Microcurrent for Marionette Lines, What Actually Helps
Medically reviewed by
4 independent reviewers
Andrew Conrad Barile, PT, DPT
Doctor of Physical Therapy (DPT) | Licensed Physical Therapist (PT) | CEO and Founder, Xtreem Pulse LLC
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Dr. Andrew Conrad Barile is a Doctor of Physical Therapy and the CEO and Founder of Xtreem Pulse LLC, the engineering company behind PureLift. He earned his Doctorate in Physical Therapy from Daemen College and is a licensed physical therapist.
He brings over two decades of clinical and entrepreneurial experience across physical therapy, craniosacral therapy and medical device innovation, built on a working knowledge of human anatomy and muscle physiology.
For PureLift LAB he reviews how current is delivered across all ten levels, from sub-sensory nanocurrent and skin-level microcurrent to motor-level EMS, and how the Infuse pass fits into the same ten-minute routine.
Bertica M. Rubio, M.D.
Board-Certified Physician, Dartmouth Medical School | Medical Director, Antiaging Regenerative Medicine Clinic
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Dr. Bertica M. Rubio is a board-certified physician and Medical Director of the Antiaging Regenerative Medicine Clinic in Redlands, California. She earned her Doctor of Medicine from Dartmouth Medical School and completed her pediatrics residency at UC Irvine Medical Center.
With decades of clinical experience, she specialises in age management medicine, regenerative medicine, wound healing and growth factor therapies, and her practice integrates evidence-based medical science with advanced aesthetic treatment.
For PureLift LAB she reviews articles for medical accuracy across the whole dial, from the gentle nanocurrent and microcurrent settings through to muscle-level EMS and the Infuse pass.
Daniel Grinberg, MD, FACS
Board-Certified Otolaryngologist | Head and Neck Surgeon | Fellow, American College of Surgeons | Mount Sinai
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Daniel Grinberg, MD, FACS is a board-certified otolaryngologist and head and neck surgeon at ENT and Allergy Associates in West Nyack, New York. He earned his medical degree from Columbia University College of Physicians and Surgeons.
He completed his otolaryngology residency at New York University Medical Center, serves as Assistant Clinical Professor at Mount Sinai School of Medicine, and is a Fellow of both the American College of Surgeons and the American Academy of Otolaryngology.
For PureLift LAB he brings a wider clinical lens, connecting at-home facial stimulation from microcurrent to EMS to the anatomy underneath, with the same rigour we apply to every device specification.
Prof. Dr. med. Ivo Buschmann
Chair of Angiology, Medizinische Hochschule Brandenburg | Clinic Director, University Clinic for Angiology
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Prof. Dr. med. Ivo Buschmann is Chair of Angiology at the Medizinische Hochschule Brandenburg Theodor Fontane and Clinic Director of the University Clinic for Angiology at the Brandenburg University Hospital.
He trained at the University of Hamburg, was a Max Planck Society Fellow at the Max Planck Institute for Heart and Lung Research, and held senior consultant posts at the Charite Universitatsmedizin Berlin before his appointment as Chair in 2016.
One of Europe's leading authorities on arteriogenesis, with over 150 peer-reviewed publications and US and EU patents, he reviews for PureLift LAB how the evidence on electrical stimulation is read and where its limits lie.
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One of the three causes of marionette lines responds to a device, the downward muscle pull, and the volume loss and skin laxity behind the rest do not.
This article sets out what to check before you start, such as:
- the three separate causes behind one line
- which muscle pulls the mouth corner down
- why toning that muscle is the wrong move
- what a device actually contributes here
- the treatments that address the other two causes
and many more!
Marionette lines are the clearest example in this category of a problem where the device is a supporting act rather than the answer.
Key Points:
Marionette lines run from the corners of the mouth toward the jaw, and they reflect volume loss, downward muscle pull and skin laxity together.
The depressor anguli oris pulls the mouth corner down, and it is usually overactive rather than weak, so strengthening it works against you.
Toning the muscles that lift, in the cheek and the midface, is the useful direction, and the gain is modest.
Botulinum toxin into the depressor anguli oris is the standard way to release the downward pull, performed by a clinician.
Filler restores the volume loss along the jaw and at the mouth corner, which is the part no device touches.
Three causes wearing one name
The first is volume: fat and bone along the jaw and around the mouth corner recede with age, so the tissue above has less support and slides.
The second is muscle: the depressor anguli oris runs from the jaw up to the corner of the mouth, and its job is to pull that corner down, which is the expression of sadness.
The third is skin: collagen and elastin loss means the skin no longer springs back, so a crease that used to appear only in expression becomes permanent.
Treating a marionette line as one problem is why so much advice about it contradicts itself.
The muscle that works against you
Most facial toning advice assumes weak muscle is the enemy, and here the opposite is true.
The depressor anguli oris is frequently overactive in people bothered by marionette lines, holding the mouth corner down even at rest.
Strengthening it with stimulation would deepen exactly the pull you are trying to release, which is the same logic that makes us unenthusiastic about building the masseter in people who clench, covered in our article on jaw clenching.
So the rule for this area is to work the lifters above and leave the depressors below alone.
What a device actually contributes
Kavanagh and colleagues in 2012 measured an 18.6 percent increase in cheek muscle thickness over twelve weeks, and a better-supported cheek takes some load off the tissue below it.
That improves the platform the mouth corner sits on, which softens how the line reads without shortening it.
The honest description is a small structural improvement above the problem rather than a correction of the problem.
Expect it to be visible to you in the mirror before it is visible to anyone else, at around the twelve week mark rather than in the first month.
What handles the other two causes
Botulinum toxin placed into the depressor anguli oris releases the downward pull and lets the mouth corner sit higher, which is often the single most effective intervention here.
Filler along the jaw and at the mouth corner replaces the volume that receded, addressing the support rather than the crease.
Resurfacing and retinoids improve the skin quality so the crease is less etched, which is the slowest of the three and the cheapest.
Combining a toxin release with a small amount of filler is the standard clinic approach, and it does in one appointment what no home routine does.
How to work the area
Keep the probe above the mouth corner, lifting upward and outward across the cheek toward the ear.
Do not sit on the muscle running down from the mouth corner to the jaw, which is the depressor you want quiet rather than stronger.
Lower the level around the mouth than on the cheek, because the tissue is thinner and more sensitive there.
Ten minutes, three minutes per side at most, four or five times a week, which is the schedule in our article on frequency.
Setting the expectation honestly
If marionette lines are the thing that bothers you most when you look in the mirror, a device is not the purchase that fixes it.
If they are one of several concerns and jawline definition matters to you as well, a device contributes to the overall picture and this particular line will move least.
We publish 7 mA at 500 ohms on Face and Pro, 7.7 mA on Pro Edition and 9 mA on Pro Plus and GLOW, and none of those figures changes the answer here.
The arithmetic on whether a device is worth it at all is in our cost benefit article.
This article sits inside our full map of the category, where we set out all 33 devices we track, what each one carries and what each brand publishes: Nine Technologies on One Dial, What the Rest of the Market Actually Carries.