Facial exercises for rejuvenation: A systematic review

Manincor, Emmanuela Oliveira de; Borges, Allya Francisca Marques; Leão, Lidiane Oliveira; Lobo, Fernanda Souza; Silva, Rayane Délcia da; Cavalcanti, Renata Veiga Andersen; Corrêa, Camila de Castro; Araujo, Cristiano Miranda de; Taveira, Karinna Veríssimo Meira

doi:10.1590/1982-0216/20242664824

Emmanuela Oliveira de Manincor

Conceptualization

Data curation

Data analysis

Writing - Original draft

Universidade Federal do Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brasil.

https://orcid.org/0009-0008-1172-0640

Allya Francisca Marques Borges

Conceptualization

Data curation

Data analysis

Project administration

Writing - Original draft

Universidade Federal do Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brasil.

Núcleo de Estudo Avançado em Revisão Sistemática e Meta-Análise - NARSM, Curitiba, Paraná, Brasil.

https://orcid.org/0000-0003-0967-4899

Lidiane Oliveira Leão

Data analysis

Methodology

Writing - Original draft

Universidade Federal do Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brasil.

Núcleo de Estudo Avançado em Revisão Sistemática e Meta-Análise - NARSM, Curitiba, Paraná, Brasil.

https://orcid.org/0009-0007-3965-0851

Fernanda Souza Lobo

Conceptualization

Data curation

Data analysis

Writing - Original draft

Universidade de Brasília - UnB, Brasília, Distrito Federal, Brasil.

https://orcid.org/0000-0002-5516-899X

Rayane Délcia da Silva

Conceptualization

Data curation

Data analysis

Writing - Original draft

Núcleo de Estudo Avançado em Revisão Sistemática e Meta-Análise - NARSM, Curitiba, Paraná, Brasil.

Universidade Tuiuti do Paraná - UTP, Curitiba, Paraná, Brasil.

https://orcid.org/0000-0003-1935-6448

Renata Veiga Andersen Cavalcanti

Conceptualization

Data curation

Data analysis

Project administration

Methodology

Writing - Original draft

Universidade Federal do Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brasil.

https://orcid.org/0000-0002-3953-4881

Camila de Castro Corrêa

Conceptualization

Data curation

Data analysis

Project administration

Methodology

Writing - Original draft

Centro Universitário do Planalto do Distrito Federal - UNIPLAN, Brasília, Distrito Federal, Brasil.

https://orcid.org/0000-0001-5460-3120

Cristiano Miranda de Araujo

Conceptualization

Data curation

Data analysis

Project administration

Methodology

Writing - Original draft

Núcleo de Estudo Avançado em Revisão Sistemática e Meta-Análise - NARSM, Curitiba, Paraná, Brasil.

Universidade Tuiuti do Paraná - UTP, Curitiba, Paraná, Brasil.

https://orcid.org/0000-0003-1325-4248

Karinna Veríssimo Meira Taveira

Conceptualization

Data curation

Data analysis

Project administration

Methodology

Supervision

Validation

Visualization

Writing - Original draft

Writing - Review and editing

Universidade Federal do Rio Grande do Norte - UFRN, Natal, Rio Grande do Norte, Brasil.

Núcleo de Estudo Avançado em Revisão Sistemática e Meta-Análise - NARSM, Curitiba, Paraná, Brasil.

https://orcid.org/0000-0001-6978-4083

Corresponding author: Karinna Veríssimo Meira Taveira, Federal University of Rio Grande do Norte - UFRN, Department of Morphology - Center of Biosciences, BR 101- Lagoa Nova, Zip code: 59072-970 - Natal, Rio Grande dop Norte, Brazil, E-mail: karinna.taveira@ufrn.br

Conflict of interests: Nonexistent

Figures (2)
Tables (3)

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Figure 1
PRISMA 2020 flow diagram for new systemac reviews which included searches of databases, registers and other sources

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Figure 2
Assessment of the risk of bias using the Joana Briggs Institute tool for case-control (A) and case series (B) studies

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Table 1
Characteristics of the studies included in the review (n = 7)

