A New Tool to Treat Facial Aging
Combating the signs of aging includes improving the appearance of the skin, replacing volume loss that occurs with age, and reducing laxity, typically through surgery. Emface, released in 2023, is a first in class device that strengthens the muscles that lift the upper face and forehead area while simultaneously improving the skin texture and underlying connective tissue in just 4 short treatments with no needles, surgery, or downtime.
“Long time patient so obviously I don’t have a problem with plastic surgery. What I don’t have right now is downtime. Emface allows me to look great while not worrying about work.”
-Actual Patient
The Technology
High Intensity Facial Electrical Stimulation (HIFES) combines supra-maximal muscle contractions with Radio frequency (RF) provides a synergistic effect to improve muscle strength and resting tone while simultaneously increasing collagen, elastin, and connective tissue remodeling. One would think that stronger muscles mean deeper wrinkles, but the improved resting tone essentially shortens the muscle length, so they maintain facial structures in a higher position without the need to contract.
Candidates for Emface
We all have a mindset about whether or how much we want to intervene in the aging process. It may be based on the philosophy of aging as gracefully as possible, avoiding toxins or injectables or the risks involved, or the fear of looking overdone. Emface may provide room for improvement without compromising core beliefs.
Another philosophy is that looking and feeling our best brings joy and confidence. (Spoiler alert that Dr Folk is writing this, and I fall into this category!) Emface can enhance and maintain what is already being done including skin treatment, injectables, and even surgery.
Who is not a Candidate for Emface
The list of contraindications is very long, in part because this is a new device and a very conservative approach to patient selection is important to maximize results and also avoid complications. Pacemakers, implanted medical devices, cardiac or brain stents, and pregnancy are a hard no. Metal in the treatment area including the head, neck, shoulder, and chest are also a contraindication. This list may change as practitioners are learning how to safely push the envelope and including more patients.
Loss of sensation in the treatment area can effect the patient’s ability to provide feedback if the treatment is getting too hot. A variety of medical conditions may also impact results, and these can all be discussed with your practitioner.
People do need to understand that noninvasive treatments provide more subtle results and this is a great adjunct but not a replacement for those seeking more dramatic results.
Your Treatment
The best description is that it feels very strange, probably unlike anything you have ever experienced before. While not painful, there is a lot of prickling and twitching. Patients are often laughing because of how unique the sensation fells. If anything does get painful, your provider can adjust settings and you are holding a button that can instantly stop the treatment.
Remove all jewelry and piercings prior to your appointment. Your skin will be cleaned with alcohol so that the applicator patches applied to the forehead and cheeks can make good contact. Immediately after your procedure your face will be very pink and rosy, and this may last from 2-24 hrs. It is fine to apply makeup following the procedure if that makes you uncomfortable.
Four treatments are typically spaced 5-10 days apart, and maintenance treatments are expected every 3-6 months depending on a patient’s results and preferences. Timing of other treatments like neurotoxins, fillers, and surgery are also important. It is best to wait 5 days from your neurotoxin, and 3 weeks from your last filler injection. Emface after facial surgery typically would start after 6 months, but this will be determined by your practitioner.
Treatment packages start at $4,000
Frequently Asked Questions
A combination of high intensity focused electromagnetic stimulation (HIFES) which stimulates supraphysiologic muscle contraction combined with radiofrequency (RF) that heats tissue to improve both skin and the underlying tissue is delivered to the cheeks and forehead. These improve resting tone to those muscles that truly lift the face and collagen, elastin, heat shock proteins, and more are stimulated.
Long term studies are still being done but maintenance treatments around every 6 months are currently recommended.
- People who are averse to injections or surgery now have an option. We will still want to maximize skin care, but this will allow people to steer clear of those options for which they have already drawn a line in the sand.
- Injection patients who want to enhance what they are already doing. Botox and fillers will still be powerful adjuncts and current recommendations are to space treatment from 1-3 months after injecting dermal fillers. When it comes to Botox, it can still be used to weaken those muscles that pull down like between your eyebrows.
- Surgery patients! Whether you are waiting for your surgery (I typically discourage more fillers if we will be adding natural fat volume at surgery) or want to enhance your results this is a great option. Will Emface replace facelifts? Not a chance (phew, my day job is safe!). It will however help to add more vertical lift which compliments what we can achieve in surgery and also help to maintain and refresh results.
The list is long when it comes to warnings and contraindications, and that is understandable for safety. HIFEM and RF don’t play well with implanted devices or metal near the treatment field so definite contraindications to Emface include pacemakers, vascular and cardiac stents, implanted plates, screws, and wires, and shoulder replacements. Dental implants may also be problematic. Providers have included many patients with more relative contraindications so we will review your medical history with you to be sure you are a safe and appropriate candidate prior to treatment.