Related Experiment Video
Updated: May 17, 2026
19:53
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
[Marionette fold treatment by depressor anguli oris section: technical note]
S Bruneau1, J-M Foletti, G Holweck
1Service de Chirurgie Maxillofaciale, Stomatologie et Plastique de la Face, Hôpital d'Instruction des Armées Laveran, BP 50, 13998 Marseille, France. stephane2912@hotmail.com
Revue De Stomatologie Et De Chirurgie Maxillo-Faciale
|October 31, 2012
Summary
Marionette folds, a sign of aging, can be permanently corrected by surgically cutting the depressor anguli oris (DAO) muscle. This effective procedure, combined with botulinum toxin, offers a lasting solution for severe marionette folds.
Area of Science:
- Plastic Surgery
- Facial Anatomy
- Aesthetic Medicine
Context:
- Marionette folds are common signs of facial aging, often expressing sadness.
- Glogau's classification identifies Type IV marionette folds as resistant to non-surgical treatments.
- Existing surgical techniques offer correction, but DAO section presents a novel approach.
Purpose:
- To describe a specific surgical technique for correcting severe marionette folds.
- To present DAO section as an effective and permanent solution for marionette folds.
- To expand therapeutic options for managing facial aging.
Summary:
- The DAO section technique involves an intrabuccal approach under local anesthesia.
- DAO muscle fibers are horizontally incised until subdermal fat is visible.
- Post-operative botulinum toxin injection prevents muscle regeneration, ensuring lasting results.
Impact:
- DAO section provides an easy, quick, and efficient surgical option for marionette fold correction.
- This technique offers perennial correction, addressing a common concern in aesthetic medicine.
- It complements less invasive methods, broadening treatment possibilities for patients and surgeons.
