Six regions, the muscles in each, and the eighteen situations where the answer sits with someone else.
This series does one thing: it takes “how a face looks” and puts it back into “which facial muscle is pulling”.
The other half matters more. Every piece in it states, for the problems that muscle causes, which ones I cannot treat and who you should see instead. On a face, working out which kind you have matters a great deal more than choosing a procedure.
Established knowledge — published literature or textbook anatomy.
Clinical observation — what I have seen in my own clinic, with the scope of it stated. Not systematically verified.
Working hypothesis — something I am testing, which I cannot yet support.
ℹ️ About the English version of this page. The Chinese series runs to nineteen long articles, one per muscle. Those are not translated yet, so the links are not here. What this page keeps is the part that works on its own: the map, and the referral table.
- Start from what is bothering you
- The map: six regions of the face
- What kind of approach to ageing this series is talking about
- Who to see: the referral and boundary table
- Situations to settle first, or discuss with a doctor
- The full chart: every muscle, what it does, what it gets blamed for
Start from what is bothering you
| What is bothering you | A muscle that may contribute — after structural and medical causes have been considered |
|---|---|
| Vertical lines between the brows, tension at the brow, a brow that will not relax | Corrugator supercilii |
| Crow’s feet, a tired look around the eye | Orbicularis oculi |
| Nasolabial folds, a gummy smile, lines beside the nostril | The lip elevator group |
| Clenching and grinding | Temporalis, with masseter |
| Neck lines, a slack neck, the lower face dragging down | Platysma |
| An unclear jawline, slackness under the chin | Platysma, with digastric lying deeper |
| Under-eye bags | Mostly orbital fat and the tear trough rather than muscle. Orbicularis oculi contributes where a roll of muscle shows on smiling |
| Hollow temples | Mostly fat and bone volume rather than muscle |
| A double chin | Mostly submental fat and skin laxity rather than muscle |
| A receding chin | Usually skeletal or a matter of soft-tissue volume. See the referral table below |
| One-sided headache | Needs medical assessment first, not a muscle |
The map: six regions of the face
Upper face — forehead and glabella
What this region governs: the height of the eyebrow, and the lines on the forehead and between the brows.
Muscles here: frontalis, corrugator supercilii, procerus, depressor supercilii, occipitalis.
Most common complaints: forehead lines, vertical glabellar lines, a dropping eyebrow.
The eye region
What this region governs: opening and closing the eye, and the fine lines and bags around it.
Muscles here: orbicularis oculi, levator palpebrae superioris.
Most common complaints: fine lines around the eye, under-eye bags, a drooping eyelid.
Midface
What this region governs: the height of the upper lip and the corner of the mouth — that is, what a smile looks like.
Muscles here: levator labii superioris alaeque nasi, levator labii superioris, zygomaticus major, zygomaticus minor, levator anguli oris, nasalis.
Most common complaints: nasolabial folds, midface flattening, a gummy smile.
Lower face and perioral
What this region governs: the position of the corner of the mouth, the shape of the lips, the chin and the jawline.
Muscles here: orbicularis oris, risorius, depressor anguli oris, depressor labii inferioris, mentalis, buccinator, digastric.
Most common complaints: drooping mouth corners, marionette lines, lip lines, an uneven chin.
Lateral face and mastication
What this region governs: opening and closing the mouth, chewing, and the contour and tension of the side of the face.
Muscles here: temporalis, masseter, medial pterygoid, lateral pterygoid, auricularis superior, auricularis anterior, auricularis posterior.
Most common complaints: tension at the side of the head, masseter hypertrophy, temporomandibular discomfort.
Neck
What this region governs: how clearly the jawline reads, and neck lines.
Muscles here: platysma, sternocleidomastoid, the suprahyoid group.
Most common complaints: neck lines, a blurred jawline, neck tension.
What kind of approach to ageing this series is talking about
A natural approach to ageing moves you a little closer to how you looked when you were younger. It will not turn you into someone else.
If you looked like this ten years ago, or looked like this when you were young, then what you are seeing is probably not ageing. Skincare and small adjustments may not give you the change you are after; that sits with plastic surgery or with larger interventions, and the risks there are larger too.
