Accordion line help - what is the best treatment? (Photo)

Hello bebelynn39, thank you for your question! These lines result from decreasing collagen in the skin, a normal part of the aging process. A neurotoxin is usually not the best treatment for this region because it can affect the smile and height of the cheeks. In our practice, we use a multi-modal approach. We recommend to do a series of RF-microneedling treatments to tighten and strengthen the skin, then progress to either PDO smooth threads (not barbed threads) and/or injection of a soft, highly mobile HA filler. The PDO threads will cause the area to produce more collagen, which will lead to impovement of the lines. The HA product can help to plump the skin back up to minimize the creasing of the skin. Best of luck, I hope this helps! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS at Center for Classic Beauty, Boston & Danvers, MA

Thank you for your thoughtful question. The lines you’re referring to, commonly called accordion lines, typically appear in the upper cheeks when smiling and are caused by a combination of facial movement, volume loss, and skin laxity over time.

Here are some of the most effective treatment options:

Dermal Fillers: Strategic placement of hyaluronic acid fillers in the midface or directly along the lines can help smooth them and restore youthful volume.

Botox or Dysport: Small amounts can be used around the cheek area to soften the muscle activity contributing to these lines, although care must be taken to preserve natural facial expressions.

Microneedling with PRP or Radiofrequency (RF): These minimally invasive treatments boost collagen and improve skin texture and elasticity over time.

Laser Resurfacing: Fractional lasers can help remodel collagen and reduce the appearance of fine lines.

Skincare Regimen: Topical retinoids, peptides, and hyaluronic acid-based products can support long-term skin health and complement in-office treatments.

A personalized approach is always best, as the ideal treatment depends on the severity of the lines, your skin type, and your aesthetic goals.

Thank you for your question! My answer will be based on the limited information and pictures provided, for a detailed and personalized plan please consult with an Aesthetic Provider in person.

Accordion lines can be cause by a number of things. It could be volume loss in your cheek bones, loss of collagen and elastin in the skin, weight loss, etc or all of the above. Depending on the cause of issue, which would only be able to be determined in person during a physical assessment, treatment for each cause you be different. Volume replaced with filler; skin quality improved with lasers or skin tightening devices such as Sofwave or Ultherapy or injectable skin boosters.

Hope this helps!

The problems here are quite common in any active cosmetic dermatology practice.
Botox, which I have personally been injecting for cosmetic reasons since 1991, works extremely For the mimetic (dynamic muscular-movement-related) crow's feet lines to the sides of the eyes. If still necessary, a low viscosity, malleable, cohesive HA filler can be used to treat the static wrinkles (wrinkles at rest) that arise after years of smiling that may persist after the Botox treatment. It can also fanned under the accordion lines lower down on the cheek to diminish their accentuation with smiling and laughing.
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Typically, the accordion lines of the face occur as the person either loses a lot of weight or in the process of aging. The process of agent affects all people slightly differently, nonetheless it involves a great deal of fat and muscle loss in the face. The best way to treat this condition is with fat grafting. Fat grafting restores the volume in the face just like adding air to a balloon would make it quite a bit tighter. As long as the fat grafting procedure is done by an expert Plastic surgeon in fat grafting techniques, the results should be natural and practically permanent. I hope to self and good luck from Leonard Grossman M.D., or in New York city