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emface art of skin md san diego

EMFACE Enhanced No-Downtime Facial Muscle Toning & Skin Tightening and Lifting

Build Facial Muscle & Tighten and Lift Facial Skin Without Surgery in the San Diego Area

Art of Skin MD is the FIRST practice in San Diego to provide EMFACE.  EMFACE combines HIFES (High Intensity Focused Electrical Stimulation) and RF energy to tone cheek and forehead muscles to improve brow position and jawline definition.  Dr. Melanie Palm is one of a few elite group of physicians nationwide to unveil this non-invasive, non-surgical, no pain approach to nonsurgical facial tightening and skin rejuvenation.  Dr. Palm serves as a clinical investigator, advisory board member, speaker and consultant for BTL, the company that makes EMFACE.

What is EMFACE?
EMFACE is a state-of-the-art radiofrequency and electrostimulation platform. It is FDA-cleared for the purpose of elevating tissue temperature for selected medical conditions. It is a no downtime, pain-free, nonsurgical means of building muscle tone to specific cheek and forehead muscles through HIFES and improving skin quality through RF.

Like other muscles in our body, facial muscles thin and lose volume with age.  Treating atrophic muscle groups on the face may provide an effective, nonsurgical means of tissue lifting, and muscle rejuvenation.

EMFACE creates facial muscle contractions through nerve depolarization–yielding better muscle tone and increased muscle mass to treated areas of the face.  EMFACE results are backed by 7 clinical studies that demonstrate increases in collagen and elastin production, skin lifting, and increases in muscle mass and tone to specific cheek and forehead muscles.

What Results are Typical with EMFACE?
BTL, the manufacturer of EMFACE, conducted multiple studies on HIFES/RF technology to demonstrate its effects on facial muscles and skin.  Clinical studies measured muscle changes by imaging (such as ultrasound  and MRI studies), monitored skin quality changes, compared photos before and after treatment, and collected patient satisfaction with the procedure.

On average, the following were achieved in EMFACE clinical studies on healthy patients:

  • 37% reduction of facial wrinkles in treated areas
  • 30% increase in muscle tone
  • 19% increase in muscle density
  • 23% improvement in lift of face
  • 26% increase in collagen
  • Two-fold increase in elastin production


emface eyelid before and after san diego

emface forehead results art of skin md


How Does EMFACE Work?
EMFACE combines two powerful technologies for the first time in a single treatment applicator:  high intensity focused electrical stimulation (HIFES) and radiofrequency (RF).  The combination of HIFES and RF treated muscle atrophy in the face and skin textural changes simultaneously.

HIFES: EMFACE produces HIFES-induced muscle contraction.  Electrical stimulation targets depolarization of motor nerves, which cause associated muscles to contract.  In EMFACE treatment, the pulse patterns of muscle contraction alternate between forehead or cheek muscle engagement, or both.  For the forehead, the frontalis muscle is targeted.  For the cheek, three muscles, the zygomaticus major, zygomaticus minor, and the risorius muscles are targeted.

A single EMFACE treatment produces approximately 75,000 electrical pulses that trigger muscle contractions.  This is accomplished over about 20 minutes.

Synchronized RF: EMFACE delivers syndronized, monopolar radiofrequency.   The treatment applicators for forehead and each cheek feels warm during a treatment cycle.

Radiofrequency creates bulk heating of tissues.  The extremely efficient delivery of RF through EMFACE applicators allows the skin to be warmed to 40-42 degrees Celsius within a few minutes of treatment.  Due to real-time feedback in the treatment applicator,  thermal sensing keep tissue warm, but not hot.  This special temperature is enough to induce new collagen and elastin growth in the skin, but not to effect facial fat.  A cooler, gentle heat is also delivered to the muscle tissue between 39.5 and 40 degrees Celsius, pre-warming muscle to receive more effective contraction.

How Many EMFACE treatments are needed?
Clinical studies with EMSCULPT for the face (forehead and cheek applicators) treated patients for 20 minutes, once a week, for a total of 4 treatments.  Maintenance is required to maintain the results, typically one treatment every 3-6 months.

Who is a Good Candidate for EMFACE?
Most adults that desire a nonsurgical means of facial rejuvenation and lift through skin and muscle toning are good candidates for EMFACE .  EMFACE is not a substitute for a surgical facelift, but offers more modest skin and tissue lifting as evidenced from clinical trials.

