Midcheek groove: the crease in the middle of the cheek
- Highlighted area
Quick facts
- Location
- On the cheek, running diagonally down and outward from the end of the tear trough.
- Anatomical basis
- Fibrous attachments between skin and bone in the region of the zygomatic ligament, and the boundary between cheek fat compartments.
- Typical shape
- Together with the tear trough and the palpebromalar groove, it forms a Y-shaped pattern in the midface.
- Relevance in HOF
- Signals loss of support in the midface and is part of cheekbone and under-eye planning.
- In Harmy
- The region lies between the Tear Trough and Cheekbone points of the marking.
The midcheek groove is the line or depression that runs diagonally down the middle of the cheek, starting at the end of the tear trough and continuing downward and outward. In the English-language literature it appears as midcheek groove or midcheek furrow. It becomes more visible with loss of volume and support in the midface and is often part of the concern of a "tired face".
Where is it and what are its limits?
The midcheek groove is the "trunk" of a Y-shaped pattern that forms in the midface with age:
| Line | Where it is | Described anatomical basis |
|---|---|---|
| Tear trough | Medial, from the inner corner of the eye downward | Tear trough ligament, at the transition between eyelid and cheek |
| Palpebromalar groove | Lateral, along the lower edge of the orbit | Orbicularis retaining ligament |
| Midcheek groove | Runs diagonally down the middle of the cheek | Fibrous attachments from skin to bone in the region of the zygomatic ligament, and the boundary between fat compartments |
Authors describe the groove as the point where the skin is held most firmly to the deeper structures, between cheek fat compartments that lose volume and descend differently. The result is a linear depression between fuller areas. Shape and extent vary between people and between the sides.
Why does it appear or get worse?
- Loss of deep volume in the midface, which reduces support for the skin.
- Descent of the superficial fat compartments relative to the fixation points.
- Bone remodeling of the maxilla and the orbital rim with age.
- Marked weight loss, which can reveal the groove even in young people.
- Constitution: in some people the groove is present early because of ligament characteristics.
Why does it matter in HOF?
The midcheek groove interrupts the ogee curve, the continuous line of the cheek profile seen in three-quarter view. It indicates that the midface has lost support, so it is usually assessed together with the cheekbone and the under-eye area, and not as an isolated line. Treatment of cheek support is covered in cheekbone filler.
How does it show up in the assessment?
- Three-quarter photo: shows the break in the cheek curve best.
- Light from above: accentuates the shadow of the groove; always compare using the same light.
- Rest and smile: when smiling, the cheek rises and the groove may fade or deepen.
- Relation to the tear trough: see whether the groove continues the tear trough, as in the Y pattern. The assessment of under-eye hollows is in under-eye circles: types and assessment.
Also called: groove in the middle of the cheek, midcheek groove, midcheek furrow, medial jugal groove.
Frequently asked questions
What is the midcheek groove?
It is the line or depression that runs diagonally down the middle of the cheek, from the end of the tear trough toward the corner of the mouth. It becomes more visible with loss of volume and support in the midface.
Are the midcheek groove and smile lines the same thing?
No. Smile lines (the nasolabial fold) run from the side of the nose to the corner of the mouth. The midcheek groove sits higher and more laterally, in the middle of the cheek, and continues the line of the tear trough downward.