As I was returning on a flight from NewYork after a plastic surgery meeting, scanning the SkyMall magazine is almost a ritual. While I never buy anything from it, the seemingly endless array of gadgets and devices that are contained within its pages are always entertaining. As part of their health offerings, devices for facial toning and wrinkle reduction are almost always seen. I have seen devices that look like dental appliances that we used to use for stretching lip and mouth scars to those that exercise the jaw. There are also numerous books available in book stores, including all old one from the 1950s that I keep in my personal library, that teach facial exercises.

Does the principle of facial exercise, no matter what method is used, really work? Claims are made that the face and neck muscles need a workout to stay fit and healthy. It is promised that sagging brows, cheeks, lips, jowls, and necks can be lifted. A more youthful appearing face can be achieved by these daily programs. The premise, of course, is an extension of well-known exercise physiology of the body that muscles can be toned and enlarged by increasing and repetitive workloads.  

While this sounds like an intuitive assumption, it largely represents flawed thinking…what I like to call a ‘truism’, something which sounds like it should be true but fails to be so on closer inspection and more in-depth analysis. The world in general, and medicine in particular, is filled with them. The flaw in thinking is two-fold: that facial muscles can actually be tightened and that the facial muscles play a significant role with the signs of facial aging that we see.

Facial aging is a multi-factorial process that largely deals with the loss of volume of different tissues. From the collagen in the skin to fat compartments in the face to even the underlying bones, tissues shrink, wither, and atrophy with time. Some people do it faster than others, but the tissue loss eventually exceeds the rate of any tissue regeneration. So droopy  brows, cheeks, jowls and necks are primarily the result of skin, fat, and fibrous layers loosening and sagging but not muscle tissue atrophy. While no definitive facial muscle studies have ever been done on how the facial muscles change with age (and I suspect they do have some atrophy in very advanced aging states),  facial muscles don’t weaken very much nor do they become loose or stretched. Your jowls don’t develop because your jaw (masticatory) muscle droop nor does your brow, cheeks or lips go south because your muscles of facial expression sag. The one exception is that of the neck where the platysma muscle does separate in the middle and sag and has formed the basis of successful facelift manipulation  for many decades.

There may be something to some neck exercises given the size and surface area of the platysma muscle, but any changes that it can make (besides never have been objectively proven) is likely to be too small to make much of a visible difference. Such evidence for improvement is completely testimonial and all before and after photographs that I have seen are glaringly inconsistent and of poor photographic quality.

Muscles of facial expression, like the muscles that move your eyes, are unique. They are quite small, work quickly due to spontaneous expression, and are of a high twitch quality. Meaning they must work fast and are already at a highly toned state given their constant repetitive movement. Like the difficulty one has with enlarging the calf muscle, toning a facial muscle is quite difficult…enlarging it is darn near impossible. The workload to do so would be more than a full-time job. Given that these muscles are ‘quite fit’ to begin with, trying to tighten or tone them for a facial rejuvenation benefit seems illogical. And trying to do so will have the opposite effect…the creation of more and deeper wrinkles from trying to work these muscles.

Facial exercising is not like that of the body. It has not aerobic benefit and cannot lift sagging facial tissues. Just like all the sit-ups in the world will not get rid of that overhanging belly and loose thighs, exercising facial muscles can not be expected to avoid the effects of time and gravity….and it certainly can’t achieve what any plastic surgery procedure can do. 

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Can Exercising Reduce Facial Wrinkles and LIft Sagging Skin ??

One methods that has been touted for over fifty years to reduce facial wrinkling and aging is exercising the facial muscles. One of the original books on this subject was entitled Lift Up Your Face from the 1950s, which I actually have a copy in my plastic surgery library. The concept continues to be espoused and written about today, now even expanding the exercise theme to include yoga facelifts, acupuncture facelifts and electric stimulation devices that promise to tighten the face through ‘muscle build-up’.

Having a good knowledge of the facial muscles and the facial aging processe, I still cannot understand how most of these approaches have any hope of being effective. Short of the platysma muscle of the neck (which I actually think can be tightened), the rest of the facial muscles are quite small and would have little impact on keeping the face uplifted as they are responsible for facial expression and not tissue suspension. The face ages as ligaments to the skin become lax, which subsequently allows skin and fat to sag (with the exception of the lips and chin) The facial muscles cannot prevent this problem, no matter how ‘tight’ one tries to make them. In fact, exercising (making extreme facial expressions) is likely to increase facial aging by making skin wrinkles worse.

For real prevention or improvement in facial aging, stick to the tried and true methods, Botox, injectable fillers, skin resurfacing, and eventually skin excisions and lifting procedures.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis