Fillers for Smile Lines, Marionette Lines and Jowls: What Works and What Doesn’t

TL;DR: Smile lines (nasolabial folds), marionette lines and early jowls are mostly signs of volume loss. Hyaluronic acid filler can soften all three, and in one trial about 80% of people were still improved at 12 months. Filling the cheek can improve smile lines about as well as filling the fold. Filler won’t tighten loose skin. At Skinfinity Aesthetics, filler is $500 per syringe.

You smile for a photo. Then you look at it later and notice the lines framing your mouth stay there, even after the smile is gone.

If that sounds familiar, you’ve probably wondered about smile lines filler. Maybe you’ve also noticed the lines running down from the corners of your mouth, or a jawline that isn’t as sharp as it used to be.

These are some of the most common concerns I see at my Mississauga clinic. They’re also the ones where people worry most about looking “done.” Nobody wants puffy cheeks or an overfilled, pillowy face.

The good news is that a natural result is very possible. The key is understanding what’s actually causing the lines. In this guide, I’ll explain how filler works for smile lines, marionette lines and jowls, what the research shows, what it costs in Mississauga, and when filler is not the right answer. By the end, you’ll know what to ask for at your consultation.

What Causes Smile Lines, Marionette Lines and Jowls?

All three sit in the lower half of the face, and they often show up together:

Here’s the part most people don’t expect. The line itself often isn’t the real problem. As we age, the face loses volume and support, especially in the cheeks and jawline. The skin and tissue above that lost volume start to fold and sag. That’s why researchers have tested injecting filler into the nearby area of volume loss, not just into the line.

So when I assess these areas, I look at the whole lower face, not just the crease you point to in the mirror.

Does Filler Work for Smile Lines?

Yes. Hyaluronic acid filler is one of the most studied treatments for smile lines, also called nasolabial folds. In a 12-month split-face trial of people with severe folds, about 80% were still responders at 12 months. Results depend on the product, the amount used and where it’s placed.

Product choice really does matter. In another 12-month trial of 80 people, two different fillers were compared side by side on each face. One held its correction in 70% of folds at 12 months, compared with 45% for the other. Both worked at first, but one lasted noticeably longer.

Placement matters just as much. A randomized study compared three approaches: filler in the cheek, filler in the fold, or both. Low volumes of filler in either the cheek or the fold gave similar improvement to the smile lines. Patients slightly preferred treating both, which used the most product.

This is why I often start by restoring a little support in the cheek. When the cheek is supported, the fold beneath it often softens on its own, and you need less filler directly in the line. That’s one of the best ways to avoid the heavy, puffy look people fear.

Does Filler Work for Marionette Lines?

It can. In a 2025 study, 69.9% of people improved by at least one grade on a marionette line scale one month after filler, in a study that followed patients for 12 months. Drooping mouth corners often respond best to filler combined with a small amount of a muscle relaxer like Botox.

Marionette lines are trickier than smile lines. The research is also thinner. The authors of that 2025 study noted a lack of published research on filler for this area before their work.

There’s a reason the combination approach works. Small muscles around the mouth and chin pull the corners of the mouth downward. When that muscle is strong, it deepens marionette lines and gives you a sad or tired expression. In a study of people with drooping mouth corners, researchers used small amounts of filler followed by a toxin injected into the muscles that pull the mouth down. The amounts of filler were tiny, around 0.2 mL per side for the mouth corners.

If that combination sounds right for you, we can plan it alongside Botox in Mississauga at the same visit.

Can Filler Fix Jowls?

Filler can soften early jowls by filling the dip in front of them and strengthening the jawline, which makes the jowl less noticeable. In a 2024 study of jawline filler, over 70% of treated people were satisfied with their lower face and jawline at 6 months. But filler can’t lift heavy, loose skin.

That same study measured the dip just in front of the jowl, called the prejowl sulcus. It improved by 4.6 mm in the treated group, compared with 2.5 mm in the control group, at 6 months. Results were similar across skin types, genders and ages, and the effect was studied for up to 12 months.

Here’s my honest take. If your jowls are mild and come mostly from volume loss, filler can make a real difference. If your jowls come mostly from loose skin, adding filler can make the lower face look heavier. In that case, I’d usually point you toward RF skin tightening or a surgical opinion instead.

