A big smile used to come with a few lines across your cheeks. Now there seem to be more of them, and some stay put long after you've stopped laughing.
These are often called accordion lines. Carefully placed filler can give the creased skin a little support, making those lines less obvious without aiming for bigger cheeks.
Dr Alex will look at how your skin folds when you smile, as well as the lines you can see at rest. That helps him recommend treatment for the change you're actually noticing.
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Dr Alex teaches doctors, dentists and nurses to carry out dermal filler treatments, alongside treating his own patients at SONÜ.
What you can see
More creases across your cheeks than you remember
You may notice a fan of fine wrinkles, a few deeper lines, or a mixture of both.
Your cheeks crease more when you smile
Some lines have started to stay
Your cheeks look fine, but the skin looks lined
The practical details
Accordion-line filler at a glance
Treatment focuses on the creases and the support beneath them. Dr Alex will assess whether filler is the best way to improve yours.
What treatment can change
Smoother cheek skin, with less obvious smile lines
The aim is to reduce the depth and visibility of the creases so they draw less attention across your cheeks.
Supporting an indented line can make it shallower and soften the shadow within it. The cheek can look less criss-crossed, particularly where a few deeper lines stand out among finer wrinkles.
Your skin will still fold when you smile. Filler works on support within the tissue rather than stopping the muscles from moving. Dr Alex will discuss which lines are likely to improve and how much smoothing would suit the skin you have.
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Choosing the right treatment
Would these cheek lines benefit from filler?
How the skin creases, and why, helps determine whether filler is a useful choice.
Fine lines and loose skin
Adding more is not always the answer
Filler won't tighten a substantial amount of loose cheek skin. Nor is filling every tiny wrinkle a good reason to keep adding volume. If the skin needs resurfacing or firmer support through another treatment, Dr Alex will explain that recommendation.
How it works
Giving a crease support from underneath
As skin loses elasticity and some of its underlying support, it can fold more deeply with repeated expressions.
Think of the difference between a fine line that appears briefly when you smile and a groove you can still see afterwards. Changes in skin quality and the tissue underneath can contribute to that progression. Sun exposure can play a part too.
Hyaluronic acid filler is a gel placed within or beneath the skin to support the areas that need it. By making an indentation shallower, it can reduce how deeply that part of the cheek creases and how strongly the line catches the light.
The product and its placement need to suit thin, moving skin. Treating these lines is different from adding projection over the cheekbone.
Your appointment
Let Dr Alex see your smile
He'll assess your cheeks in person, both relaxed and moving, and ask what you'd most like to change.
Look at the lines together
Choose an approach
Treat the areas that need support
Allow the result to settle
Why Dr Alex
Why choose Dr Alex for accordion-line filler?
Fine cheek lines need a different approach from cheeks that have lost their shape. Dr Alex assesses the creases, the skin and the underlying support together, so the recommendation isn't simply to add more cheek volume.
He teaches doctors, dentists and nurses across several filler ranges and is currently a trainer for Evolus's Estyme filler range. He has also helped launch Estyme and Aliaxin LV in the UK.
For your cheeks, he'll explain where filler could help and where a treatment such as laser would be more useful. The aim is smoother-looking skin that still suits the rest of your face.
GMC-registered doctor · 7072776
Full Member of BCAM
International toxin trainer
Aesthetics Awards winner 2021
Side effects and suitability
What should you know before treatment?
Bruising, swelling, tenderness and small injection marks are possible after cheek-line filler.
Possible side effects
Visible or palpable bumps and unevenness can occur, especially when treating fine lines in thin skin. Infection, delayed inflammation and allergic reactions are also possible.
An uncommon but serious complication is filler blocking a blood vessel. This can damage the skin and, very rarely, cause sight loss or a stroke. Dr Alex will explain the risks relevant to the proposed treatment before you decide.
When to get urgent help
Contact SONÜ immediately for unusual or increasing pain, or skin turning pale, grey, dusky or mottled. Seek urgent medical care if you cannot reach the clinic. For any change in vision, sudden weakness or difficulty speaking, call 999 and mention the filler treatment.
When treatment may need to wait
Tell Dr Alex about allergies, medicines, previous filler and any reactions to it, pregnancy or breastfeeding, and relevant medical conditions. Active infection or inflammation in the treatment area needs assessment before injections.
You can take time to consider the recommendation before going ahead.
Treatment costs
How much does accordion-line filler cost?
Treatment starts from £400 for the first 1 ml. We’ll agree the amount, areas and total cost with you before treatment.
Your questions
Questions about accordion-line filler
From the name of the lines to what treatment can realistically change.
What are accordion lines?
Are they the same as nasolabial folds?
Will filler make my cheeks bigger?
Will I still smile normally?
Would Botox be better for these lines?
Should I have laser instead?
How long does accordion-line filler last?
Does it hurt?
Can I have this if I already have cheek filler?
Can I go back to work afterwards?
Other approaches
When skin texture or cheek shape needs more attention
CO2 laser and CoolPeel address suitable surface wrinkles and texture. Polynucleotides focus on skin quality, while cheek filler restores the shape of cheeks that have lost volume.
Your next step
Bring your smile. We can look at the lines.
Book a consultation with Dr Alex at SONÜ in Hale, Altrincham. He can examine the creases across your cheeks and explain whether filler, a skin treatment or a combination could give you the smoother appearance you have in mind.
SONÜ Medical Aesthetics
34 Hale Road, Hale, Altrincham, WA14 2EX
Doctor-led treatment in a relaxed, private clinic
Close to Hale station and easy to reach from Altrincham, Manchester and Cheshire