Hopefully, during this pandemic isolation period, people find more time for their mental, physical, and beauty routines. This time we focus on targeted muscle movements that have a dermatological effect on human facial features. The main ideas behind the theme of motion dermatology are based on physiotherapy and dermatology knowledge. Instead of buying new cosmetic serum, magic supplement, or visiting a cosmetologist, masseuse, or plastic surgeon, motion dermatology inspires and promotes beauty and health achieved through exercise and targeted movements. Investing just 10 – 15 minutes once or twice a day in your emotional and physical well-being will reward you with obvious results. Such activity could become a healthy substitute for emotional shopping or binge eating addictions. Purposeful facial care requires just a little bit of your time as well as a positive attitude, discipline, persistence, determination, and reliable information on the topic.

Posture determines a facial condition

It is important to emphasize that facial condition is determined by the overall physical/mental state of the body as well as the posture. The correct and harmonious body posture is a framework for youthfulness and beauty. Therefore, to perfect facial features it is very important to correct and balance body posture. The facial area is particularly affected by correct cervical spine curvature, the position of chin and shoulder girdle, and also overall body condition (musculoskeletal system, blood, and lymph circulation, innervation, etc.). Athletes can confirm the medical fact that may not be obvious to everyone – when you train your body, you will see the changes in your face as well.  

According to Spine treatment center physiotherapist Greta Girskė, many people develop forward head posture while sitting long hours in their office chairs. When you develop forward head posture it means that the back muscles that move and support your upper back, shoulders, neck, and head are overloaded. Certain muscles become short, tight, and strained while opposite muscles, neck flexors become weaker. If such muscle imbalance is left uncorrected, the problem only worsens. In addition, head, neck, and shoulder positions affect the jaw condition. Muscles that are responsible for chewing also influence our vestibular system. Medical studies suggest that incorrect jaw position may affect not only the deformation of the face, but it may cause dizziness, vertigo, tinnitus, not to mention wrinkles around the eyes, and nasolabial folds.

Facial muscles tone and elasticity directly depend on blood circulation in the cervical part of the spine. Thus, to preserve the elasticity of your muscles and ligaments, it is important to maintain the normal function of blood vessels, the supply of nutrients to the muscles, and ensure uninterrupted innervation.

Cervical hyperlordosis (exaggerated spinal curvature) may cause shortening of the jawline and softer chin line. To have and maintain youthful and healthy face motion dermatology protocol suggests the following face care routine: stretching of neck extensor and chest muscles, strengthening of neck flexor muscles. After releasing muscle tightness, stiffness in the back part of the neck, and continuing with the targeted exercises, the chin should become firmer, the jawline – more refined, the shape of the face – lucid and toned. ‍

Platysma – facial easel

The platysma is an invisible carcass of our neck and face beauty. It is a wide, flat, sheet-like superficial neck muscle that runs from the upper chest/shoulder area, up through the neck, and attaches to the skin around the mouth and the lower jawbone. The platysma muscle supports and lifts up neck skin, shapes the frontal neckline, lower jawline, lips, and nasolabial area.

The platysma is not connected to any bone structure therefore with aging tends to lose tone and elasticity. It has fewer sebaceous glands than the face and extremely narrow adipose tissue, making this area of the body prone to dryness and wrinkling. Decrease of elastin and collagen in the skin leads to loss of elasticity and easier succumb to gravity which means that the soft tissue starts the sagging process. This muscle is not involved in moving the neck and head, it is activated only when making a special physical effort or during stressful/painful moments. The neglected platysma is the cause of facial features deformation while aging which results in saggy skin of the lower jaw, drooping mouth corners, loss of skin tone of the lower part of the face as well as sagging chin. Therefore, it is important to proactively monitor and strengthen the platysma muscle to maintain a harmonious, graceful neck, shoulder line, youthful facial features for as long as possible.

Without proper care platysma muscle with time begins to split into separate parts and to form transverse folds and wrinkles. No exercises, massages, or cosmetics can reverse such a process and the only solution would be plastic surgery.

Purposeful strengthening exercise for the platysma

Sit or stand facing forward, relax your shoulders, place your lower lip over your upper lip and tilt your head back, thrust your chin upward slightly to feel resistance along your lower jawline and from chin to chest. Breath correctly - breathe in when contracting the muscle, breathe out when relaxing the muscle. The back muscle must remain relaxed.

Your highness – forehead

The forehead is the most representative area of our face. It exposes our age, lifestyle, even health disorders. It is a mirror of our inner world and emotions. It is common knowledge that the forehead folds are formed by facial expressions. However, not everyone knows that forehead wrinkles can be corrected or even prevented by exercising the muscle in the back of our heads - epicranius occipitalis. The facial muscles are connected to the scalp, when you pull your scalp down it raises your eyebrows. To prevent forehead wrinkles it is recommended to take care of the back part of your head, spasms of the neck and shoulders.

