Polynucleotides for Marionette Lines: Clinical Results and Treatment Options

Marionette lines are folds that extend from the corners of the mouth towards the chin. They can become more noticeable as skin quality, facial volume and structural support change over time.

Polynucleotides are injectable biostimulatory products used to support skin quality and tissue repair. They may be considered as part of a wider treatment plan for suitable patients, particularly where skin quality is a concern.

Evidence specifically focused on marionette lines is still developing. Results, treatment protocols and suitability can vary by product, patient and practitioner assessment.

This guide explains what polynucleotides are, how they may be used around marionette lines, and the factors practitioners should consider when planning treatment.

Table of Contents

1. What are polynucleotides?
2. Why do marionette lines form?
3. Can polynucleotides improve marionette lines?
4. When can patients expect to see results?
5. What does the evidence show?
6. Polynucleotides vs dermal filler for marionette lines
7. What should practitioners consider when planning treatment?
8. Recovery and aftercare
9. Safety and patient suitability
10. Who may be suitable for polynucleotides?
11. Frequently asked questions
12. Developing your knowledge of skin rejuvenation treatments

1. What are polynucleotides?

Polynucleotides are purified DNA fragments, commonly derived from fish sources. In aesthetic practice, they are used as biostimulatory products that may support tissue repair and improve skin quality over time.

They do not add volume in the same way as dermal filler. Instead, their role is generally to support hydration, elasticity and the overall quality of the skin.

Polynucleotides are one of several treatment options that may be considered when a patient presents with lines, laxity or changes in skin quality. The most appropriate option will depend on the patient’s anatomy, skin condition, concerns and treatment goals.

Key points

• Polynucleotides may support skin quality around marionette lines.
• They do not replace volume where structural loss is the main concern.
• Results develop gradually and vary between patients.
• Treatment planning should be based on patient assessment, product guidance and appropriate training.
• Online learning can support theoretical knowledge, but it does not replace supervised practical training or clinical judgement.

2. Why do marionette lines form?

Marionette lines usually develop through a combination of changes in the lower face. These can include reduced collagen and elasticity, volume loss, skin laxity, repeated facial movement and changes in the underlying facial structure.

For some patients, the main concern is reduced skin quality around the mouth and chin. For others, deeper structural changes or volume loss may be more significant. This distinction matters because it affects which treatment approach may be appropriate.

A careful consultation should assess the whole lower face rather than treating the visible line in isolation.

3. Can polynucleotides improve marionette lines?

Polynucleotides may help improve skin quality around marionette lines in suitable patients. They may be considered when the aim is to support hydration, elasticity and gradual tissue regeneration.

They are not designed to create immediate volume or lift. Where marionette lines are mainly caused by significant volume loss or structural change, polynucleotides alone may not provide enough improvement.

For this reason, treatment should be individualised. A practitioner may decide that polynucleotides are suitable on their own, as part of a combined approach, or not the most appropriate option for that patient.

4. When can patients expect to see results?

Results from polynucleotides develop gradually. Some patients may notice early changes in skin quality within a few weeks, while fuller improvements can take several months to develop.

The response will vary depending on the product used, treatment plan, skin quality and individual healing response. Practitioners should set realistic expectations during consultation and avoid presenting one fixed timeline or outcome for every patient.

The aim is usually a gradual improvement in skin quality rather than a dramatic or immediate correction.

5. What does the evidence show?

Current research suggests that polynucleotides may support improvements in skin hydration, texture, elasticity and fine lines. However, evidence specifically focused on marionette lines remains limited.

This means practitioners should be careful not to promise a particular degree of improvement. Treatment decisions should be based on individual assessment, product guidance and clinical judgement.

For patients with mild to moderate lines and concerns about skin quality, polynucleotides may be a useful option. For deeper lines or more significant structural change, another approach may be more suitable.

6. Polynucleotides vs dermal filler for marionette lines

Polynucleotides and dermal fillers have different roles in treatment planning.

Dermal filler may be used where volume restoration or structural support is required. Polynucleotides may be considered where the aim is to support skin quality and tissue repair.

