Facial exercises improve appearance of middle-aged women

Jan 3 2018

A 30-minute daily or alternate-day facial exercise program sustained over 20 weeks improved the facial appearance of middle-aged women, resulting in a younger appearance with fuller upper and lower cheeks, reports a new Northwestern Medicine study. This is the first scientific study to test the premise of facial exercise improving appearance.

"Now there is some evidence that facial exercises may improve facial appearance and reduce some visible signs of aging," said lead author Dr. Murad Alam, vice chair and professor of dermatology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine dermatologist. "The exercises enlarge and strengthen the facial muscles, so the face becomes firmer and more toned and shaped like a younger face.

"Assuming the findings are confirmed in a larger study, individuals now have a low-cost, non-toxic way for looking younger or to augment other cosmetic or anti-aging treatments they may be seeking,"Alam said.

The study was published Jan. 3 in the journal JAMA Dermatology.

As the face ages, skin loses elasticity and fat pads between the muscle and skin become thinner. The fat pads, which fit together like a jigsaw puzzle, give the face much of its shape. As skin becomes saggy, the thinning fat pads atrophy and slide, causing the face to "fall down."

"But if muscle underneath becomes bigger, the skin has more stuffing underneath it and the firmer muscle appears to make the shape of the face more full," said senior study author Emily Poon, an assistant research professor in dermatology at Feinberg. "Muscle growth is increasing the facial volume and counteracting the effects of age-related fat thinning and skin loosening."

How the study worked

Study participants, middle-aged women 40 to 65 years old, underwent two sets of face-to-face 90-minute training sessions from a facial exercise instructor. At home, they continued to do these exercises for a total of 20 weeks. For the first eight weeks, they did the exercises daily for 30 minutes. From nine to 20 weeks, they did the same exercises every other day for 30 minutes a session.

The facial exercises were developed and provided by Gary Sikorski of Happy Face Yoga, who is a coauthor on the study.

"Facial exercises that may be beneficial include those that entail puckering and squeezing the cheeks," Alam said. "There are many muscles that collectively allow movement of the cheeks, and our study showed that building these up makes the upper and lower cheeks look fuller."

Participants learned and performed 32 distinct facial exercises, each one for about a minute. One is The Cheek Lifter: Open mouth and form O, position upper lip over teeth, smile to lift cheek muscles up, put fingers lightly on top part of cheek, release check muscles to lower them, and lift back up. Repeat by lowering and lifting the cheeks.

Another exercise is The Happy Cheeks Sculpting: Smile without showing teeth, purse lips together, smile forcing cheek muscles up, place fingers on corners of the mouth and slide them up to the top of the cheeks, hold for 20 seconds.

Of the 27 participants initially recruited, 16 did all the exercises for the entire duration of the study. Limitations of the study were the small sample size and that the participants were all middle-aged women. It remains to be seen if the results are generalizable to other populations, the authors said.

Study results

The primary outcome measure was assessment of standardized photographs before facial exercise compared to photographs after facial exercise by two blinded dermatologists. They assessed the photos by using a standardized facial aging scale (Merz-Carruthers Facial Aging Photoscales). The dermatologist raters looked separately at 19 features of the face and rated all of those at three different time points: at the beginning, at week eight and at week 20.

Also, they rated each participant's age at the beginning, at eight weeks and at week 20. Lastly they asked how happy participants were with the results.

The raters found that upper cheek and lower cheek fullness, in particular, was significantly enhanced as a result of the exercises. In addition, the raters estimated average patient age decreased over the course of the study. It started at 50.8 years, dropped to 49.6 years at eight weeks and then to 48.1 years at 20 weeks.

"That's almost a three-year decrease in age appearance over a 20-week period," Alam said.

Participants also reported being highly satisfied with the results and noticed improvement on nearly all the facial areas that were rated.