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Database Search (April 25, 2023, updated July 18, 2024) Cochrane ("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") in Title Abstract Keyword AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital") in Title Abstract Keyword Embase ('myofunctional therapy'/exp OR 'myofunctional therapy' OR 'myofunctional therapies' OR 'orofacial myotherapy' OR 'oral myotherapy' OR 'orofacial myology' OR 'exercise therapy'/exp OR 'exercise therapy' OR 'remedial exercise' OR 'remedial exercises' OR 'exercise therapies' OR 'rehabilitation exercise' OR 'rehabilitation exercises' OR 'facial massage' OR 'facial exercises' OR 'facial exercise' OR 'face yoga' OR 'orofacial exercises') AND ('facial expression' OR 'facial expressions' OR 'face expression' OR 'face expressions' OR 'esthetics' OR 'aesthetics' OR 'skin wrinkling' OR 'wrinkles' OR 'skin rejuvenation' OR 'facial rejuvenation' OR 'facial aging' OR 'esthetic logopedics' OR 'glabellar' OR 'glabellar lines' OR 'glabellar wrinkles' OR 'tear trough' OR 'infraorbital') LILACS ("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises" OR "Terapia Miofuncional" OR "Miologia Orofacial" OR "Terapia por Exercício" OR "Exercício de Reabilitação" OR "Exercício Terapêutico" OR "Terapia por Ejercicio") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital" OR "Expressão Facial" OR "Expressão da Face" OR "Expressão do Rosto" OR "Estética" OR "Envelhecimento da Pele" OR "Enrugamento da Pele" OR "Envelhecimento Solar da Pele" OR "Fotoenvelhecimento da Pele" OR "Expresión Facial" OR "Envejecimiento de la Piel") LIVIVO ("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital") PubMed/ Medline ("Myofunctional Therapy"[Mesh] OR "Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy"[Mesh] OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression"[Mesh] OR "Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics"[Mesh] OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital") Scopus (TITLE-ABS-KEY (("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises" )) AND TITLE-ABS-KEY (( "Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital" ))) Web of Science ("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital") Google Scholar "Myofunctional Therapy" OR "facial exercise” AND "Facial Expression" OR "Esthetics" OR "Skin Wrinkling" filetype:PDF ProQuest ("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital")

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Author, Year Reason for exclusion* Franco et al., 20021 2 Hwang et al., 20182 2 Khanna et al., 20023 2 Matos et al., 20104 2 Silva et al., 20105 2 *1. Studies with children and older adults; 2. Studies involving invasive procedures such as chemical peels, botulinum toxin injections, dermal fillers, laser treatments, facelifts, eyebrow and eyelid surgery, and acupuncture techniques, and combined treatments or studies using facial muscle training devices; 3. Studies without a comparator group, not reporting facial rejuvenation, or with patient self-report 4. Reviews, letters, books, conference abstracts, case reports, opinion pieces, technical articles, guidelines, reviews, or any other descriptive study. Excluded References: 1. Franco MZ, Scattone L. Fonoaudiologia e dermatologia: um trabalho conjunto e pioneiro na suavização das rugas de expressão facial. Fono Atual. 2002;5(22):60-6. LILACS | ID: lil-418054. 2. Hwang UJ, Kwon OY, Jung SH, Ahn SH, Gwak GT. Effect of a facial muscle exercise device on facial rejuvenation. Aesthet Surg J. 2018;38(5):463-76. https://doi.org/10.1093/asj/sjx238 PMID: 29365050. 3. Khanna N, Gupta SD. Rejuvenating facial massage - A bane or boon? Int J Dermatol. 2002;41(7):407-10. https://doi.org/10.1046/j.1365-4362.2002.01511.x PMID: 12121555. 4. Matos KDF, Loreto PM, Nery TdCS, Souza VdAM, Souza CB. Análise da eficácia de um trabalho fonoaudiológico com enfoque estético. Revista Fragmentos de Cultura - Revista Interdisciplinar de Ciências Humanas. 2010;20(3):413-32. https://doi.org/10.18224/frag.v20i3.1457 5. Silva NL, Vieira VS, Motta AR. Eficácia de duas técnicas fonoaudiológicas da estética facial no músculo orbicular dos olhos: estudo piloto. Rev. CEFAC. 2010;12(4):571-8. https://doi.org/10.1590/S1516-18462010005000091