How Much Does Filler for Smile Lines Cost in Mississauga?

At Skinfinity Aesthetics, dermal filler is $500 per syringe. Smile lines or marionette lines often take about one syringe. A fuller lower face plan, such as cheeks plus folds, or jawline work, usually takes more.

Here’s a rough guide at our price, before HST:

A few things to know:

• Consultation: Your first visit is a $25 consultation, where I assess your whole lower face and give you an exact plan.
• HST is added on top.
• Combination plans: if you add a muscle relaxer for the mouth corners, Botox is priced per unit.

For a deeper look at how many syringes each area needs, see my guide to the cost of fillers in Ontario.

Side Effects and How to Avoid the “Overfilled” Look

Most side effects from filler are mild and short-lived. But the smile line area has a few things worth knowing about.

More common in the smile lines. A 2023 review of 19 trials found that swelling, lumps and firmness were more common in the nasolabial fold than in the midface, lips or lines around the mouth. Pain, redness and bruising were similar across areas. This is one more reason I prefer using small amounts in the fold and supporting the cheek instead.

Rare but serious. Filler can occasionally block a blood vessel. Ischemic events, where blood flow is cut off, happen in about 0.3% of hyaluronic acid filler treatments. A 2024 systematic review lists complications that range from inflammation and infection to tissue necrosis, and stresses the need for high safety standards and ongoing training.

Filler can be reversed. Hyaluronic acid filler can be dissolved with an enzyme called hyaluronidase. Ophthalmologists call it the mainstay of treatment for blood flow problems, and it should be on hand during every filler appointment.

To avoid the overfilled look:

• Treat the cause, not just the line. Support the cheek and jawline first.
• Go slowly. It’s easy to add a little more at a follow-up. It’s harder to take it away.
• Choose your injector carefully. A medically supervised clinic with experience in facial anatomy matters more than the lowest price.

Getting Filler for Smile Lines in Mississauga

If you’re considering filler for smile lines, marionette lines or jowls in Mississauga, here’s what to ask at any consultation:

• Where will you inject, and why? A good injector should explain whether they’re treating the line, the cheek, the jawline or a combination.
• Which product, and how much? Different fillers last different lengths of time, as the research above shows.
• Do you have hyaluronidase on site? The answer should always be yes.
• What happens if I don’t like the result? You should hear about follow-up visits and options to adjust or dissolve.

Skinfinity Aesthetics is located in the Winston Churchill Medical Centre in Meadowvale, which is easy to reach from Streetsville, Erin Mills, Churchill Meadows, Brampton and Milton. Filler treatments are done in a medically supervised setting, and every plan starts with a full lower face assessment.

The Bottom Line on Fillers for Smile Lines, Marionette Lines and Jowls

Filler can soften smile lines, marionette lines and early jowls, and results often last around a year. The secret to a natural look is treating the cause. That usually means supporting the cheek or jawline, not just filling the line.

Remember that filler adds volume. It doesn’t tighten loose skin. If your jowls are mostly skin laxity, another treatment may serve you better.

Want to know which approach fits your face? Book a $25 consultation through our dermal fillers in Mississauga page. I’ll assess your whole lower face and give you an honest plan, even if that means using less filler than you expected.

Frequently Asked Questions

How long does filler for smile lines last?

Often around a year, depending on the product. In one trial, about 80% of people were still improved at 12 months. Another trial found one filler held correction in 70% of folds at 12 months versus 45% for a different product.

Is it better to fill the cheeks or the smile lines?

Often the cheeks. A randomized study found low-volume filler in the cheek gave similar improvement to filling the fold directly. Supporting the cheek can also help you avoid a heavy, overfilled look around the mouth.

Can Botox fix marionette lines?

Not on its own in most cases, but it can help. Researchers have combined small amounts of filler with a toxin in the muscles that pull the mouth corners down. The toxin relaxes the downward pull, and the filler restores lost volume.

Will filler make my face look puffy?

Not when it’s done carefully. Swelling and lumps are more common in the nasolabial fold than other areas, so using small amounts there and supporting the cheek instead helps keep results natural.

What’s the best treatment for jowls without surgery?

It depends on the cause. If your jowls come mostly from volume loss, jawline filler can help, with over 70% of people satisfied in one study. If they come mostly from loose skin, RF skin tightening may be a better fit.