Neither treatment is automatically better. The right option depends on the cause of the marionette lines, the patient’s anatomy, their treatment goals and their expectations.

Some patients may be suitable for a combined approach. This should only be decided following a full assessment and appropriate discussion of benefits, limitations and potential risks.

For a broader understanding of skin-focused treatment approaches, practitioners can explore our Skin Rejuvenation Masterclass.

7. What should practitioners consider when planning treatment?

Treatment around the lower face requires a thorough understanding of facial anatomy, skin quality, product characteristics and patient suitability.

Injection approach, treatment depth, product volume and session planning can vary depending on the product used and the patient’s individual presentation. Practitioners should follow the relevant product instructions for use and work within their training, competence and professional scope of practice.

A consultation should also consider:

• The cause and severity of the marionette lines
• Skin quality and degree of laxity
• Volume loss and lower-face structure
• Medical history and potential contraindications
• The patient’s expectations and willingness to accept gradual results
• Whether another treatment, or a combined approach, may be more appropriate

For practitioners considering whether to offer this treatment, our guide on adding polynucleotides to an aesthetic clinic provides further context.

8. Recovery and aftercare

Mild redness, swelling, tenderness and bruising can occur after treatment. The severity and duration of these effects vary between patients and may depend on the product used, treatment area and injection technique.

Aftercare advice should be tailored to the patient and the product used. Practitioners should provide clear written aftercare guidance and advise patients when to contact the clinic if they have concerns after treatment.

As with any injectable treatment, patients should be appropriately consented and understand the expected recovery process before proceeding.

9. Safety and patient suitability

Polynucleotides are generally used by appropriately trained practitioners following a full assessment. As with any injectable procedure, local reactions and adverse events can occur.

Possible local reactions may include redness, swelling, bruising, tenderness and temporary small bumps at injection sites. Practitioners should assess suitability carefully, follow product guidance and ensure patients know how to seek advice if they have concerns after treatment.

Suitability should always be assessed individually. Practitioners should consider relevant medical history, current skin conditions, allergies, pregnancy or breastfeeding status, and any factors that may affect healing or treatment safety.

Where appropriate, patients should be advised to seek guidance from their treating doctor or relevant healthcare professional.

10. Who may be suitable for polynucleotides?

Patients may be suitable for polynucleotides where the main aim is gradual improvement in skin quality around the lower face. They should understand that results are not immediate and that treatment may not fully correct deeper lines caused by substantial structural change.

Age alone does not determine suitability. Assessment should focus on the patient’s skin quality, degree of structural change, medical history, treatment goals and expectations.

Patients seeking immediate volume restoration or a more significant structural change may need a different treatment approach.

11. Frequently asked questions

Do polynucleotides fill marionette lines?

No. Polynucleotides do not work like dermal filler and are not used to create immediate volume. They may support skin quality and gradually soften the appearance of suitable lines.

Are polynucleotides suitable for deep marionette lines?

They may be considered as part of a treatment plan, but they may not provide enough improvement on their own where there is significant volume loss or structural change. A full facial assessment is needed.

Can polynucleotides be combined with other aesthetic treatments?

In some cases, yes. Combination treatment should be based on patient assessment, product guidance and the practitioner’s clinical judgement.

How long do polynucleotide results last?

Results and maintenance needs vary between patients, products and treatment plans. Practitioners should discuss this during consultation rather than promise one fixed duration.

12. Training in skin rejuvenation treatments

Polynucleotides may be a useful option for supporting skin quality around marionette lines in suitable patients. They are not a direct substitute for treatments designed to restore volume or structural support.

As evidence specific to marionette lines is still developing, practitioners should use careful assessment, clear patient communication and an individualised treatment plan.

Our Skin Rejuvenation Masterclass covers relevant skin rejuvenation approaches, patient assessment and practical considerations. You can also explore our full range of aesthetic training courses to find the most suitable next step for your experience and training goals.

Medically reviewed by: Mark Aziz, Clinical Liaison
Last medically reviewed: 28th September 2026