages. They exist on almost everyone to some degree, even in youth, but several factors cause them to become more pronounced over time.
Volume Loss in the Midface and Jawline
As we get older, the fat pads in the cheeks and midface gradually lose volume and begin to shift downward. This loss of support means the skin around the nose, mouth, and chin no longer has the same underlying structure holding it up, which allows folds and creases to deepen and become more visible.
Repeated Facial Movement
Every smile, laugh, and expression uses the muscles around the mouth and cheeks. Over decades, this repeated movement can etch these lines into the skin more permanently, especially once the skin's elasticity starts to decline.
Collagen and Elastin Breakdown
Collagen and elastin are the proteins responsible for keeping skin firm, plump, and able to bounce back into place. Collagen production naturally slows down starting in our mid-to-late twenties, and by the time most people reach their forties or fifties, the skin has noticeably less of the structural support it once had. This is one of the biggest contributors to sagging around the nasolabial and marionette areas.
Sun Exposure and Environmental Damage
Years of sun exposure break down collagen fibers faster than the natural aging process alone. If you have spent a lot of time outdoors without consistent sun protection, you may notice these lines showing up earlier or more severely than expected.
Gravity and Skin Laxity
As skin loses elasticity, gravity has more of an effect on facial tissue, pulling it downward. This is why marionette lines and nasolabial folds are often paired with a general sense of sagging along the jawline and cheeks.
Who Notices These Changes, and When?
Most people start to notice deepening nasolabial folds and marionette lines sometime in their late thirties through fifties, though the timeline varies widely based on genetics, sun exposure, smoking history, and skin type. Some people notice these lines becoming stubborn even earlier if they have thinner skin or a history of significant sun damage. Others may not see much change until their sixties. If you are catching your reflection and thinking your face looks "tired" or "heavier" around the mouth even when you are not frowning, that is usually a sign these folds have started to deepen.
How PDO Threads Address Nasolabial Folds and Marionette Lines
Once volume loss and skin laxity are the underlying issue, the most effective treatments are the ones that address both the physical lift and the skin quality underneath. This is where PDO thread treatments come in.
PDO stands for polydioxanone, a dissolvable suture material that has been used safely in medicine for decades. During a PDO thread treatment, fine threads are inserted beneath the skin in targeted areas, such as along the nasolabial folds, the marionette line region, or the jawline. These threads work in two ways.
First, they provide an immediate, gentle lifting effect by mechanically repositioning loosened tissue. Second, and just as important for longer-term results, the threads stimulate the body's own collagen production as they gradually dissolve over the following months. This biostimulation effect is part of why many clients continue to see improvement in skin texture and firmness even after the threads themselves have fully absorbed.
For clients dealing specifically with nasolabial folds and marionette lines, PDO threads can help soften the appearance of these creases and restore a more lifted, refreshed contour to the lower face, without the downtime associated with surgical procedures. This makes it a popular option for anyone noticing early to moderate sagging who wants a natural looking improvement rather than a dramatic change.
It is worth noting that fillers are another option for restoring volume in the nasolabial area, and Dolce Vida offers fillers in Hamden as well. Depending on your skin and goals, your provider may recommend threads, filler, or a combination, but for concerns rooted in skin laxity and sagging, threads are often the more targeted solution.
What to Expect During a PDO Thread Treatment
A typical PDO thread appointment starts with a consultation where your provider examines the areas of concern and discusses your goals. The treatment itself is done in-office, usually within about 30 to 60 minutes depending on how many areas are being treated. A topical numbing agent is generally used to keep the process comfortable.
Afterward, you may notice mild swelling, tightness, or slight bruising in the treated areas, which is completely normal and typically resolves within a week or two. Many clients see an initial lifting effect right away, with additional improvement in skin texture and firmness developing over the following months as collagen production ramps up.
Are You a Good Candidate for PDO Threads?
PDO threads tend to work best for people who have mild to moderate skin laxity and are noticing early signs of sagging, rather than those with significant loose skin that might need a more surgical approach. If you are dealing with deepening nasolabial folds, softening along the jawline, or marionette lines that make your expression look more tired than you feel, you may be a strong candidate. A consultation is the best way to know for sure, since your provider can assess your specific concern, including how it relates to broader sagging skin concerns, and map out a plan tailored to your face.
Aftercare Basics
Recovery from PDO thread treatment is generally straightforward. Most providers recommend avoiding excessive facial movement, strenuous exercise, and pressure on the treated areas for the first week or so. Sleeping on your back when possible and avoiding facials, saunas, or dental work for a short window afterward also helps the threads settle properly. Your provider will walk you through specific aftercare instructions based on the areas treated.
Ready to Talk to Someone Who Actually Gets It
If deepening smile lines or marionette lines have been on your mind, you do not have to just live with them or guess at what might help. The team at Dolce Vida Med Spa in Hamden can walk you through whether PDO threads make sense for your skin and your goals. Right now, the practice's Liberty Thread Lift special is a great way to explore this treatment if you have been considering it. You can also browse the full PDO thread service page for Hamden to learn more about the process, or visit the Dolce Vida homepage to see everything the practice offers. This page was updated August 2026 to reflect current information.
When you are ready to take the next step, reach out to the Hamden office to schedule a consultation and get real answers about your options.
Frequently Asked Questions
What is the difference between nasolabial folds and marionette lines?
Nasolabial folds run from the sides of the nose down to the corners of the mouth, while marionette lines extend from the corners of the mouth down toward the chin. Both are caused by similar factors, including volume loss, collagen breakdown, and skin laxity, and both can respond well to PDO thread treatment.
How long do results from PDO threads last?
Results generally last anywhere from six months to over a year, depending on the individual, the area treated, and how the body responds to the biostimulation process. The threads themselves dissolve gradually, but the collagen they help produce can continue supporting the skin for a while after.
Does getting PDO threads hurt?
Most clients describe the sensation as mild pressure or pulling rather than significant pain, especially since a topical numbing agent is typically applied beforehand. Some tenderness or tightness afterward is normal and usually fades within a few days.
Can PDO threads be combined with other treatments?
Yes. Many clients pair PDO threads with fillers or other skin treatments to address both volume loss and skin laxity at the same time. Your provider can help determine the right combination based on your specific concerns.
How do I know if I need PDO threads or filler for my smile lines?
If your main concern is sagging or loss of firmness, PDO threads are often the better fit because they lift tissue and stimulate collagen. If the concern is mostly about lost volume without much laxity, filler may be more appropriate. A consultation is the best way to figure out which approach, or combination, fits your face.