Facial yoga: Can exercising your facial muscles make you look younger?


Norman Swan: How to hold back the ageing process is the fundamental goal of a multibillion dollar industry, and a lot of focus is on the most visible evidence of ageing, the face, with lifts, fillers and Botox. But what if you could do this without needles and tens of thousands of dollars in expenditure? That's what facial yoga is offering, and a trial has recently been published of what some might think is a fad. Murad Alam is Professor of Dermatology at Northwestern University in Chicago.

Murad Alam: It's been something that has captured the popular imagination, it certainly seems like a good idea. If you could exercise your body, why not exercise your face?

Norman Swan: What happens when your face ages that suggests that exercise might make it better? Isn't it just the skin and the underlying tissue falling apart and everything sags and goes to pot?

Murad Alam: That's pretty much it. There are several specific components. First of all the top layers of the skin do sag, they become less elastic, they slide down lower on the face. Underneath that there is a subcutaneous fat envelope, spongy fat tissue. And in recent years it has become clear that that subcutaneous fat layer is comprised of the jigsaw-puzzle-like fat pads that interlock and create the shape of the face.

Norman Swan: So this is your chubby face.

Murad Alam: That's your chubby face, exactly. And over time those become thinner as well, and those also slide down in the face, thereby creating hollowing and loss of volume in the face.

Norman Swan: So then you get to the muscle underneath the fat.

Murad Alam: Yes, underneath the fat is the muscle layer, and that is where we feel facial yoga works. We don't really know a way to make the skin more elastic and we don't really know away noninvasively to make the fat pads fatter, but we do know how to make the muscle which is underneath the fat bigger.

Norman Swan: So this is bigger biceps as applies to the face, essentially.

Murad Alam: Exactly.

Norman Swan: When you did this trial, did you just pick up the exercises that facial yoga does, or did you invent your own?

Murad Alam: We did not invent our own, we tried to find somebody who was enthusiastic, who was skilled at training participants in one method of such exercise called facial yoga.

Norman Swan: So here's the ultimate challenge Murad, on radio describe the exercises. I know there's 32 of them, we're not going to go through all 32, but give us a flavour that we can mimic you as you go.

Murad Alam: The ones that we found to be most useful are in the mid-face and they entail things like puckering your mouth, blowing out your chin, scrunching your jaw, affecting your lower and upper cheeks. You basically look ridiculous doing these.

Norman Swan: So how do you mimic weight? To really bulk up your muscles you've got to do reps to…I mean, the theory here…it sounds as though I know what I'm talking about, but the theory is that you do maybe 15 reps and you put on weight that to get you to fatigue and essentially you bulk up muscle by fatiguing it on a regular basis and increasing the stress on the muscles, you get tear in the fibres and muscle growth and hypertrophy. How do you imitate that in the face?

Murad Alam: It's not a weight based exercise in the face obviously, it's repetition based, but it is very modest repetition. There are 32 exercises in the program we studied, and they are done for a total of 30 minutes, so it's only about a minute per exercise. The facial exercises are much smaller, and the amount of volume we're trying to add is much smaller. So maybe that's good enough, or at least it appears to be.

Norman Swan: So okay, let's get down to the study as well because it wasn't a randomised controlled trial, this was really a proof of concept where you studied a group of women aged between 40 and 65. So just describe the study and how you measured the outcome.

Murad Alam: Sure. So, exactly like you said, we got slightly more than 20 women, ages 40 to 65. We had Mr Sikorski, who was our trainer, train them in two training sessions of 90 minutes each on how to do these exercises. And thereafter they did these exercises at home, first for 30 minutes a day for the first eight weeks, and 30 minutes every other day for the next 12 weeks. And the way we measured the result is we had a normed validated scale that we assessed patient photographs on, both before and after. And in addition to that we had blinded raters look at the photographs jumbled up and try to determine how old patients looked.

Norman Swan: And what did you find?

Murad Alam: We found that they did look a little bit younger, they looked about almost three years younger and that in fact improvement continued also in the second half of the study when they were only doing exercises 30 minutes every other day.

Norman Swan: And presumably it didn't happen in all the women. What proportion of the women saw benefit?

Murad Alam: The majority saw some benefit but also we had a number of dropouts. I think that's important to realise. About a quarter of the patients decided not to follow through with the program, and when you have dropouts you have to wonder why that's happening. In some cases it's just the inconvenience of doing the exercises or coming back for a repeat training session, but it's certainly possible that some of those patients also didn't notice as much benefit.

Norman Swan: And what about skin types? So you can have Anglo Irish, very fair skin, redheads, people of Indian ethnicity, did you get different responses according to different skin types or ethnicities?

Murad Alam: Our test pool was predominantly Caucasian patients, and we would expect them to maybe need it the most because they tend to get the greatest degree of fat atrophy. But interestingly one of our best results was an African American patient.

Norman Swan: What about wrinkles and creases? You actually might create them with the exercises.

Murad Alam: That's an excellent point and we were concerned about that because there were people who laugh and smile a lot and get crows feet, these crinkles around their eyes, and some of us frown and that gives us lines on our forehead. So when we are actively exercising are we in fact creating those lines? We didn't find that to be the case. Our hypothesis is when people smile a lot or frown and create lines, they are doing so for many, many minutes, probably many hours every day, whereas in the context of this training we were doing each exercise for only one minute a day at most.

Norman Swan: There's a huge industry in fillers and presumably this replaces that, but one part of the face where people put in fillers is the lips. Where there any changes to the lips with all the puckering that was going on?

Murad Alam: We did not see any changes that we could call statistically significant at the lips.

Norman Swan: But does this potentially replace cosmetic procedures such as lasers, fillers, Botox?

Murad Alam: I don't think so. I think this is something that patients may choose to do in addition to those three procedures and improve their overall results, but the procedures you mentioned work really well and are extremely safe, and they provide a consistent benefit in virtually all patients. So I suspect both the degree and the reliability of the improvement that people get from those safe, effective procedures will still be the gold standard, but facial yoga might be done in addition.

Norman Swan: So cosmetic dermatologists live to fight another day.

Murad Alam: Exactly!

Norman Swan: Murad Alam, thank you very much indeed for joining us.

Murad Alam: Thank you very much.

Norman Swan: Well, I hope you are suitably contorted after that. Murad Alam is Professor of Dermatology at Northwestern University in Chicago.

© Australian Broadcasting Company (2018)