Facial Muscle Anatomy and Visible Aging
Medically reviewed by
4 independent reviewers
Andrew Conrad Barile, PT, DPT
Doctor of Physical Therapy (DPT) | Licensed Physical Therapist (PT) | CEO and Founder, Xtreem Pulse LLC
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Dr. Andrew Conrad Barile is a Doctor of Physical Therapy and the CEO and Founder of Xtreem Pulse LLC, the engineering company behind PureLift. He earned his Doctorate in Physical Therapy from Daemen College and is a licensed physical therapist.
He brings over two decades of clinical and entrepreneurial experience across physical therapy, craniosacral therapy and medical device innovation, built on a working knowledge of human anatomy and muscle physiology.
For PureLift LAB he reviews how current is delivered across all ten levels, from sub-sensory nanocurrent and skin-level microcurrent to motor-level EMS, and how the Infuse pass fits into the same ten-minute routine.
Bertica M. Rubio, M.D.
Board-Certified Physician, Dartmouth Medical School | Medical Director, Antiaging Regenerative Medicine Clinic
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Dr. Bertica M. Rubio is a board-certified physician and Medical Director of the Antiaging Regenerative Medicine Clinic in Redlands, California. She earned her Doctor of Medicine from Dartmouth Medical School and completed her pediatrics residency at UC Irvine Medical Center.
With decades of clinical experience, she specialises in age management medicine, regenerative medicine, wound healing and growth factor therapies, and her practice integrates evidence-based medical science with advanced aesthetic treatment.
For PureLift LAB she reviews articles for medical accuracy across the whole dial, from the gentle nanocurrent and microcurrent settings through to muscle-level EMS and the Infuse pass.
Daniel Grinberg, MD, FACS
Board-Certified Otolaryngologist | Head and Neck Surgeon | Fellow, American College of Surgeons | Mount Sinai
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Daniel Grinberg, MD, FACS is a board-certified otolaryngologist and head and neck surgeon at ENT and Allergy Associates in West Nyack, New York. He earned his medical degree from Columbia University College of Physicians and Surgeons.
He completed his otolaryngology residency at New York University Medical Center, serves as Assistant Clinical Professor at Mount Sinai School of Medicine, and is a Fellow of both the American College of Surgeons and the American Academy of Otolaryngology.
For PureLift LAB he brings a wider clinical lens, connecting at-home facial stimulation from microcurrent to EMS to the anatomy underneath, with the same rigour we apply to every device specification.
Prof. Dr. med. Ivo Buschmann
Chair of Angiology, Medizinische Hochschule Brandenburg | Clinic Director, University Clinic for Angiology
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Prof. Dr. med. Ivo Buschmann is Chair of Angiology at the Medizinische Hochschule Brandenburg Theodor Fontane and Clinic Director of the University Clinic for Angiology at the Brandenburg University Hospital.
He trained at the University of Hamburg, was a Max Planck Society Fellow at the Max Planck Institute for Heart and Lung Research, and held senior consultant posts at the Charite Universitatsmedizin Berlin before his appointment as Chair in 2016.
One of Europe's leading authorities on arteriogenesis, with over 150 peer-reviewed publications and US and EU patents, he reviews for PureLift LAB how the evidence on electrical stimulation is read and where its limits lie.
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Your face is built in five layers and skincare only reaches the top one, which explains why a good routine can leave the shape of your face completely unchanged.
This article walks through the anatomy that decides how a face ages, such as:
- The five layers, from bone to skin
- What the SMAS is and why it matters
- Why facial muscles behave unlike any others in your body
- Which layer each treatment actually reaches
- Why no single product addresses all five
and many more!
By the end you will be able to place any product or treatment in the layer it works on.
Key Points:
Facial aging happens in bone, fat, ligaments, muscle and skin, and all five change at once rather than in sequence.
Around forty small muscles sit inside a connected sheet called the SMAS, which is why the face moves as one piece rather than in parts.
Facial muscles attach to skin rather than bone at one end, which is why they move your face and why they lose tone without use.
Skincare reaches the top layer, filler replaces the fat layer, and EMS works on the muscle layer, so they are not competitors.
Nothing at home reaches bone or repositions ligaments, and no honest article claims otherwise.
Most frustration with anti-aging products comes from a single misunderstanding, which is that the face is treated as one thing when it is five things stacked on top of each other.
Once you can see the layers, it becomes obvious why an excellent serum leaves your jawline exactly where it was.
Bone, the foundation
The skull is not fixed. It remodels through life, and the changes are not evenly distributed.
The eye sockets widen, the mid-face loses projection and the jaw loses height and angle, so the frame everything else is draped over gets slightly smaller and less defined.
Nothing available at home changes bone, and it is worth knowing that some of what you see in the mirror is structural rather than something you failed to prevent.
