Episode 6259 custom

What Facial Exercises Actually Change

In a 2018 JAMA Dermatology trial, blinded doctors estimated facial exercise participants looked nearly three years younger.

Oct 25 22:54 Transcript

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nutrition-and-diet physics

Episode Details

Episode ID: MWP-6461
Published: Oct 25
Duration: 22:54
Audio: Direct link
Pipeline: V5.22
TTS Engine: chatterbox-regular
Script Writing Agent: GPT-6.1 Sol
Topics: nutrition-and-diet physics

AI-Generated Content: This podcast is created using AI personas. Please verify any important information independently.

The prompt

The prompt that started this episode, as sent in (production notes for the hosts removed).

Today I want to talk about face yoga and all these exercises that supposedly change the way your face looks. My algorithm has really latched onto this lately, so I’m constantly seeing videos claiming you can tighten your jawline, lift your cheeks, reduce wrinkles, improve symmetry, or basically exercise your way into a mini facelift.
Intuitively, part of it seems plausible to me. We do have muscles in our faces, and clearly changing muscle mass elsewhere in the body changes appearance. You can even see that sometimes in people who start lifting weights heavily—their face and jaw can look different. But my dad, who knows a lot about craniofacial anatomy, insists most of this is nonsense.
So what does the evidence actually say? Can facial exercises meaningfully change muscle tone, jawline definition, cheek position, symmetry, or signs of aging? Are some claims plausible while others are complete fantasy? And is there any downside—like making wrinkles worse by repeatedly contracting the same muscles? Basically, what can face yoga realistically do, if anything?

Online tutorials frequently promise that facial exercises can lift sagging skin, carve out a sharper jawline, and reverse visible aging. However, clinical evidence tells a much narrower story. A frequently cited study published in JAMA Dermatology in January 2018 evaluated participants practicing thirty-two Happy Face Yoga exercises for twenty weeks. Blinded physicians reviewing photos on the Merz-Carruthers photographic scales noted a modest increase in upper- and lower-cheek fullness, lowering apparent age by nearly three years. Despite these findings, the study lacked a comparison control group and saw substantial dropout. Broader systematic reviews confirm the scientific evidence remains low quality, demonstrating that while targeted exercise can strengthen oral muscles, it cannot reliably tighten loose skin or correct facial asymmetry.

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Happy Face Yoga Facial exercise program used in the trial
JAMA Dermatology Journal publishing the 2018 facial exercise trial
Merz-Carruthers Photographic Scales Rating scales used to grade facial appearance
My Weird Prompts Podcast hosting this episode

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#6259: What Facial Exercises Actually Change

Can you exercise your cheeks into a facelift, or just into larger cheeks? Hannah wants us to untangle that, because her feed has become very interested in renovating her face. The videos promise a sharper jawline, lifted cheeks, fewer wrinkles, better symmetry. The plausible part is that faces contain muscles, and muscles can grow. The objection, from her dad, who knows craniofacial anatomy, is that most of the promised changes don't follow from that.

The cheeks are where his skepticism needs a small exception. There is a measurable cheek-fullness result worth taking seriously. The leap from that to tightening loose skin is where the sales pitch takes over.

I also want to know what happens to the skin we're repeatedly folding while pursuing the allegedly younger face. A forehead workout sounds suspiciously like worrying with a timetable.

That downside is much less settled than the confident tutorials suggest. We can explain why the concern makes anatomical sense without pretending somebody has measured the long-term risk.

Good. My forehead already has an unpaid position.

The most informative trial was published in JAMA Dermatology in January two thousand eighteen. It matters because physicians rated photographs without knowing where those photographs belonged in the treatment sequence. That takes the judgment beyond participants looking in a mirror and deciding their effort must have accomplished something.

Beyond, yes. Not all the way to proving the exercise caused it. You can blind the person looking at a photograph while leaving a rather large hole where the comparison group should be.

There was no comparison group. That's the central limitation. Everybody received the exercises, and the investigators followed the people who completed the program. Still, blinded assessment is useful. A small uncontrolled trial can give you a credible signal to investigate without settling the treatment question.

The wider literature doesn't provide a strong foundation underneath it, either. A review focused specifically on facial training and the soft-tissue profile found only four eligible studies. Just two had controls. Broaden the question to strengthening and rejuvenation, and you get more papers, but a collection of small experiments measuring different things.

Different things being an important escape hatch. Lip strength, cheek volume, skin elasticity, looking younger. If I improve one, I don't get to collect the others at reception.

They require different measurements. An ultrasound can detect thicker muscle. A force measurement can detect stronger lip closure. Neither tells you whether somebody's jawline looks sharper. Even apparent age is its own outcome, influenced by several visible features.

You're about to fall in love with the ultrasound.