Author, Year, Country	Characteristics of participants		Training program			Aesthetic myofunctional intervention	Assessment of results	Results	Type of study
Author, Year, Country	Sample	Age	Number of sessions	Frequency of sessions	Type of exercise	Aesthetic myofunctional intervention	Assessment of results	Results	Type of study
Arizola HGA et al., 2012, Brazil⁶	11 F: 11 M: 0	40-50 years	10	Twice a week for 5 weeks	Not reported	-Facial muscle release management -Facial muscle stretching -Exercise for aesthetic speech treatment -Counter-resistance exercise	Clinical observation with photography and muscle palpation. A questionnaire was conducted on the changes perceived by patients and third parties. Satisfaction before and after speech-language-hearing therapy was assessed using a 100 mm visual analogue scale.	Speech-language-hearing treatment provided facial changes perceived by clients, third parties, and specialists. After speech-language-hearing aesthetic treatment, 8 (72.7%) reported a good feeling and 2 (27.3%) perceived a more relaxed face.	Case-control
De Vos MC et al., 2013, Belgium¹⁸	18 F: 18 M: 0	47 years in the experimental group and 46 in the control group	49	Daily for 7 weeks	4 isometric exercises	An exercise to reduce horizontal wrinkles on the forehead (frontal muscle); an exercise to reduce vertical wrinkles above the upper lip (orbicularis oris); an exercise to reduce the nasolabial fold (orbicularis oris and zygomaticus minor muscles); and an exercise to reduce double chin and define the jaw better (masseter, sternocleidomastoid and mylohyoid muscles)	Judges evaluated the participants' images. There were 10 lay people (5 men and 5 women), aged 30 to 40 years.	The panel chose the image of the upper lip after therapy most often as the younger-looking one in the experimental group.	Case-control
Frazão Y et al., 2012, Brazil¹	3 F: 3 M: 0	41, 48, and 49 years	12	Once a week + maintenance at home	Isotonic and isometric exercises and massages; adjustment of vocal intonation and amplitude of articulatory movements; drainage; reorganization of facial muscle dynamics	Not reported	Initial interview, filming chewing and swallowing functions; filming facial expressions in spontaneous speech and performing specific movements; photographic record	Reduction of exaggerated facial expressions in communication (n=3), the eyes were more symmetrical and there was a reduction in bags in the lower eyelid (n=1), a reduction in malar wrinkles, improved chewing and swallowing, and improved facial contour (n=1) The effectiveness of speech-language-hearing intervention in facial aesthetics has been proven.	Case series
Nishimura H et al., 2017, Japan¹³	20 F: 20 M: 0	30-54 years	Not reported	Not reported	Facial massage	Facial massage	The nasolabial folds, upper, lower, and lateral cheeks, and lower eyelids were analyzed based on photographs.	Facial massage caused morphological changes in several facial sites; soft tissues were moved upwards around the jaw; the thickness of the adipose tissue in the nasal ala increased after massage. The shapes of the facial expression muscles were also changed after massage. Apparently, massage did not affect the shape of the nasolabial folds but caused morphological changes in the cheek, changing the appearance of the nasolabial folds.	Case series
Okuda I et al., 2022, Japan¹⁷	5 F: 3 M: 2	29-37 years	14	Twice a day for 2 weeks	Massage	Massage	CT scan (analyzed by two radiologists)	The malar mound thinned and shifted cranially and horizontally. The SMAS height (the greatest vertical distance from the SMAS) increased. The rate of change in cheek thickness was significantly correlated with SMAS height. These changes were attributed to the lifting and tensor effects of facial massage. SMAS: superficial musculoaponeurotic system	Case series
Paes C et al., 2007, Brazil¹²	10 Sex not reported	33-63 years (mean: 43.5)	16	1 meeting a week	Guidelines for facial care, isotonic, isometric, and isokinetic exercises, massages, facial manipulations, and stomatognathic functional balance, including masticatory training	Not reported	Medical history survey, assessment, photographic record, and a performance protocol	The projection measures of the nasolabial fold to the tragus on both sides decreased significantly. Positive results were found in the cheek and mouth areas. All patients noticed some change in their faces after speech-language-hearing treatment. Other people noticed some change in the faces of 7 patients but not in 3 - the ones who performed the exercises least frequently. Smoothness and relaxation occur after performing the isometric exercises Regarding wrinkles, 8 patients observed that they became smoother, and 4 patients reported having noticed greater firmness in facial tone. Sensation of lightness (n=6) and rest and rejuvenation (n=4)	Case series
Takacs AP et al., 2002, Brazil¹⁴	8 F: 6 M: 2	31-66 years (mean: 48.4)*	90	6 exercises once a day for 3 months	Six isometric exercises	Raising the eyebrows by wrinkling the forehead for 7 seconds; bringing the eyebrows together for 7 seconds; closing the eyes tightly for 7 seconds; protruding the lips for 7 seconds; lateralizing the corners of the mouth by opening the lip line for 7 seconds; contracting the right and left cheeks with resistance for 7 seconds.	Questionnaire. 11 individuals were given pre- and post-therapy photographs of each patient and were asked to specify the photographs in which the patient appeared younger and older	The exercises helped reduce wrinkles, expression lines, and facial sagging in all individuals, with varying degrees and locations of improvement. There was a reduction in the nasolabial fold (n=7); reduction in dark circles (n=5); reduction in sagging cheeks (n=4); reduction in transverse wrinkles on the forehead (n=3); reduction in wrinkles around the eyes (n=3); a rested, relaxed, and serene face (n=3); more defined lips, and a change in posture (n=1). Patients noticed firmer mouths and foreheads, thicker lips, a more relaxed expression, a rested face, bright and fresh skin, and lifted lines on the lips, eyes, eyebrows, and cheeks.	Case series

