Objective Analysis of the Impact of Facial Neuromuscular Electrical Stimulation on Facial Muscle Morphology

Abstract Background Neuromuscular electrical stimulation (NMES) has gained popularity as a noninvasive approach for facial rejuvenation. Although NMES is known to increase muscle mass, its effects on facial muscle morphology and the relationship between muscle changes and the overlying facial contour have not been elucidated. Objectives To evaluate the effects of facial NMES on muscle mass and facial contours using 3-dimensional computed tomography (CT). Methods Fifteen healthy women were enrolled in this prospective split-face trial. One participant was excluded because of noncompliance, and data from 14 participants were analyzed. The NMES was applied to the left infraorbital and temple areas using a periorbital-specific flexible thin-film electrode device, with the right side serving as the control. Computed tomography examinations were conducted at baseline and after 8 weeks of NMES application. The thicknesses of the orbicularis oculi muscle (OOM) and temporal muscle, and the length of orbital fat herniation and temporal contours were quantitatively assessed. Results On the NMES-applied side, OOM thickness significantly increased and the length of fat herniation decreased (P < .001). Furthermore, temporal muscle thickness increased and the temple contour improved significantly on the NMES-applied side compared with the control side (P < .001). Strong negative correlations were observed between muscle thickness and the corresponding morphological changes (OOM vs length of fat herniation, r = −0.73; temporal muscle vs temple contour, r = −0.71). Conclusions In this pilot study, facial NMES enhanced muscle mass and ameliorated age-related morphological changes, suggesting its potential as a noninvasive strategy for facial rejuvenation. Level of Evidence: 3 (Therapeutic)