Facial lines fall into three groups: dynamic lines made by muscle movement, static lines in the skin itself from collagen loss and sun exposure, and folds created where the volume underneath has been lost. Each responds to a different treatment. All three are assessed at Coastal Dermatology + Aesthetics in San Luis Obispo.
Three different things that all look like a line
Lines are not one problem with one answer, and that is the single most useful thing to understand before spending money on them. Almost every line on a face belongs to one of three groups, and the treatment that transforms one of them does very little for another.
Muscle lines. The crease between your brows when you concentrate, the crow’s feet when you smile, the horizontal lines when you raise your eyebrows. These are made by the muscle folding the skin, over and over, for years. They are the ones people notice first because they arrive earliest.
Skin lines. Fine crosshatching on the cheeks, crepe texture under the eyes, the vertical lines on the upper lip. These sit in the skin itself, where collagen and the springy fibers underneath have thinned. Years of sun is the biggest single contributor to this group.
Folds from lost volume. The crease running from the nose to the corner of the mouth, hollowing under the eye, a softening along the jaw. These are not really lines at all. They are shadows and creases that appear because the volume underneath has gone, and treating the surface does not address them.
Most people over thirty have some of all three. The mix is what the plan is built from.
Muscle, skin, and lost volume. They look alike in a mirror and they need different treatments, which is why “what should I get for my lines” has no useful answer until somebody has looked at your face.
What causes it
Repetition, which is just having a face
Every expression you have made for decades has folded the same piece of skin in the same place. Early on the skin springs back completely. As the support underneath thins, it springs back less, and the fold eventually stays visible when your face is at rest. That progression is why muscle lines are the earliest to appear and the most straightforward to soften.
Collagen, which your body makes less of every year
The scaffolding under your skin thins steadily, and it starts earlier than most people expect. Thinner support means the skin creases more easily and recovers more slowly, which is what turns an expression into a line that stays.
Sun, which accelerates all of it
Ultraviolet light breaks down collagen and the springy fibers faster than time alone does, which is why years of sun shows up as lines rather than only as color. On the Central Coast this matters more than people assume, because year-round outdoor weather and a marine layer that hides how strong the light is add up quietly. This is also the one cause you can still act on.
Ultraviolet light breaks down the collagen and springy fibers under your skin faster than time does. Daily broad-spectrum protection is the cheapest line treatment there is, and it is the only one that works while you sleep. [3]
The mirror test that tells you which kind you have
You can narrow this down yourself in about a minute, and it will make your consultation a much better conversation. Stand at a mirror in good light and do these three things in order.
| Step | What to do | What it tells you |
|---|---|---|
| 1 | Make the expression that creates the line, then relax your face completely. Watch the line | If it vanishes when you are still, it is a muscle line. That is the group that responds to a neuromodulator |
| 2 | With your face still relaxed, look at what is left. Is there a fine line etched into the skin? | A line still visible at complete rest is a skin line. That group responds to resurfacing, microneedling and collagen treatment |
| 3 | Lie back, or lift the skin of your cheek gently upward with two fingers. Does the crease flatten out? | If lifting from underneath flattens it, it is a volume problem rather than a line, and a face that has emptied is where the answer is |
Most people find they have all three, in different places. The forehead is often muscle, the cheeks often skin, the fold beside the mouth often volume. That is why a single product rarely satisfies anyone, and why the useful question at a consultation is not “what should I get” but “which of these do I have the most of.”
One thing the test will not tell you is whether what you are seeing is loose skin rather than a line, because loose skin and an emptied face look alike in a mirror and need different treatment. That one takes a person.
Areas we treat
Between the brows
Muscle, almost always, and one of the earliest to appear
Forehead
Muscle, and the group that responds most predictably
Outer corners of the eyes
Muscle at first, gradually adding a skin line underneath
Under the eyes
Skin texture, often with a hollow underneath doing half the work
Upper lip
Skin lines, and one of the areas where resurfacing earns its place
Nose to mouth
Volume, most of the time, rather than a line at all
Cheeks
Skin texture and lost volume together
Neck and chest
Skin lines from sun, and frequently ahead of the face
Services are prompt, friendly, professional and most of all comfortable…it was an extraordinary experience.
The Coastal difference
Nobody here is selling you one thing
This is the most contested term in this market and almost every page competing for it is a page about a single product. That is the structural problem with the category: if a practice offers one route, every face that walks in turns out to need that route.
