Facial Electrical Muscle Stimulation for Soft-tissue Lifting and Symmetry Enhancement

Background: Facial neuromuscular electrical stimulation (NMES) has been used to support facial muscle recruitment in functional settings; however, evidence for aesthetic applications remains limited. This exploratory case series descriptively documents soft-tissue appearance changes and treatment tolerance following a standardized anatomical treatment approach with individualized stimulation settings targeting the lip elevator complex and orbicularis oculi. Methods: Seven adults (5 women, 2 men; age range 24-39 y) underwent 10 NMES sessions at 1-2 week intervals using a commercially available device (EVE Titan). Bilateral periocular and perioral stimulation was delivered for approximately 20 minutes per side. Standardized frontal and oblique photographs were obtained before treatment and approximately 1 month after the final session using the Janus Pro imaging system. Results: All participants completed the treatment series without interruption and reported no adverse events. Across the 6 participants seeking tone/symmetry enhancement, posttreatment photographs demonstrated subtle qualitative trends, including commissural elevation and improved perioral/periocular tone under standardized imaging. In the participant with functional smile asymmetry, posttreatment photographs suggested improved commissural alignment during smiling. Conclusions: In this small, descriptive case series, targeted facial NMES was feasible and well tolerated, with qualitatively observable photographic changes in soft-tissue appearance and symmetry.