What Areas of the Face Can be Treated with EMFACE?
EMFACE is FDA-cleared for the following areas that benefit from either increased muscle tone and/or enhanced tissue/skin heating:

  • Forehead (frontalis muscle, which may improve brow position)
  • Cheeks (zygomaticus major, zygomaticus minor, and risorius muscles, which may lead to jowl improvement, cheek lifting, and jawline refinement)



EMFACE Treatment FAQ

What does EMFACE feel like?  Does EMFACE hurt?
EMFACE is not painful, it simply feels like a warm treatment pad with overlying mild muscle contractions.  In my personal experience, muscle contractions on the forehead feel like a caterpillar bending on the skin surface.  Cheek muscle stimulation feels like the applicator pad is being lightly peeled away, even though it is in place.  You may squint, clench, or smile lightly during cheek muscle treatment due to nearby muscle recruitment during treatment.

How much muscle mass will I tone with a series of EMFACE?
In clinical studies, patients gained 30% muscle tone and 19% muscle density after 4 treatments with EMFACE.

Won’t Forehead treatment with EMFACE make my horizontal forehead lines worse?
No, forehead wrinkles typically diminish with EMFACE treatment to the frontalis muscle.  The forehead muscle mass increases its resting tone, which supports the forehead tissues more adequately.  RF treatment of the skin with EMFACE helps stimulate new collagen and elastin formation, leading to improvements in skin texture.

What does building muscles in my cheek do for facial rejuvenation?
Increasing muscular tone of three critical cheek muscles helps to build the strength of deeper, supportive structures of our face.   Until now, we have not had an FDA-cleared device that significantly increases muscular tone and density.   With aging, muscles become finer, elongated, and less bulky.  As they lie deep to skin and fat, aging facial muscles provide less support to overlying tissues, contributing to telltale signs of facial aging.   Increasing muscular tone to our cheek muscles may provide a lifting effect to our face, including improvement of jowls, lifting of cheeks, and improvement in jawline definition.

How should I prepare for EMFACE treatment?
Preparation for EMFACE treatment is straightforward.  Come to our clinic with a clean face without makeup or skincare products.  Otherwise, these may interfere with the adhesive nature of the EMFACE treatment pads on the forehead and cheeks.  At clinic, your face may be prepared further with cleansing or alcohol pads to remove any residual oils, moisturizers, or skincare products.

How long is an EMFACE treatment session?  How many treatments will I need?
An EMFACE treatment session lasts 20 minutes. Clinical studies on EMFACE were a total of 4 treatments–once weekly but treatments may be spaced 2-14 days apart.

What should I expect immediately after EMFACE treatment?
The area of EMFACE treatment may be warm and mildly pink or red following treatment.  This may persist for a few hours to a day following treatment.   Sensitivity to adhesive from the treatment applicator pads may exaggerate this response.  Muscular pain is possible but not likely following treatment.  If you experience any pain during treatment, there is a Therapy Discomfort Button you may press to stop treatment.

Is there any downtime following EMFACE treatment?
No, the majority of patients immediately resume normal activities following treatment.

How long does it take to see results following EMFACE?
Results from EMFACE are typically noticed 1-3 months following the final treatment.


emface art of skin md san diego


Who is a poor candidate for EMFACE?  Are there contraindications?

  1. Patients who have a contraindication to treatment are not candidates for EMFACE.
  2. Pregnant and nursing females should not undergo treatment with EMSCULPT.
  3. Possible contraindications to treatment include but are not limited to the following:


  • Metal or electronic implants in the treatment area
  • Cardiac pacemakers
  • Implanted defibrillators
  • Implanted neurostimulators
  • Drug pumps
  • Malignant tumor
  • Febrile conditions
  • Active collagen or autoimmune diseases or impaired immune function
  • Bacterial, viral infections or acute inflammations
  • Tuberculosis
  • Kidney or liver failure or hepatitis
  • Poorly controlled endocrine disorders, such as diabetes
  • Varicose veins, pronounced edemas, blood vessel or lymphatic vessel inflammation
  • Hemorrhagic conditions
  • Neurological disorders (such as multiple cerebrospinal sclerosis or epilepsy)
  • Acute neuralgia or neuropathy
  • Serious psychopathological disorders (such as schizophrenia)
  • Electroanalgesia without exact diagnosis of pain etiology
  • Recent surgical procedures in the treatment area within the last three months or before complete healing
  • Isotretinoin use in the past 12 months
  • Radiation therapy or chemotherapy
  • Current condition or history of skin cancer, or current condition of any other type of cancer or pre-malignant mole
  • Any active condition in the treatment area, such as sores, psoriasis, eczema, rash or rosacea


emface art of skin md san diego


Is EMFACE safe?  Are there any side effects from EMFACE treatment?
Yes, focused electrical stimulation energy from EMFACE is considered safe.  As mentioned previously, mild muscle pain is a listed side effect, but uncommon.  Skin may be pink to red, or slightly dry after treatment from RF treatment and the adhesive on the EMFACE applicator.