What I do is physical, and what it works on is the tone of the facial muscles. The closest comparison is one-to-one strength training at a gym: a coach will not turn you into somebody else, but will get the parts that should be working to work, and the parts that should be relaxing to relax. The expression work and face yoga you do at home belong to the same family of things. The difference is precision about where each facial muscle sits — the way a coach knows better than you which fibre a given movement reaches.
And because it belongs to that family, it has the same properties as resistance training. One session does not produce a line. Fat does not disappear. It needs to continue, and a long gap lets it fade again.
The comparison has a limit, and it should be said plainly: what I do in clinic is facial acupuncture, using very fine needles that pass through skin. That makes it an invasive procedure, in a different class from massage or face yoga at home. So alongside the “who to see” table there is a second set — situations where the answer is not now.
⇒ That is why every article in this series carries two tables: one for how many kinds of this problem there are, and one for which kind I cannot treat, and who to see instead. The second table matters more than the first.
Who to see: the referral and boundary table
This gathers the referral advice from across the series. What it says, each time, is: the source of this problem is not in muscle, and I cannot help with it. If any row below describes you, see that specialty first.
This table deals with which specialty a problem belongs to. It does not clear anything for treatment. Not appearing here does not mean now is a suitable time; what should be settled first is the next section.
Specialty names differ between health systems, so each row names the function as well.
| Situation | Who to see first |
|---|---|
| 🔴 New temple pain over the age of 50, with tenderness over the temple, having to stop partway through chewing, or any visual symptom | The same day: emergency department, or rheumatology. Giant cell arteritis has to be excluded, and that cannot wait for a routine appointment |
| 🔴 Sudden one-sided facial weakness, an eye that will not close, a drooping mouth corner | Immediately: emergency department, neurology, or ENT |
| 🔴 An upper lid that will not lift, worse with activity and better after rest | Ophthalmology or neurology — neuromuscular disease has to be excluded |
| 🔴 Sudden one-sided ptosis, especially with pupils of different sizes, restricted eye movement, double vision or severe headache | Immediately: emergency department. Imaging is needed the same day |
| 🔴 A sudden severe headache reaching maximum intensity within seconds to a minute | Immediately: emergency department |
| 🔴 A headache that has changed in character, or is becoming more frequent | Neurology |
| 🔴 A lump in the neck, unexplained neck swelling, a change in swallowing or in the voice | ENT, or general surgery |
| Clicking, locking or restricted opening at the jaw joint, or a change in your bite | A dentist, or a TMJ / orofacial pain clinic |
| Grinding at night | A dentist — a splint may protect the teeth and sometimes reduce symptoms, but it does not reliably stop sleep bruxism or treat a single underlying cause |
| A gummy smile or a receding chin that is skeletal in origin | A dentist, or an orthognathic assessment (oral and maxillofacial surgery with orthodontics) |
| Snoring, daytime sleepiness; a child breathing through the mouth | ENT, starting with a sleep assessment |
| Long-standing nasal obstruction or allergic rhinitis | ENT, or Chinese medicine. This one affects nasolabial folds and dark circles more than skincare does |
| Volume loss: hollow orbits, a flattened midface, hollow temples (the atrophic kind) | Plastic surgery |
| Platysmal bands, or deep fullness beneath the chin | Plastic surgery |
| Under-eye bags that have clearly prolapsed, with skeletal change alongside | Oculoplastic surgery |
| A double chin that is fat | Weight management. The lead here is fat, with muscle playing a minor part |
| Forward head posture and other postural and structural problems | Physiotherapy, manual therapy, and your own postural habits |
| Persistent dry eye, red eye, or a change in vision | Ophthalmology. Chinese medicine can work alongside, and does not replace an eye examination |
Situations to settle first, or discuss with a doctor
The table above answers who to see. The list below answers whether now is a suitable time. Most of these can be treated once they are resolved or assessed:
- Acute infection, inflammation or an unhealed wound on the face
- Current anticoagulant medication, or abnormal clotting
- Pregnancy
- A tendency to keloid
- Other facial procedures recently — botulinum toxin, laser, radiofrequency, ultrasound, fillers, thread lifts — where the interval needs assessing
- A strong fear of needles, or having fainted during needling before
Clinical consensus
Every one of these comes back to an in-person assessment. Matching yourself against a web page does not count.