The structure of the head tendons should be like an elastic helmet. Stiff and hard scalp forms wrinkles and a line of concern on the forehead, lowers eyebrows, eyelids, causes bags under the eyes. Face care routine should include scalp massage with the fingertips or hairbrush. Massaging the back of the head reduces tensions in the scalp as well as the face and forehead.

Forehead wrinkles are also caused by the tense/stiff muscles of mastication, and a weakened, abnormal jaw position. Muscle of mastication stiffens due to stress and abnormal bite so it is important to relieve that tension. Often jaw becomes tense, weak, and loses its youthful line due to incorrect tongue position. The correct tongue position – against the teeth placed on the lower jaw - should become a habit. Correcting posture and getting rid of psychological tension help to relieve the spasms in the jaw.

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‍Forward head posture correction exercises‍

‍I EXERCISE: stretching of cervical extensor muscle while lying down

If you can't touch your sternum with your chin when assessing your neck movement, it indicates that your cervical extensor muscle is weakened and you must stretch it, instead of strengthening it. Generally, cervical extensors are shortened and tenser than cervical flexors. Thus, it should be stretched while lying down and only later while sitting down.

‍Lie down on your back, slightly bend your knees, put your hands on the back of your head, lock your fingers. Point your chin towards your chest, but keep your neck muscles relaxed, only use your arms to push your head towards your chest. Keep your shoulders on the ground. Hold the position for 20-30 seconds, repeat 4 times. You should feel a slight stretch in the back of your neck, but if you feel the stretch in-between the shoulders, it means your upper back extensor is also shortened. During this exercise also abdominal muscles contract isometrically.

‍II EXERCISE: strengthening of cervical flexor muscles

Lie on your back with your knees bent and feet flat on the floor. Bend your arms 90 degrees and put them on the ground so that your palms are parallel to each other and are facing up. Slightly breath in, point your chin towards your chest, and bend your neck while exhaling. Do 15 repetitions 4 times.

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‍III EXERCISE: stretching of upper and lower parts of the pectoral muscle (bent-arm doorway stretch)

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Assume a split stance in a doorway, put your left leg in the front, bring your arms up to shoulder height and position the palms and inside of the arms on the doorway, press the chest through the open space to feel the stretch in your arms and anterior shoulders, do not tilt your neck back, do not arch your waist, straighten your right knee (you might feel stretch in your right calf). If your start feeling pain in your lumbar area, it means you are doing the exercise incorrectly (most likely you arch the waist too much). Hold the stretch for 20-30 seconds, repeat 4 times.

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‍PLASTIC AND RECONSTRUCTIVE SURGEON – GABRIELĖ LATAKAITĖ-ČIULADĖ COMMENTS ON PLATYSMA MUSCLE THAT DETERMINES THE BEAUTY OF THE FACE AND NECK.

Is the subcutaneous neck/face muscle - platysma in the majority of people weak and loose, or, on the contrary, tense and stiff?

The neck consists of the following extremely important structures - skin, superficial subcutaneous adipose tissue, platysma, deep subcutaneous adipose tissue, glands, deep muscles. Usually, the appearance of the neck is determined not only by genetic predisposition, but also by external factors such as smoking, sun exposure, sudden weight loss, and so on. The connection between the skin and the platysma is also known to be extremely important, as these tissues are closely related. Over time, influenced by the biological processes and external factors, the tonus of platysma decreases, resulting in subcutaneous muscle diastase - separation. This condition is most commonly found in people aged 40-60. According to scientific studies, the volume of the neck muscles in men is about 60 percent larger, and therefore these muscles are stronger than in women. Therefore, we can conclude that their platysma muscle is also stronger and harder.

How can a person self-assess the condition of her/his platysma muscle? Are there any specific assessment tests for that?

If there is an increase in the angle between the lower jaw and the neck (more than 90 degrees), it can signify that the tonus of the platysma muscle might be weaker than the norm. The amount of subcutaneous adipose tissue should also be considered. Platysma muscle tonus can be assessed by tightening these neck muscles - saying the letter Y: if the significant lateral vertical folds are formed, it means there is hypertension in those areas (it can be fixed with the help of botulinum toxin injections). However, if a gap forms in the middle of the neck, then the diastase of the subcutaneous neck muscle may be suspected. It can be corrected surgically.

When does platysma muscle need to be adjusted surgically?

As I mentioned before, hypertension is treated with botulinum toxin injections to reduce the transmission of nerve impulses to the muscle and thus beautify the form of the neck. If there is a diastasis and an increased angle of the neck - lower jaw and decreased tonus, plastic surgery can be performed (the incision of about 4 cm is made in the under-chin wrinkle, the superficial subcutaneous adipose tissue is removed, the detached central platysma parts are stitched up and the deep subcutaneous adipose neck tissue removed) to restores the anatomically correct under-chin. However, such a surgery is performed if there is no significant excess of skin. If there is an excess of skin (usually from the age of 60) then complex treatment is applied: platysma surgery together with skin excess removal and skin tightening surgery.

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