How does EMFACE compare to other methods of skin tightening such as radiofrequency, radiofrequency with microneedling, or Ultherapy?
EMFACE is a nonsurgical, noninvasive approach to facial muscle toning, skin lifting, and skin improvement.  It combines radiofrequency with electrical stimulation.  It is FDA- cleared for treatment of the forehead and cheeks.

Radiofrequency is frequently used for skin tightening.  It works by bulk heating the skin to a temperature that induces new collagen growth.  RF on its own does not affect muscles.

Radiofrequency with microneedling is available on a variety of device platforms from multiple manufacturers.  Microneedling at more superficial depths tend to help with skin texture and rejuvenation, whereas deeper RF microneedling depths found on Infini, Profound, or Morpheus8 devices can induce skin tightening.   However, none of these devices target muscle toning. Additionally, many deeper penetrating microneedling RF devices require significant measures to ensure patient comfort including regional anesthesia or analgesics during treatment.

Ultherapy uses microfocused ultrasound to target two tissue layers – the dermis of the skin and the SMAS–connective, collagen-rich tissue that encases our muscles of facial expression.  The targeted ultrasound energy causes thermal coagulation points, or heat generation, that induces new collagen growth and subsequent tissue tightening.  Ultherapy does not have a direct effect on muscle mass or tone.

Can EMFACE be combined with other cosmetic treatments?
EMFACE has not been studied for use in conjunction with other medical or cosmetic procedures.  However, EMFACE can be combined with noninvasive facial procedures from injectable fillers and neuromodulators, to collagen stimulators, lasers, IPL, and energy-based technologies.   Dr. Palm and her team use combination treatment, but often space procedures out appropriately for optimized outcomes, safety and manufacturer’s guidance, and patient comfort and downtime.


emface forehead before and after san diego

emface under eye results art of skin md


Can I still get Botox if I am receiving EMFACE treatments?  Will I need Botox after EMFACE to my forehead?
EMFACE treatments have not been studied in conjunction with Botox use to the face.  Patients that have had Botox to their forehead muscle may feel less stimulation of the muscle during treatment.

EMFACE treatment to the forehead has been shown to increase the frontalis muscle density and tone.  Forehead wrinkles in clinical before and after photos are diminished in many patients, and brow position can be improved.  EMFACE may help some patients that have not traditionally been good candidates for Botox, Dysport, or Xeomin treatment to their forehead as it improves resting tone of the frontalis.

Is increased facial muscle tone and density permanent following EMFACE treatment?
Muscle mass is not permanent but likely lasts 6 months or longer.  Periodic EMFACE treatments maintains the muscle tone achieved from an initial series of EMFACE treatment.

What happens if I gain weight following EMFACE treatment?
A healthy lifestyle including diet and exercise maintenance are encouraged during any aesthetic facial treatment. An increase in weight will allow fat stores to accumulate which may affect facial contours or transition from face to neck. Weight changes may obscure the effects of EMFACE treatment, or impact how HIFES energy levels are delivered during treatment.

How much does EMFACE cost?
EMFACE is sold as a package of four treatments.  Periodic maintenance with a single treatment every 3-6 months is encouraged.  Price is determined by the areas treated:  full face, forehead only, or cheeks only.

Why Choose Art of Skin MD in San Diego for EMFACE treatment?
Dr. Palm is among the first physicians nationally to offer EMFACE to her patients.  She serves on the medical advisory board of BTL, the manufacturers of EMFACE, EMSCULPT, and EMSCULPT NEO technology.  Art of Skin MD has had early and advanced knowledge and expertise to deliver appropriate and meaningful results with EMFACE.

If you are looking for an EMFACE expert in the San Diego area for non-invasive, non-surgical facial skin tightening and muscle toning, call Dr. Melanie Palm at 858.792.SKIN (7546) to schedule your appointment.