Fat, in compartments rather than a sheet
Facial fat is not one continuous layer, it sits in distinct compartments separated by walls of tissue, and each compartment behaves differently with age.
The compartments in the upper face tend to shrink while some in the lower face persist or descend, which is why a face can look hollow at the top and heavy at the bottom simultaneously.
This is the layer filler replaces, and it is also why weight loss shows in the face first for many people.
Ligaments, the anchor points
Retaining ligaments run from bone through to skin at specific points, holding the soft tissue in place like the buttons on an upholstered chair.
As they loosen, tissue slides downward between the anchor points, and the fold that appears above a still-tight ligament is what produces several familiar lines.
Surgical lifting works partly by addressing this layer, and nothing at home repositions a ligament.
Muscle, and why facial muscles are unusual
Around forty small muscles sit under the skin of the face, and they are built differently from the muscles in your arm.
Most muscles attach bone to bone, and facial muscles attach bone to skin at one end, which is exactly why they can move your face into expressions.
It is also why their tone shows up as facial shape, since a muscle attached to skin holds that skin where it sits.
They are held inside a connected sheet called the SMAS, the superficial musculoaponeurotic system, which links them so the face works as one coordinated structure rather than as forty separate parts.
Like any untrained muscle, they lose tone without use, and unlike the muscles you train at the gym, almost nobody trains these deliberately.
What the research shows about the muscle layer
In the largest facial trial of its kind, 108 women used daily muscle stimulation for twelve weeks and ultrasound measured an 18.6 percent increase in cheek-muscle thickness, with a clear difference from the untreated group at six weeks (Kavanagh 2012).
A double-blind, sham-controlled trial in adults over 65 found muscle thickness and bite force increased after six weeks (Chang 2020), and CT imaging in a later study showed the muscle around the eye thickening after eight weeks (Okuda 2026).
Those are category studies run with their own devices and protocols, so they show what facial muscle stimulation can do rather than what any particular product does.
What they establish is that this layer responds to training, which is the premise the whole category rests on.
Skin, the layer everyone treats
The outermost layer is where texture, tone, fine lines and radiance live, and it is where essentially all skincare acts.
Collagen and elastin decline, cell turnover slows, and the barrier holds moisture less well, all accelerated considerably by ultraviolet exposure.
A split-face study makes the layer distinction neatly, because the microcurrent side improved eye-wrinkle volume and dermal density while the EMS side improved lifting measures, which is two treatments working on two layers of one face (Kwak 2023).
Placing every treatment in its layer
Sunscreen and retinoids work on skin, and they are the highest-value thing most people can do, which is why they belong in every routine.
Microcurrent works on skin at the cellular level, so it belongs with texture and radiance rather than with shape.
EMS works on muscle, so it belongs with firmness and definition along the jaw, cheek and neck.
Filler replaces fat, so it belongs with hollowing and volume loss.
Surgery addresses ligaments and excess skin, which nothing else reaches.
None of them substitutes for another, and a routine that only ever treats the skin will change the skin and leave the shape alone.
What this means practically
Decide which layer your main complaint sits in before you buy anything.
Rough texture, dullness and fine lines are skin. Softening along the jaw and a cheek losing its shape are muscle. A cheek that has genuinely emptied is fat. Deep folds that persist when you press the skin flat involve ligaments.
Most people over forty have concerns in more than one layer, which is why the choice is usually about order rather than about picking a winner.
Working the muscle layer
All five PureLift models run nanocurrent at level 1, microcurrent at level 2, EMS from level 3 to 10, and Infuse as a second pass, so one device covers both the skin-level currents and the muscle work.
The session is three minutes on each side of the face, at a level where you can see the muscle answer, followed by the Infuse pass, about ten minutes in total.
Face at $499 and Pro at $699 reach up to 7 milliamps, Pro Edition at $799 reaches up to 7.7, and Pro Plus + at $899 and GLOW at $999 reach up to 9, all measured at 500 ohms and always written as up to.
GLOW alone adds light, red at 634 nm cleared for the treatment of wrinkles, blue at 465 nm cleared for mild-to-moderate inflammatory acne, and purple, which is red and blue running together.
Every model is cleared through the FDA 510(k) pathway, under records K190269 for Face, K230506 for Pro and Pro Edition, K221443 for Pro Plus + and K243587 for GLOW.
All five are made in Japan in an ISO 13485 facility.
Anyone with a pacemaker or another implanted electronic device, anyone pregnant, and anyone with epilepsy or a seizure disorder should not use the device at all.
For the technologies compared, read the complete technology guide, and for the routine, read the beginner's guide.
Model figures verified on 9 September 2026 against the PureLift LAB store and FDA records K190269, K230506, K221443 and K243587. Every model runs nanocurrent, microcurrent, EMS and Infuse; consumer copy always says up to.
Two related questions come up often alongside this one, and we have answered both in full: what still works after sixty and what does not, and which muscles a session actually reaches.