Exercise The Face?

Ever get stuck on an infomercial? You know, it's late. You can't sleep. And you can only watch so many episodes of "Batman" on TV Land before you start to think, "Hmmm, maybe Bruce Wayne IS good looking." Yes, not healthy, I know, but what comes next is even worse.

So I'm watching late-night television, and I happen upon an infomercial for a facial-muscle stimulator. I almost changed the channel, because the contraption looked suspiciously like the mask donned by Hannibal Lecter in "The Silence of the Lambs"a movie that literally had me sleeping with the light on for three months.

But, in the interest of science, I persevered and watched the rest of the "story."

Apparently, you just wear this mask-type-thing for the prescribed minutes per day and, voila! You have instantly avoided the need for a facelift! Imagine, just sitting around looking like a horror-movie freak, and you can have a tight, toned, younger-looking face.

Ah, if only it were that easy.

"Claims of passive improvement in the muscle tone, such as [those made by] facial muscle stimulators, have probably been around for more than a century," states Edward A. Pechter, M.D., a board-certified plastic surgeon based in Valencia, California and an assistant clinical professor of plastic surgery at the University of California, Los Angeles. "If they really worked, everyone would be aware of it by this time."

Even with the doubts of the medical community, there still are loads of self-proclaimed experts hawking all sorts of facial exercise programs. You know, standing in front of a mirror and make funny faces. Reminds me of my mother's constant admonitions to stop making faces, lest my face should freeze into one of those positions (forget that I am a California nativerarely do the temperatures in my neck of the woods fall below 50 degrees).

Why Our Faces Sag

Let's face it (pun intended), as we get older things tend to go south. Our once-firm, once-toned skin and muscles tend to lose their elasticity and for lack of a better term, oomph. When we look in the mirror, we start to notice our little badges of honor: fine lines, wrinkles and, eventually, sagging skin.

"Facial skin sags primarily in response to the relentless force of gravity over time," explains Pechter. "Certain factors might accelerate this... such as weight fluctuation and poor skin elasticity."

Around this time many people, at least those who don't believe in aging gracefully, start to look for that magic bullet. For some, it's a trip to the plastic surgeon. To others, it's a trip to the local bookstore to pick up the latest read on facial exercises.

Exercise the face? Keep reading.

Unfreezing the Face

Many in the facial exercise community tout that their programs can help reverse the effects of gravity, helping to lift and tone the muscles and skin of the face all without surgery. Sounds great, but does it work?

That depends on whom you ask.

Dermatologists and plastic surgeons say that if these "exercises" actually worked, everyone would know about them by now. Not to mention that these docs are routinely using Botox to relax the very muscles of expression you are thinking of exercising further.

Envision a great bicep. You worked to build it; now you're paying the dermatologist to relax it in order to get rid of the deeply grooved lines those buff muscles have created.

Facial exercise gurus say that the medical community just hasn't looked into this practice as much as they should.

In theory, here's what proponents of facial exercises say SHOULD happen: After following a regimen of facial exercises for a prescribed amount of time (duration varies by program), the subject will find that the muscles and skin of the face have been lifted, making the skin more taut, and helping to erase lines and wrinkles.

Facial exercises run the gamut from simply making what look like funny faces to hooking up to a facial muscle stimulator machine. Some newer methods require the use of the hands to help provide resistance to the muscles of the face.

According to Deborah Crowley, founder of FlexEffect Facial Resistance Training, you can help erase the lines, sags and wrinkles of aging skin by training the underlying muscles of the face. Crowley, a certified personal trainer and former competitive bodybuilder, uses the term "facial building" to describe her program of resistance exercises designed for the face.

Crowley believes her system, based on the same principles applied to resistance training for the rest of the body, is effective at increasing the facial "fullness" that tends to wither over time. She says that, in many cases, a regimen of facial building can eradicate the need for many people to undergo cosmetic surgery procedures. She cautions: "Facial building is not a magic bullet. It is only one of several procedures you should do to keep your face firm and youthful. When needed, cosmetic surgery can be a wonderful thing."