We carry all three routes, which means the recommendation can follow your face instead of the inventory. Sometimes the honest answer is a neuromodulator and nothing else. Sometimes it is that the crease you dislike is a volume problem and no amount of surface work will reach it. Sometimes it is sunscreen, a retinoid and a conversation in a year, and that is a real outcome of this appointment rather than a polite deferral. A board-certified dermatologist assessing all three at once is a different consultation from a treatment room with one machine in it.
Neuromodulators for muscle lines, resurfacing and collagen treatment for skin lines, and volume restoration for folds, all under one roof. The recommendation follows your face rather than what happens to be in the room.
Is it right for you?
This is a good conversation to have if:
- You have run the mirror test and found more than one kind, which most people do
- You have had a treatment elsewhere that did not do what you hoped, which often means it was aimed at the wrong group
- You want to know what you actually have before you spend anything
- Lines have started staying visible when your face is at rest
- You would rather start early and lightly than wait and do more later
Worth knowing before you book:
- Muscle lines respond earliest and most predictably. Skin lines take a course and time
- A fold that flattens when you lift the skin is a volume conversation, not a line one
- Everything here works better on skin that is protected daily from the sun
There is no obligation attached to finding out which you have, and some people leave with a skin care plan rather than a treatment.
Holding onto the result
Worth doing
- Broad spectrum sunscreen, SPF 30 or higher, water resistant, every day before you go outside [3]
- Treat your neck and chest as part of your face, because they show skin lines early
- Keep a routine simple and consistent rather than long and occasional
- Come back on the interval you agreed rather than when the result has fully worn off, which is easier and usually less work
Worth knowing
- Muscle lines return as movement returns. That is the treatment wearing off rather than failing
- Skin lines improve gradually over a course and keep improving for months after it ends
- Your face carries on aging underneath any result, which is what maintenance is for
- Sun protection is the only part of this you do every day, and it is the part that compounds
Treatments we offer
A different route for each of the three, and most plans use more than one. Pick a treatment to see how it works.
What treatment costs
What a plan costs depends entirely on which of the three you are treating and how much of each, which is worked out at the consultation. You get the plan and its cost before anything is booked.
The three kinds
Muscle lines, skin lines, and folds from lost volume
The quickest test
Does the line disappear when your face is completely still?
What drives skin lines
Collagen loss and accumulated sun exposure
Where the plan comes from
Which of the three you have, and usually you have more than one
Wrinkles and fine lines frequently asked questions
How long the mirror test above takes. Make the expression, relax completely, then lift the skin. What the line does at each step tells you which of the three you are dealing with.
Offered at
Want to know which kind you have? Request an appointment
Fill out the form below, book online in Santa Maria (opens online scheduler), or give us a call. Cosmetic and aesthetic appointments need no referral. For medical dermatology in San Luis Obispo, we are accepting new patients by referral from your primary care physician; send the referral across and then use the same form. In Santa Maria, medical appointments are available without a referral for PPO patients, and for HMO patients we are in-network with Santa Maria Physician's Choice.
A consultation fee of $125 is due at the time of booking.
Sources and medical review
1. American Academy of Dermatology Association. “Many ways to firm sagging skin.” States that non-surgical options give “modest lifting and tightening,” that best results from radiofrequency appear at about 6 months and “can last 2 to 3 years with the right skin care,” and that non-surgical options “still cannot give you the results of a surgical procedure like a facelift, eyelid surgery, or neck lift.” https://www.aad.org/public/cosmetic/younger-looking/firm-sagging-skin · Medical Organization
2. American Academy of Dermatology Association. “Skin conditions that lasers can treat.” Laser and light treatments are listed as useful to reduce wrinkles and fine lines, alongside age spots, scars and other concerns. https://www.aad.org/public/diseases/a-z/skin-conditions-lasers-treat · Medical Organization
3. American Academy of Dermatology Association. “How to select a sunscreen.” Broad spectrum, SPF 30 or higher, water resistant, reapplied every two hours outdoors and after swimming or sweating. https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/how-to-select-sunscreen · Medical Organization
Content on this page is for educational purposes and is not a substitute for professional medical advice. The self-assessment described on this page narrows the possibilities and does not replace an examination. Results vary by which kind of line is being treated, by individual anatomy and by how consistently sun protection is maintained. Neuromodulators, fillers, resurfacing and microneedling each carry their own risks, which are discussed individually before anything is scheduled. Individual results may vary. A consultation fee of $125 is due at the time of booking.