Only briefly. It can test a proposed mechanism. You usually prefer a device that measures something over somebody enthusiastically describing their reflection.

I prefer the device not to sell me cheekbones afterward.

Reasonable condition. The larger systematic review, published in two thousand twenty-one, collected eleven studies involving roughly three hundred people. Its verdict was low-quality evidence despite some positive findings. Put that alongside the blinded photographs, and we have something narrower than either enthusiastic endorsement or total dismissal.

The trial recruited women with sun damage and mild-to-moderate facial volume loss. That's already a different proposition from a young person wanting a more angular face. Adding fullness might help one person achieve precisely what the other is trying to remove.

Their ages ranged from forty to sixty-five. The intervention was substantial, too. Participants learned thirty-two exercises through two instructor-led sessions, each lasting ninety minutes. The instructor was also a coauthor and developed the Happy Face Yoga program.

A training course for having a face.

They then practiced for thirty minutes daily during the opening eight weeks. After that, the schedule dropped to alternate days through week twenty. This was coached practice over months, not a brief movement copied from a video.

Half an hour is enough time to discover several new objections to your appearance. Did the photographs show a broad improvement, or did the positive result concentrate somewhere specific?

Cheek fullness was the convincing result. The upper-cheek rating rose from one point one to one point eight on the photographic scale. That's a modest shift on an appearance measure, not a measurement of how far tissue moved upward.

Important distinction. A fuller cheek can occupy more space without relocating the rest of the face.

The lower-cheek scores improved by a similar amount. Two blinded physicians did the ratings using the Merz-Carruthers photographic scales. Their average age estimate also dropped, from about fifty-one to about forty-eight by the end.

Three years younger, judged from photographs. That is interesting. It also sounds extremely vulnerable to being advertised as biological age reversal by somebody standing beside a ring light.

Apparent age, specifically. Nobody measured reversal of cellular aging. The authors themselves said the program may modestly improve the appearance of selected middle-aged women. Every limiting word in that sentence is doing useful work.

Selected women who finished it.

Yes. Twenty-seven enrolled, and sixteen completed. That leaves eleven who didn't finish. We'll need to come back to what that does to the interpretation. First, what do you think changed in the cheeks, Corn?

Muscle size seems plausible, but I'm not convinced that smiling against resistance necessarily supplies enough load. We're accustomed to seeing muscle growth under fairly demanding conditions. A face already spends the day moving.

Ordinary movement and sustained resistance differ. The proposed mechanism is hypertrophy, meaning growth of the muscle itself. A separate device-based experiment used ultrasound and found larger cross-sectional area in a cheek muscle, plus thickening around the upper lip and mouth.

Your ultrasound has arrived.

It has, and it's brought limitations. That experiment also had weak methodology. It supports anatomical plausibility, not certainty that this particular exercise program grew the same muscles enough to explain the photographs.

Still, the cheek muscle involved, the zygomaticus major, helps draw the mouth upward. Nearby muscles lift the upper lip. Increased bulk in that region could change the visible contour, especially where someone has lost volume.

Whereas lifting sagging skin requires more than increasing the size of something underneath it. Aging changes collagen, elastic tissue, fat compartments and the structures supporting them. You can't infer repair of all that from a thicker mouth muscle.

You could alter the surface appearance without repairing those structures. That's why I wouldn't dismiss a cosmetic benefit. Fullness can matter visually. It just doesn't establish the advertised tightening mechanism.

Fine. I concede the cheek can improve while keeping my objection to the verb.

The less encouraging controlled experiment involved eighteen women doing daily isometric exercises over seven weeks. Improvement was confined to the upper lip. The jawline, forehead and folds beside the nose didn't show a significant advantage over controls.

Small enough that it might miss an effect, but it certainly doesn't supply evidence for the jawline promise.

Nor did the broader review rescue that claim. Only five of its studies had a control group. The systematic review concluded the level of evidence was low, with a median quality score of three point five.

Folks, if your algorithm is serving you face yoga, serve it right back with the Cheeky Cheek Press, the only exerciser calibrated to the Merz-Carruthers Photoscales, so you can lift, tighten, and symmetrically inflate your jawline while you sleep. And here is the crazy part, the price just keeps dropping while I talk. It started at two hundred dollars, now it is one hundred and forty, now it is ninety, and I am throwing in a craniofacial anatomy poster, a certified instructor's whistle, and a blinding machine so your own raters cannot see the wrinkles. But wait, the deal ends before I finish describing it, so the price is now sixty, now forty, now fifteen dollars, and it is gone. It is gone, folks. It ended mid sentence. That is how fast the evidence moves.

Calibrated to photographic scales... that isn't a device calibration standard. The first claim alone...

Herman, don't peer-review the whistle.

