This procedure corrects the “puppet lines” at the corner of the mouth that can not be improved with a full face-lift. The surgery is usually done under local anesthesia and is no more traumatic than the removal of a large mole or small skin cancer. Dr. Marsh describes it as a “drive by surgery”. It results in a very inconspicuous scar. This procedure is used when fillers can no longer satisfactorily improve these “marionette lines”.