The effectiveness of facial exercises for facial rejuvenation: a systematic review.

BACKGROUND Although aesthetic correction of facial aging had long been the exclusive domain of plastic surgeons and dermatologists, alternative nonmedical approaches to facial rejuvenation are becoming more popular, such as facial acupuncture, facial acupressure, and facial exercises. However, the effectiveness of these alternative approaches is still a topic of debate. OBJECTIVES The authors review the evidence of the effectiveness of facial exercises for facial rejuvenation. METHODS A literature search was performed in Medline, Web of Science, Science Direct, SciELO, and LILACS databases for the terms facial rejuvenation, facial exercises, facial massage, face building, face yoga, (oro)facial (a)esthetics, (a)esthetic logopedics, and (a)esthetic speech therapy. Nine reports were identified from the search and were subject to further assessment. RESULTS Although positive outcomes were achieved in all 9 studies, none of the studies used a control group and randomization process. They were single case reports, small case series, or studies with a single-group pretest-posttest design. Moreover, the effectiveness assessments in most of the studies were purely subjective, carried out by the authors and/or the patients themselves, without blinding. CONCLUSIONS The evidence to date is insufficient to determine whether facial exercises are effective for facial rejuvenation. Evidence from large randomized controlled trials will be needed before conclusions can be drawn.