The full chart: every muscle, what it does, what it gets blamed for
There are more muscles on a face than the ones above. This chart lists the main muscles of facial expression and mastication.
| Region | Muscle | What it does | Commonly blamed for |
|---|---|---|---|
| Upper face | Frontalis | Lifts the eyebrow | Forehead lines, dropping brow |
| Upper face | Corrugator supercilii | Pulls the brow head down and in | Vertical glabellar lines |
| Upper face | Procerus | Pulls the centre of the glabella down | Horizontal glabellar line |
| Upper face | Depressor supercilii | Pulls the inner brow down | Part of the glabellar complex |
| Upper face | Occipitalis | Shares the galea aponeurotica with frontalis | Scalp tension |
| Eye region | Orbicularis oculi | Closes and narrows the eye | Fine lines around the eye, under-eye bags |
| Eye region | Levator palpebrae superioris | Lifts the upper eyelid | Drooping eyelid |
| Midface | Levator labii superioris alaeque nasi | Lifts the upper lip and the nostril rim | Upper segment of the nasolabial fold |
| Midface | Levator labii superioris | Lifts the upper lip | Middle segment of the nasolabial fold |
| Midface | Zygomaticus major | Pulls the mouth corner up and out | Drooping mouth corner, midface descent |
| Midface | Zygomaticus minor | Lifts the outer upper lip | Gummy smile |
| Midface | Levator anguli oris | Lifts the mouth corner | The height of the mouth corner |
| Midface | Nasalis | Wrinkles the nose, moves the nostril | Bunny lines across the nasal bridge |
| Lower face | Orbicularis oris | Closes the lips, shapes speech | Lip lines, lip shape |
| Lower face | Risorius | Pulls the mouth corner horizontally outward | The shape of a smile |
| Lower face | Depressor anguli oris | Pulls the mouth corner down | Marionette lines, drooping mouth corner |
| Lower face | Depressor labii inferioris | Pulls the lower lip down | Asymmetry of the lower lip |
| Lower face | Mentalis | Pushes the lower lip up, lifts the chin skin | An uneven chin |
| Lower face | Buccinator | Holds the cheek against the teeth | Chewing and oral control |
| Lower face | Digastric | Opens the mouth, lifts the hyoid | The jawline |
| Lateral face | Temporalis | Closes the mouth | Tension at the side of the head |
| Lateral face | Masseter | Closes the mouth; the main source of chewing force | Masseter hypertrophy, masseter pain |
| Lateral face | Medial pterygoid | Closes the mouth, protrudes the jaw | Restricted opening |
| Lateral face | Lateral pterygoid | Opens the mouth, protrudes the jaw | Temporomandibular discomfort |
| Lateral face | Auricularis superior | Lifts the auricle (vestigial in humans) | Tension above the ear |
| Lateral face | Auricularis anterior / posterior | Moves the auricle forward and back (vestigial) | No specific complaint |
| Neck | Platysma | Pulls the lower face and mouth corner down | Neck lines, the jawline |
| Neck | Sternocleidomastoid | Turns and flexes the head | Neck tension, a blurred jawline |
| Neck | Suprahyoid group (the rest) | Opens the mouth, swallowing | The floor beneath the jaw |
A few of these are not treated on their own in practice — depressor supercilii, occipitalis, depressor labii inferioris and the remaining suprahyoids — so separating them out would suggest an independence they do not have in clinic.
Where the rest of the answers sit
This map is about muscle. A face is more than muscle, and the answer to a great many of these questions sits with another specialty.
I take the questions I cannot answer from inside Chinese medicine to physicians in other fields, and publish their answers in their own words, under their own names — ENT, dentistry, structural therapy, ophthalmology and oculoplastics, dermatology and aesthetic medicine. How that is done, and what has come back, is written up in Cross-discipline questions: how I work with physicians in other specialties (in Chinese).
That series runs with physicians in Taiwan, where I can verify a colleague’s training and standing before I publish their answer under their name.
This is a series overview. It is health education and cannot replace individual diagnosis and treatment. Sections marked Clinical observation are clinical experience that has not been systematically verified, and other explanations are possible. Whether something is suitable for you, and how much it can change, depends on individual conditions and needs an in-person assessment. If any situation marked 🔴 in the referral table above applies to you, seek medical care first. Last medical review: 29 August 2026.
