Efficacy of Conservative Techniques for Mechanical Facial Rejuvenation: A Systematic Review

A boom in the online popularity of conservative mechanical facial rejuvenation techniques, such as facial exercises, myofunctional therapy, and manual massages, has proliferated as noninvasive alternatives to aesthetic procedures. Despite this, scientific evidence regarding their efficacy and safety remains unclear. The aim of this study is to determine the efficacy of conservative mechanical facial exercises and related paraphernalia or adjuncts in achieving optimal facial aesthetic outcomes. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered on PROSPERO. Databases, including PubMed/MEDLINE, Embase, Web of Science, SciELO, AMED, PROQUEST, Google Scholar, CENTRAL, OVID, and SCOPUS, were searched for studies evaluating mechanical facial exercises in adults. Studies reporting objective and validated subjective facial aesthetic outcomes were included. Risk of bias was assessed using the Cochrane and JBI tools. Twelve studies comprising 321 women aged 30 to 70 met the inclusion criteria. Interventions included facial exercises (n = 6), myofunctional therapy (n = 4), and manual massage (n = 2). Reported improvements were confined to localized regions, such as the cheeks, jawline, and periorbital areas. Tools used included Cutometers (Courage + Khazaka electronic GmbH, Cologne, Germany), ultrasound, expert/self-assessments, and quality-of-life metrics. No adverse events were reported; however, methodological heterogeneity, small sample sizes, and a lack of male participants limited generalizability. Although some region-specific aesthetic improvements have been observed, current evidence remains insufficient to establish the efficacy of these mechanical facial rejuvenation techniques with confidence. The literature lacks standardized protocols that account for hormonal status and facial anatomy variability. Larger, randomized controlled trials with diverse populations are necessary to improve the current body of evidence. Level of Evidence: 3 (Therapeutic).