Refining cheek and mid face contour

The foundation of facial support

The mid-face, which includes the area beneath the eyes down to the cheeks, acts as the central pillar of the face. Over time, factors like genetics, sun exposure, and the natural loss of bone density and fat pads lead to volume depletion in this region. This volume loss causes several cascading effects:

• Downward migration: Tissues start to shift downward, contributing to the formation of nasolabial folds (smile lines) and accentuating the appearance of jowls in the lower face. Dedicated treatments are available for reducing nasolabial folds, and for jowl contouring.
• Under-eye hollowing: The support beneath the eyes diminishes, often deepening the tear trough and creating a tired, hollow look. For targeted refinement of under-eye hollowness, explore our dedicated under-eye treatment.
• Loss of definition: The once-defined cheekbone structure becomes flattened or deflated, making the face appear aged or heavier.

By volumising the dermal structure of key areas of the mid-face, we effectively re-establish the foundation, providing a supportive contour that benefits the entire facial profile.

Strategic contouring for a comprehensive lift

Our treatment strategy targets specific anatomical points to maximise lift and refinement using minimal product. This strategic placement ensures natural movement and durable results:

• Zygomatic arch (cheekbone): Augmenting the lateral and superior projection of the cheekbone creates a defined, high contour. This is vital for framing the eyes and upper face.
• Apex of the cheek: Volumising at the apex—the highest and most anterior point—provides the central lift required to smooth the skin below and soften shadows.
• Indirect under-eye improvement: By establishing a smooth transition from the cheek up to the undereye area, we can indirectly reduce the depth of under-eye hollows (tear troughs). This supportive technique creates a seamless, natural gradient between the mid-face and the lower eyelids.

Tailoring structure for masculine vs. feminine aesthetics

Successful facial contouring requires a clear understanding of the key aesthetic differences between genders. We personalise the application of structural support based on your desired look:

Feminine contouring:

• Placement focus: Central and anterior projection (forward volume).
• Visual outcome: Creates a smoother, softer convex curve and a more heart-shaped or oval face.

Masculine contouring:

• Placement focus: Lateral and high projection, often lower on the cheekbone.
• Visual outcome: Creates a flatter, more angular transition from the cheek to the temple for a chiselled appearance.

By adhering to these principles, our clinicians ensure the results look structurally authentic and harmonious with your overall features, whether you seek definition, softness, or a supportive lift.

Accordion Lines (Cheek Wrinkles): Causes and Treatment

Navigating the lines that form on your cheeks can feel confusing, particularly when they seem to deepen every time you smile or laugh. These creases, commonly referred to as accordion lines or cheek wrinkles, are the vertical creases that appear on the outer parts of your cheeks, extending from the nose down towards the mouth.

Unlike nasolabial folds, which are often caused by volume loss, accordion lines are fundamentally linked to how the skin on your cheek folds repeatedly during expression.

Understanding Accordion Lines

Accordion lines are the fine, vertical creases that appear on the mid-face. They are most noticeable during facial movement, which is why they are often called “smile lines” or “dynamic cheek wrinkles.” Over time, as collagen and elastin diminish, these lines can become visible even when the face is at rest.

The anatomy behind their formation involves three key elements in the mid-face:

• Skin and Dermal Layers: Loss of essential proteins like collagen and elastin reduces the skin’s ability to bounce back after folding.

• Underlying Facial Muscles: Repeatedly folding the skin in the same places during smiling or laughing creates visible creases over time.

• Cheek Fat Pads: These pads provide volume and foundational support. As they gradually thin and shift with age, there is less underlying cushion, allowing the skin to fold more easily and deeply.

Why Do Accordion Lines Appear?

The appearance of these lines is tied to a combination of internal aging processes and external factors:

1. Diminished Skin Foundation: As we age, the supportive structures in the skin (collagen and elastin) decrease, meaning the skin loses its natural resilience and firmness.

2. Repetitive Facial Expressions: The muscles used for smiling repeatedly crease the skin. When the skin loses its structural support, these folds eventually leave behind visible lines even when the face is relaxed.

3. Loss of Mid-Face Volume: The thinning and shifting of natural cheek fat pads remove the underlying support for the skin, causing it to fold and crease more easily during expression.

4. Environmental Damage: External factors such as UV radiation, pollution, and smoking accelerate skin aging, impairing the skin’s ability to repair and regenerate itself.

Because they reflect a change in both the skin’s surface quality and the underlying facial structure, effective treatment must address both components.

Comprehensive Treatment Approaches

There isn’t one single solution for accordion lines. The most effective approach is a personalized plan that combines improvements to skin quality, structural support, and long-term collagen stimulation.

1. Structural Volume and Support

• The Issue: Loss of mid-face support allows the skin to fold deeply.

• The Approach: Adding gentle, strategic support to the mid-face can restore a smoother contour and soften the creasing effect created during smiling and laughing.

2. Optimising Skin Quality

• The Issue: Poor skin quality (lack of hydration, elasticity) means the skin holds onto creases.

• The Approach: Medical-grade skincare that focus on hydration, improving elasticity, and smoothing fine surface wrinkles.

3. Stimulating Collagen and Elastin

• The Issue: The skin’s support network is weakening over time.

• The Approach: Treatments that stimulate the production of new collagen and elastin can strengthen the skin from within, improve long-term resilience, and slow the progression of lines. This is a crucial element of long-term management.

Preventative Care

Treatment is not only about correction; prevention is essential for maintaining results. This includes:

• Daily SPF: Protecting the skin from damaging UV exposure.

• Consistent Skincare: Using active ingredients, antioxidants, and retinoids (where appropriate).

• Early Intervention: Considering subtle treatments when lines are first visible with expression, before they become deeply etched at rest.

Goals, Results & Ongoing Care

The overall aim of treating accordion lines is to soften existing wrinkles and prevent future deepening while preserving your natural facial movement and expression.

• Potential Results: Clients typically see smoother cheek contours, less visible creasing when smiling, and softer wrinkles when the face is at rest.

• Ongoing Maintenance: Long-lasting results require ongoing care, which may involve follow-up treatments tailored to your skin’s needs, and a commitment to daily high-quality skincare and sun protection.

Are accordion lines the same as nasolabial folds?

No. Nasolabial folds are the deep creases from the nose to the corners of the mouth, primarily caused by volume loss and sagging. Accordion lines are the fine, vertical creases on the outer cheek, primarily caused by repeated skin folding during smiling and loss of skin elasticity.

Can skincare alone fix accordion lines?

Skincare (especially sun protection and retinoids) is vital for improving skin quality and elasticity, but it generally cannot address the underlying loss of mid-face volume and structural support that contributes to the lines.

What is the best age to treat accordion lines?

Treatment is effective at any age. Early treatment (when lines are still dynamic) can prevent them from becoming deep and static. Treating them when they are more prominent often requires a more comprehensive approach.