The actual strength findings are more straightforward. People can improve lip closure, tongue strength and muscular endurance through targeted training. Those outcomes have practical meaning for oral function. The problem comes when a demonstration of strength is presented as proof of rejuvenation.

Trumpet players are useful here. Lots of repeated work around the mouth, without somebody designing a routine around before-and-after photographs.

Players practicing at least six hours weekly showed stronger cheeks and greater lip endurance than controls. Other tone-related measures didn't differ. It's a useful check on the suggestion that any intensive facial activity automatically produces the resting appearance the videos promise.

Although we shouldn't turn trumpet playing into a randomized trial of face yoga. Different movements, different people, different reasons for doing it.

I was about to stretch that comparison, and you're right. It demonstrates that strength, endurance and what gets called tone don't travel together automatically. It doesn't tell us the maximum cosmetic effect of a particular routine.

The word tone is wonderfully employable. Sometimes it means resting muscle tension, sometimes definition, sometimes whatever the presenter thinks looks expensive.

A person selling tone needs to specify what changes and how they measured it. A stronger lip seal has a testable meaning. A toned face without an outcome measure gives you considerable room to declare success.

Symmetry is another promise that sounds precise until somebody has to identify the source of the asymmetry. Bone, dental relationships, muscle activity, soft tissue. A generic routine couldn't reasonably address all of those.

The facial-exercise evidence doesn't establish correction of asymmetry. Even a plausible targeted intervention would need to identify the cause first. Exercising both sides equally doesn't demonstrate that a structural difference will shrink.

Equal homework for unequal problems.

Would you personally trade the time for the cheek result, assuming the result held up?

Probably not. I might care about the appearance of lost volume, but the schedule matters. Half an hour every day competes with things I already value, including doing absolutely nothing with my mouth. Someone else might enjoy the ritual. That's a different calculation from being told it's a free facelift.

Your commitment to inactivity has finally acquired a comparator.

It has excellent retention.

Retention is exactly the practical difficulty here. Around forty percent of the original group didn't complete the program. We shouldn't assume why each person stopped, but the people left at the end aren't necessarily representative of everyone who tries.

They could have enjoyed it more, found it easier, noticed more benefit. Or simply had more room in the day. We don't know. What we do know is that satisfaction among finishers answers a narrower question than satisfaction among everyone recruited.

Participants reported improvement across most of the facial features they were asked about, far more broadly than the blinded photographs supported. Their impressions matter as experiences. They aren't independent confirmation of improvement in every feature.

Once I've spent months making supervised fish faces, I have a substantial emotional investment in the fish.

Expectations can influence ratings without anybody being dishonest. That's one reason to separate satisfaction from externally assessed appearance. Another is that the routine itself could provide relaxation or a pleasant sense of attention to oneself.

Enjoying the routine would be a perfectly acceptable benefit. I object when the pleasant ritual is used as a receipt for skin tightening.

A future trial should measure those separately. Appearance, enjoyment and function can all improve or fail independently. Lumping them together conceals which benefit somebody actually received.

Hannah's concern about wrinkles needs that same separation. Moving a muscle more effectively doesn't tell us what happens to the skin folding over it. The forehead and the area around the eyes aren't blank sheets awaiting more strength.

Repeated expression creates dynamic lines. As skin changes with age and sun exposure, some lines become visible even at rest. That makes the concern about repeated contractions plausible. It does not establish that a face-yoga routine accelerates wrinkles.

I need to narrow that... the specific long-term exercise question hasn't been properly answered in the evidence we're discussing. We shouldn't claim either that the routine causes deeper lines or that it prevents them.

The uncertainty is inconveniently located exactly where the anti-wrinkle promise lives.

Also, routines vary. Gentle resisted movement and exaggerated repeated squinting are different exposures. Without defining the movements, intensity and duration, even the question of harm becomes too vague.

I'd be particularly wary of assuming soreness means progress. That attitude migrates from gym culture very easily. A sore jaw isn't a preview of a better jawline.

Jaw pain, headaches or irritation would be reasons to stop provoking the area, rather than evidence that the treatment is working. More force doesn't solve the mismatch between the tissue you're loading and the appearance you want.

Her dad's anatomical objection survives rather well there. The lower face includes the shape of the mandible, the masseter, fat under the chin and the overlying skin. Working the cheeks doesn't selectively remove submental fat.

Enlarging a masseter can also make the lower face look broader. Whether someone likes that is aesthetic preference, not automatic improvement. The claim that facial muscle growth always creates a thinner, sharper face is internally inconsistent.

You cannot promise more muscle and less face indiscriminately.

What do you make of the observation that people sometimes look different after taking up weight training? Does that persuade you about facial exercises at all?

