Accordion lines
Accordion lines are fine vertical or fan-shaped lines on the outer cheeks that appear when smiling. Unlike nasolabial folds, they sit farther out on the cheek and reflect compression of the skin during expression. They may become visible at rest as skin quality changes.
What you may notice
- Fine cheek lines during a broad smile
- A fan-shaped or pleated pattern
- More visible lines on sun-damaged skin
- Different prominence on each cheek
Why it can happen
Smiling compresses the mobile cheek over deeper tissues. Reduced elasticity, ultraviolet damage, thin or dry skin, genetics and age-related volume changes can make the folds more apparent. Adding volume without assessing movement may not improve the pattern and can make the cheek look heavy.
What may help
Sun protection and appropriate skincare support surface quality. Resurfacing or collagen-remodelling procedures may help selected static texture; injectables require conservative, anatomy-based planning because cheek movement and smile function should be preserved. Evidence and expected improvement vary by treatment.
When to consult
Consultation can distinguish surface lines from volume loss or tissue descent. A new fixed crease with a skin lesion, lump, facial weakness or pain should be medically assessed.
Evidence and sources
- DermNet. Facial lines and wrinkles [Internet]. Auckland: DermNet New Zealand Trust; 2004 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/facial-lines-and-wrinkles (new tab)
- DermNet. Ageing skin [Internet]. Auckland: DermNet New Zealand Trust; 2018 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/ageing-skin (new tab)
- American Society of Plastic Surgeons. Skin rejuvenation and resurfacing [Internet]. Arlington Heights (IL): American Society of Plastic Surgeons; [cited 2026 Nov 7]. Available from: https://www.plasticsurgery.org/cosmetic-procedures/skin-rejuvenation-and-resurfacing (new tab)
- US Food and Drug Administration. Wrinkle treatments and other anti-aging products [Internet]. Silver Spring (MD): FDA; 2024 [cited 2026 Nov 7]. Available from: https://www.fda.gov/cosmetics/cosmetic-products/wrinkle-treatments-and-other-anti-aging-products (new tab)