Cosmetic surgeons for years have disputed the claims that facial exercises can yield true improvement in the sagging of facial skin. "The muscles of facial expression are virtually in constant use whenever a person is awake from the time they are born," Pechter says. "This being the case, it is hard to fathom how a few additional 'exercises' would provide any benefit."

A traditional surgical facelift, Pechter says, does more than simply stretch the skin. "Most people turn to facelift surgery to address loose folds of skin that appear in the face with aging, but contrary to popular belief, the improvement from a traditional facelift comes from not simply pulling the skin back tightly but from repositioning it to a more youthful location."

However, according to Pechter, there are some facial muscles that do sag. "An example is the paired platysma muscles in the neck. (In humans, the platysma is found only in the neck, whereas in horses the platysma runs under the skin for the full length of the body, which is what allows those animals to retract their skin to shoo away flies on their back). When you see an older person with vertical bands of tissue on their neck... what appears to be loose skin is actually the stretched out borders of the platysma. A 'corset platysmaplasty' is often performed during facelift surgery to tighten these loose muscle edges in the manner of a old-fashioned corset."

Flex and LiftOr Lift and Tuck?

Purveyors of facial exercises say many if not most people can avoid a surgical facelift by following a targeted program of facial training. Crowley says the biggest benefit of her program is that it helps replace the "fullness" of the face.

Crowley says her program takes a while to yield results. "In about three weeks, most people will notice some increased tautness and some beginning thickness in the cheek. In about three months, you should see some really nice changes, such as beginning lift, growing firmness and fine lines starting to soften and disappear." Crowley explains that the most noticeable results are apparent between six months and one year.

On the other hand, plastic surgeons have research and the medical establishment on their side. Plus, the results are instantly palpable. "A good facelift will 'turn back the clock' a certain number of years varying with each individual, rather than giving them a completely new look. The lift does not last for a certain number of years and then suddenly 'fall apart.' Rather, the clock resumes ticking as soon as the lift is accomplished and features of aging will gradually reappear" states Pechter.

One of the major gripes physicians have with these facial exercises is just plain theory. Since we all move the muscles of our faces almost constantly, day after day, it seems odd that exaggerating these movements would prove any benefit. Medical professionals stress that the muscles of the face are not like other muscles of the body, such as those of the arms, legs, abdominal region. Sure, those muscles do get firmer from exercise, but as for the surrounding skin well, if the skin has lost elasticity from the effects of aging, smoking or other causes, the skin's still going to be there.

Consider this: People who lose large amounts of weight often are in need of surgery to remove the excess skin. No amount of exercise, physicians say, will tighten all of that extra skin. If you apply this theory to the face, the answer seems obvious.

However, since there are virtually no risks involved with facial exercises (other than your time), it can't hurt to try them, right? Most medical professionals see nothing wrong with the routines themselves though they debate the effectiveness.

Plastic surgery, on the other hand, does come with a certain set of risks (just like risks involved in any surgical procedure), so it's worth it to give the decision some serious consideration and to find an experienced, board-certified plastic surgeon. Believe it or not many physicians without a specialty in plastic surgery can perform some cosmetic surgery procedures.

Pechter says that a typical surgical facelift takes approximately four hours to complete, so "general health problems (such as diabetes or severe heart disease)" are a red flag to the surgeon. Also, "Smoking greatly increases the risk of complications with facelift surgery because the nicotine and carbon monoxide in cigarette smoke decrease circulation to the skin, which is already being challenged by the operation. Circulatory problems can cause some of the skin that has been lifted and stretched to die."

Another important consideration: "People who are not good candidates psychologically because of unrealistic expectations or improper motivation (doing the surgery for someone else or for a relationship rather than for themselves) is a red flag for problems," Pechter warns.

Robin Heinz Bratslavsky
DERMAdoctor Staff Writer

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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