It persuades me that appearance can change during a period when somebody changes their habits. It doesn't isolate the cause. Body-fat changes, weight changes, even the photographs themselves could account for the difference. I'd need a more specific connection before giving the cheek routine credit.

That's the right distinction to make with a visible transformation. It can be entirely genuine while the proposed explanation is wrong. The facial-exercise claim has to earn its own evidence.

There is another awkwardness. The strongest-looking cheek result comes from people selected for some facial volume loss. If you're young and already have full cheeks, more fullness may move you away from the fashionable hollow-cheeked result.

Treatment goals need a starting condition. The trial doesn't establish the same outcome in men, younger adults or people with a different facial structure. Even within its selected population, some people may respond more than others.

Yet the tutorial starts with everybody facing the same camera.

More recent work hasn't resolved that. A trial published in two thousand twenty-five measured muscle tonus, stiffness and elasticity after intensive face yoga. It involved twelve women over eight weeks, again without a control group.

Hm.

Newer measurements, familiar uncertainty.

Instrument measurements are useful, but they don't remove the need for comparison. A measured change in a mechanical property also needs a demonstrated relationship to the appearance people want. We shouldn't assume that a different number means a visibly younger face.

This is where your medical habits are useful, Herman. You want the machine, and then you insist the machine answer an inconveniently specific question.

I've learned not to let a decimal point choose the treatment goal.

Temporarily. You were quite attached to the cheek ultrasound.

Still am. Affection with conditions.

The marketing ecosystem works in the opposite direction. A face-yoga video can show a movement immediately, while the claimed result remains months away. The demonstration feels concrete even when the outcome is untested.

A method shown clearly can borrow credibility from its own clarity. I can see exactly how to push against my cheek. That doesn't mean I can see whether it lifts anything.

An analysis of those videos published last year found loose methods and little connection with classical yoga. The label collects different exercises under a familiar wellness identity. It doesn't specify a standardized treatment.

The word yoga is carrying rather a lot of luggage.

For somebody trying it, that variability matters. The modest trial result belongs to an instructed program. It can't validate every short clip using the same label, particularly clips promising different outcomes.

Nor should the absence of an injection be treated as proof of effectiveness. Natural describes the sales positioning. It doesn't tell me which tissue changed.

Can you imagine a result that would change your view?

A controlled comparison showing a visible benefit that ordinary observers can detect, maintained beyond the supervised enthusiasm. I'd also want to know whether people enjoyed it enough to continue. If the benefit disappears because the daily commitment is intolerable, that belongs in the result.

Photographs need consistent lighting, pose and expression, too. People tend to treat them as self-explanatory evidence.

I agree with that. Expression can change, though, not just the lamps. Corn, you were careful about the photographs earlier. I had mine taken in a boarding house in Bath in nineteen eighty-five. The man travelling through had a cheek-exercise course. His name was Edwin Prowse. He took the first photograph immediately after telling me the course cost forty pounds.

That would affect the expression.

He offered a twenty-week version using resistance against my own hand. The mouthpiece wouldn't fit an anteater's snout. I did the hand version. My cheekbones had never looked better, according to Edwin. He measured both cheeks with calipers borrowed from the breakfast cook. I don't know whether they were calibrated. They normally measured pastry.

That would make small differences hard to interpret.

The cook measured me every morning. Edwin had left by Tuesday. She entered the figures in the margins of the guest ledger and drew a graph beside the breakfast charges. After a fortnight she started charging my left cheek for a single room. It had crossed the line into the next column. I paid until she put it down as a permanent resident.

Breakfast included?

Only mine. I disputed the extra charge. She removed it, which was decent. I still think about Edwin because he said the final photograph had to be taken with exactly the same joke as the first. He never wrote the joke down. Your thirty minutes sounded manageable, Herman, but finding a travelling man who remembers one sentence takes longer. The cook stopped asking me to smile in the end. She took the final photograph without any instructions. She was careful with people who didn't like having their picture taken.

... A controlled trial that keeps expression consistent and follows people long enough to assess wrinkles would move this forward. For now, I'd take the modest cheek-fullness finding seriously, without upgrading it into a facelift. Hannah's dad has the stronger case on the jawline.

Thanks to Hilbert Flumingtop for producing the show.

If you want more of this, try episode ten, How ASR Went From Frustration To ... Whisper Magic; and episode seven, Building Custom ASR Tools. This has been My Weird Prompts, the human-AI collaboration podcast.

If you enjoyed this, leave us a review wherever you listen. It helps other curious people find the show.

See you tomorrow.

Keep your before photograph honest.

This episode was generated with AI assistance. Hosts Herman and Corn are AI personalities. It may contain errors: disclaimer · report an error

What Facial Exercises Actually Change

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#6259: What Facial Exercises Actually Change