When we think about facial aging, we tend to think about what we can see: fine lines, wrinkles, sagging skin, and changing contours. Underneath the skin, however, another important part of the aging process is taking place. Your facial muscles and the connective tissues surrounding them help create the shape, movement, and support of your face. EMFACE at RefinedMD takes these deeper structures into account with a noninvasive treatment designed to address both facial muscle and skin.
That approach makes EMFACE different from treatments focused primarily on the skin’s surface. Using synchronized radiofrequency and High-Intensity Facial Electrical Stimulation, or HIFES, the technology targets multiple layers of facial tissue during the same treatment. The result is a fascinating intersection of anatomy and aesthetics, and recent research is giving us an increasingly detailed look at what happens beneath the surface.
Your Face Is an Intricate Muscular System
The face contains approximately 20 flat skeletal muscles specifically responsible for facial expression, along with additional muscles responsible for functions such as chewing. Unlike many skeletal muscles elsewhere in the body, facial-expression muscles frequently insert into the skin rather than simply connecting bone to bone. That arrangement allows relatively small muscular movements to raise your eyebrows, smile, purse your lips, wrinkle your nose, and produce the countless expressions you make every day.
Those muscles also contribute to facial shape and support. Aging occurs across multiple anatomical layers, including bone, fat, connective tissue, muscle, and skin. Changes in muscle quality and the connective tissue framework can therefore influence how the overlying face looks. This broader understanding of facial aging is one reason researchers have become interested in treatments that go deeper than the skin alone.
Think of EMFACE as a Workout for Your Face
EMFACE uses HIFES energy to produce contractions in selected facial muscles, including muscles responsible for elevating the cheeks and brows. During treatment, applicators are placed over strategic areas of the forehead and cheeks. Electrical stimulation activates the targeted muscles repeatedly while synchronized radiofrequency delivers controlled heat to the surrounding tissues.
A 2025 prospective study offers an interesting look at what this process may accomplish. Researchers studying 37 patients found increased thickness of the zygomaticus major, one of the muscles involved in smiling and elevating the cheek. Electromyography measurements also showed a 39.3 percent increase in signal strength, indicating improved muscle function. These findings help demonstrate why muscle deserves a place in the conversation about nonsurgical facial rejuvenation.
Radiofrequency Works on a Different Level
While HIFES is stimulating facial muscles, synchronized radiofrequency addresses the skin and connective tissues. Controlled heating is used to encourage remodeling within collagen and elastin structures, two components essential to skin firmness and elasticity. The two technologies therefore approach facial aging from different directions during a single session.
Research has also examined these changes at the tissue level. In one histological study, investigators took skin biopsies before and after a series of four treatments combining radiofrequency with facial muscle stimulation. They observed statistically significant increases in areas occupied by collagen and elastin during follow-up. The study was small, but the biopsy findings provide an intriguing biological explanation for improvements researchers have observed in skin appearance.
What Recent Research Is Showing
EMFACE research has expanded considerably. A 2025 study of upper-face treatment followed 37 patients after four weekly sessions and used three-dimensional imaging, electromyography, and high-resolution ultrasound. Researchers reported improvements in forehead and crow’s-feet wrinkles as well as measurable changes in eyebrow position that remained evident at the 24-week assessment.
Another 2025 study followed patients with mild to moderate facial laxity for six months after four treatments. Researchers found sustained improvements in forehead and cheek lifting and skin firmness, with no serious adverse events reported. A separate 2025 retrospective study using three-dimensional imaging found changes in facial volume distribution after treatment, including increased zygomatic volume in the cheek region and decreased volume around the mandibular region.
Twenty Minutes With No Surgical Downtime
For all of the complicated science occurring beneath the applicators, the patient experience is remarkably straightforward. A typical EMFACE treatment takes approximately 20 minutes. You will feel muscle contractions and warmth as the two forms of energy work simultaneously, but the procedure does not require needles, incisions, or anesthesia.
A standard treatment series commonly consists of four sessions spaced approximately one week apart. Because the treatment is noninvasive, there is no traditional surgical recovery period, making it relatively easy to incorporate appointments into a normal schedule. Improvements may continue developing after the series is completed as the tissues respond to treatment, so the process is more gradual than walking out with an instantly altered face.
Facial Rejuvenation Is More Than Skin Deep
Modern aesthetics increasingly recognizes the face as an interconnected anatomical system. Skin matters, but so do fat distribution, connective tissue, bone structure, and the muscles responsible for supporting and moving the face. EMFACE is particularly interesting because it allows providers to address the skin and selected facial muscles together without adding volume or requiring surgery.
That does not make EMFACE a replacement for a facelift, filler, neuromodulators, or other treatments. Each addresses different aspects of facial aging, and the best choice depends on your anatomy and goals. If you are interested in a noninvasive approach that looks beneath the surface, schedule a consultation at RefinedMD to learn whether EMFACE could complement your personalized facial rejuvenation plan.