By now, you’ve probably heard all about BTL’s Emsculpt, the body treatment that combines high-intensity focused electromagnetic (HIFEM) technology with radiofrequency to simultaneously burn fat while toning muscles. How it works makes total sense—it’s an über-powerful workout with fat-melting properties. But when learning about Emface, BTL’s newest professional treatment billed as Emsculpt for face muscles, we were a bit confused. Does it make sense to treat your face in the same way you’d treat your body? Wouldn’t intentional muscle contractions in the face create wrinkles? And couldn’t it affect the appearance of other facial procedures? Here, we break down this innovative technology to get a better understanding of how it works, who it’s for, and if Emface is worthy of the hype.
What is Emface, and how does it work?
Like the OG Emsculpt, Emface from BTL Aesthetics is a treatment that uses two forms of energy. One is radiofrequency, which we know triggers collagen and elastin production to firm up skin and smooth out lines and wrinkles. The other is high-intensity focused electrical stimulation (HIFES). HIFES differs in that the electromagnetic stimulation is not as intense. “HIFEM creates an electromagnetic field, which causes 100% depolarization in the entire muscle—which is what’s required for big body muscles,” says Dr. Yael Halaas, a board-certified plastic surgeon in New York City and a lead investigator of the BTL Emface machine throughout its five-year development. This depolarization is what causes those profound and rapid-fire muscle contractions. However, this level of pump is not desirable for the face. “The face muscles are millimeters thin—we have dozens of them, and we want to be extremely specific in which facial muscles we target.”
During each 20-minute session of the Emface procedure, you’ll be targeting four different muscles. Three of these—the zygomaticus major, zygomaticus minor, and risorius, all of which help you smile—are in the cheeks, and the fourth is the frontalis, or forehead muscle (the same one that gets injected with Botox when you’re trying to combat horizontal lines). The HIFES causes those muscles to contract, which results in a peculiar sensation (Jessica Simpson said it tickled and gave her “chill bumps”), funny facial expressions, and increased strength.
Facial treatments to build muscle may sound peculiar, but consider facial yoga. “[Facial] yoga helps just like exercise helps the body,” opines Dr. Halaas. “We know from anatomical and electrophysiologic studies that there’s a decrease in tone during the aging process. We also know that as we age, the midface and forehead sag and lose volume.” The premise of Emface is that it works those facial muscles in a more intense and efficient way than we could ever do ourselves, restoring the muscle tone that’s lost over time and having a lifting effect that can pull a sagging face back up.
Emface is also said to support the SMAS, or superficial musculoaponeurotic system. “It’s a fibrous sheath, like a piece of fascia without muscle, that you can yank on,” explains Dr. Gerald Imber, a board-certified plastic surgeon in New York City. “When we tighten up the lower portion of the face in a facelift, we resect a portion of the SMAS and suture it up tighter.” This tissue begins at the cheekbone, stretches past the corners of the mouth, then attaches at the jawline; when it’s pulled up, so is the rest of the face. Dr. Imber notes that because there is no muscle to tighten within the SMAS, no amount of electrical stimulation will firm it up, but the radiofrequency of Emface can promote new elastin production within it, potentially promoting skin tightening. Dr. Halaas adds that the strengthening of those facial muscles can also help pull it up and sculpt the area.
To achieve the optimal results, you’ll book at least four 20-minute treatments, spaced one week apart, with subsequent maintenance appointments as needed. Not only is it needle-free, but there’s minimal downtime involved (think slight flushing of the skin). Your provider will be able to make a treatment plan that’s tailored to your unique goals.
Do the facial contractions caused by Emface cause wrinkles?
“A crinkle can lead to a wrinkle,” as the saying goes, and making the same facial movements for years on end can create lasting folds in the skin. “I’ve always been a firm believer that facial muscle exercise of any kind is a wrinkle workout,” says Dr. Imber. “Every time you smile and squint, you’re using the muscles, and you’re getting a smile line, crow’s-feet.” He adds that if you’re having the frontalis contract more in order to thicken it, you have to be making wrinkles.
According to Dr. Halaas though, the benefits of Emface include improving skin and reducing fine lines and wrinkles at the same time. “We’re able to engage these muscles in a way that is much more efficient and without really wrinkling the skin,” she explains. Clinical studies of human histology provided by BTL show that with Emface treatment, collagen improved by 26% and elastin levels increased by 129%.
[It is worth noting that I, the writer, am currently in the process of trying this treatment. I was treated about two months ago with Botox in the forehead and therefore am unable to fully discern any wrinkling that could be created by the muscle contractions of Emface. (The applicators also cover the majority of our frontalis.) “If you are using Botox in that area and then you are using the frontalis simulation, you might build up the thickness of the frontalis without having new horizontal wrinkles because you’re using Botox as well,” suggests Dr. Imber. However, I have observed an involuntary scrunching of the nose during treatment, an area that is not addressed by Emface, though can be treated with Botox.
Related: Emface Before and After: Is It Worth It? My Honest Review and Results
Can you get Emface if you have Botox or filler in your face?
Just like you can’t go get filler and then get a facial, you can’t be treated with injectables and then immediately sit for an Emface treatment. Wait until you’ve fully recovered and any bruising has subsided; a waiting period of at least two weeks post-injection is ideal. Otherwise, Dr. Halaas highly encourages pairing this procedure with Botox and fillers. “If you think about it, it’s like cosmetic physical therapy—it’s enhancing your baseline and preventing you from getting to a worsened state,” she says.
Currently, studies are being performed on how Emface affects the efficacy of your injectables. “I can tell you from my experience thus far, having treated dozens of patients, we did not see any metabolization of Botox or filler at an abnormal rate,” says Dr. Halaas. Conceivably, if your goal is to reduce your reliance on these treatments, Emface could help do so by smoothing forehead lines and adding volume to the cheeks (but you’re out of luck if your filler goal is fuller lips).
Is Emface a viable alternative to a facelift?
You know the answer, right? Yes, there are some pretty impressive before-and-afters of Emface on the brand’s website. And if you’re seeing early to moderate signs of aging, you may be able to stave off surgery with Emface. But generally speaking, noninvasive treatments can’t deliver the same results of plastic surgery. Though, say, Emsculpt Neo can help repair and strengthen ab muscles, it’s no substitute for a tummy tuck; nor is Emface a substitute for a facelift. “Radiofrequency works great, that’s been proven,” says Dr. Imber, who uses radiofrequency treatments like RF microneedling and TruSculpt ID at his practice. “[Otherwise,] don’t start to reinvent the wheel.”
However, if you’ve already gotten a facelift, this may be just the treatment you’ve been looking for in order to maintain your results. “I have a group of patients now who we’re studying using ultrasound evaluation,” says Dr. Halaas. “These were patients who had facelifts a year or so ago and had remarkable results—I think that this is going to be a fantastic way for patients to maintain their post facelift results many years later.”