Database	Search (April 25, 2023, updated July 18, 2024)
Cochrane	("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") in Title Abstract Keyword AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital") in Title Abstract Keyword
Embase	('myofunctional therapy'/exp OR 'myofunctional therapy' OR 'myofunctional therapies' OR 'orofacial myotherapy' OR 'oral myotherapy' OR 'orofacial myology' OR 'exercise therapy'/exp OR 'exercise therapy' OR 'remedial exercise' OR 'remedial exercises' OR 'exercise therapies' OR 'rehabilitation exercise' OR 'rehabilitation exercises' OR 'facial massage' OR 'facial exercises' OR 'facial exercise' OR 'face yoga' OR 'orofacial exercises') AND ('facial expression' OR 'facial expressions' OR 'face expression' OR 'face expressions' OR 'esthetics' OR 'aesthetics' OR 'skin wrinkling' OR 'wrinkles' OR 'skin rejuvenation' OR 'facial rejuvenation' OR 'facial aging' OR 'esthetic logopedics' OR 'glabellar' OR 'glabellar lines' OR 'glabellar wrinkles' OR 'tear trough' OR 'infraorbital')
LILACS	("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises" OR "Terapia Miofuncional" OR "Miologia Orofacial" OR "Terapia por Exercício" OR "Exercício de Reabilitação" OR "Exercício Terapêutico" OR "Terapia por Ejercicio") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital" OR "Expressão Facial" OR "Expressão da Face" OR "Expressão do Rosto" OR "Estética" OR "Envelhecimento da Pele" OR "Enrugamento da Pele" OR "Envelhecimento Solar da Pele" OR "Fotoenvelhecimento da Pele" OR "Expresión Facial" OR "Envejecimiento de la Piel")
LIVIVO	("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital")
PubMed/ Medline	("Myofunctional Therapy"[Mesh] OR "Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy"[Mesh] OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression"[Mesh] OR "Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics"[Mesh] OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital")
Scopus	(TITLE-ABS-KEY (("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises" )) AND TITLE-ABS-KEY (( "Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital" )))
Web of Science	("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital")
Google Scholar	"Myofunctional Therapy" OR "facial exercise” AND "Facial Expression" OR "Esthetics" OR "Skin Wrinkling" filetype:PDF
ProQuest	("Myofunctional Therapy" OR "Myofunctional Therapies" OR "Orofacial Myotherapy" OR "Oral Myotherapy" OR "Orofacial Myology" OR "Exercise Therapy" OR "Remedial Exercise" OR "Remedial Exercises" OR "Exercise Therapies" OR "Rehabilitation Exercise" OR "Rehabilitation Exercises" OR "facial massage" OR "facial exercises" OR "facial exercise" OR "face yoga" OR "orofacial exercises") AND ("Facial Expression" OR "Facial Expressions" OR "Face Expression" OR "Face Expressions" OR "Esthetics" OR "Aesthetics" OR "Skin Wrinkling" OR "Wrinkles" OR "Skin rejuvenation" OR "Facial rejuvenation" OR "facial aging" OR "esthetic logopedics" OR "glabellar" OR "glabellar lines" OR "glabellar wrinkles" OR "crow’s feet lines" OR "crow’s feet" OR "crow’s feet wrinkles" OR "tear trough" OR "infraorbital")

Author, Year	Reason for exclusion*
Franco et al., 2002¹	2
Hwang et al., 2018²	2
Khanna et al., 2002³	2
Matos et al., 2010⁴	2
Silva et al., 2010⁵	2

[TFN1] Captions: SMAS: superficial musculoaponeurotic system; 3D-CT: tridimensional computed tomography.

[TFN2] *calculated by the authors

Facial exercises for rejuvenation: A systematic review

ABSTRACT