How to get rid of these accordion lines? (Photo)

Question

Hello, I am 32 years old and have started to notice these accordion lines when I smile, I primarily notice them on the left side of my face. How can I eliminate and eradicate them? Aquagold? Filler? Laser? I have enclosed a photo at rest and smiling. Thank you!

John Tang, MD · Answer

Accordian lines which are the concentric lines around the mouth typically seen with smiling is a difficult problem to treat but if you understand why they form then it will be easier to correct.  They are typically formed when there is a loss of fat in both the areas where the muscle hits the submalar space ( below the cheek near the laugh line) and in the area in front of the the ear (preauricular space).  I find that Sculptra works best for this problem.  Sculptra is product that naturally encourages your body to product collagen which then helps to volumize these areas.  In the preauricular area, it helps to support the lower face which ends up lifting the skin and stretches the accordian lines (it works like a mini face lift).  I also like Sculptra in this area because it looks the most natural and has the longest duration (up to 2 years).  If you attempt to inject a HA filler here, sometimes the area looks too full and less natural.

Robert W. Kessler, MD, FACS · Answer

Thank you for your question.These lines are the result of muscle action on the skin. They become more pronounced as we age because of volume loss of the cheeks and decreasing elasticity of the skin. You do not have these lines present at rest which means less aggressive treatment options are needed.You are wise to act on this early. Volume augmentation which maintains your appearance and a good skin care regimen will help with this now and slow the development of it over time.Seek out a board certified plastic surgeon with a focus on facial aesthetics to evaluate you and offer guidance on how to move forward.Good luck and I hope this is helpful.

Jonathan Kulbersh, MD · Answer

These can be camouflaged with filler. It will take 1-2 weeks for final results. I suggest getting a consultation with a cosmetic dermatologist. Hope this helps.

Aditya Sood, MD, MBA, FACS · Answer

That is a great question! It seems as though you have dynamic wrinkles which are more pronounced on the left side of your mouth/smile. These types of wrinkles are caused by muscle activity around the modiolus (or anchor point of several muscles on either side of the mouth). I think you may be well suited for a neurotoxin (botox) injection to your muscles on this side of your mouth. Fillers are always an option to help soften up wrinkles around the mouth, but they are generally moreso indicated for static lines (or lines present at rest) or volume related issues. Hope this helps and good luck!

How to get rid of these accordion lines? (Photo)

Answers (5)

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