Facial Manipulation Research Articles

The Transmastoid Retrolabyrinthine Approach in Acoustic Neuroma Surgery: Our Experience in 189 Patients.

This study aimed to describe our experience with the retrolabyrinthine or infralabyrinthine approach in acoustic neuroma surgery, and to discuss its advantages, limitations, complications, and the outcomes of hearing and facial function preservation. This study was a retrospective analysis of all acoustic neuroma cases, operated with a retrolabyrinthine approach in our hospital. This study was conducted at a tertiary university hospital. In total, 189 patients underwent hearing preservation and acoustic neuroma surgery, operated through the retrolabyrinthine approach, in our department. The average age was 43.6 years; there were 105 women and 84 men. All patients had unilateral tumors, 99 occurring in the right ear and 90 in the left ear. A retrolabyrinthine approach was performed in all 189 patients to remove vestibular schwannoma. All tumors graded I and II using Koos tumor grading with serviceable hearing when the speech reception threshold (SRT) was better than 50 dB, and word recognition scores of 50% or higher. Considering the 189 patients, good exposure of the internal auditory canal was possible in all patients, with total removal of the tumor in all patients, even though it was necessary to sacrifice the posterior canal in 12 of the cases, all classified as Koss II. Hearing was preserved in 49.73% of patients; 1% had permanent grade II House-Brackmann facial paralysis. The retrolabyrinthine approach showed security during facial nerve manipulation, small chance of morbidity, and good proportion of hearing preservation when tumor are up to Koss I and II classification.

Deepfakes and beyond: A Survey of face manipulation and fake detection

The free access to large-scale public databases, together with the fast progress of deep learning techniques, in particular Generative Adversarial Networks, have led to the generation of very realistic fake content with its corresponding implications towards society in this era of fake news.This survey provides a thorough review of techniques for manipulating face images including DeepFake methods, and methods to detect such manipulations. In particular, four types of facial manipulation are reviewed: i) entire face synthesis, ii) identity swap (DeepFakes), iii) attribute manipulation, and iv) expression swap. For each manipulation group, we provide details regarding manipulation techniques, existing public databases, and key benchmarks for technology evaluation of fake detection methods, including a summary of results from those evaluations. Among all the aspects discussed in the survey, we pay special attention to the latest generation of DeepFakes, highlighting its improvements and challenges for fake detection.In addition to the survey information, we also discuss open issues and future trends that should be considered to advance in the field.

Tampered and Computer-Generated Face Images Identification Based on Deep Learning

Image forgery is an active topic in digital image tampering that is performed by moving a region from one image into another image, combining two images to form one image, or retouching an image. Moreover, recent developments of generative adversarial networks (GANs) that are used to generate human facial images have made it more challenging for even humans to detect the tampered one. The spread of those images on the internet can cause severe ethical, moral, and legal issues if the manipulated images are misused. As a result, much research has been conducted to detect facial image manipulation based on applying machine learning algorithms on tampered face datasets in the last few years. This paper introduces a deep learning-based framework that can identify manipulated facial images and GAN-generated images. It is comprised of multiple convolutional layers, which can efficiently extract features using multi-level abstraction from tampered regions. In addition, a data-based approach, cost-sensitive learning-based approach (class weight), and ensemble-based approach (eXtreme Gradient Boosting) is applied to the proposed model to deal with the imbalanced data problem (IDP). The superiority of the proposed model that deals with an IDP is verified using a tampered face dataset and a GAN-generated face dataset under various scenarios. Experimental results proved that the proposed framework outperformed existing expert systems, which has been used for identifying manipulated facial images and GAN-generated images in terms of computational complexity, area under the curve (AUC), and robustness. As a result, the proposed framework inspires the development of research on image forgery identification and enables the potential to integrate these models into practical applications, which require tampered facial image detection.

Manual Physiotherapy of Fascia - Introduction to Myofascial Release and Fascial Manipulation.

Abstract Fascia is formed from a superficial fascia, a deep fascia, a perimysium fascia, a perimysium fascia, a endomysium fascia. There are 6 Center of Coordination (CC) on a perimysium fascia. There are 8 Center of fusion (CF) on a deep fascia. When these abnormalities occur, fascia densification, substrate gelation, and hyaluronic acid aggregation occur. Fascial dysfunction spreads over a wide range through the deep fascia, and the past history often becomes a problem. Treatments for this fascial dysfunction include Muscle Pain Relief, Myofascial Release, and Facial Manipulation. This time, I will explain about Myofascial Release and Fascial Manipulation with case examples.

Observation using thermography of post-operative reaction after fascial manipulation®.

Fascia Manipulation® is one of the methods focusing on the deep fascia. The assumption is that fascial manipulation is carried out on precisely determined points - coordination centres (cc), and on a limited area so as the friction occurring during manipulation would cause a local rise in temperature due to the inflammatory reaction. Rise in temperature influences modification in consistency of elementary matter in the manipulated area, and by the same token causing a decrease in the negative effects of fascia densification which stems from accumulation of hyaluronic acid. The purpose of the research is to prove the thesis that fascial manipulation causes local rise in temperature due to inflammatory reaction. For the research, 25 individuals with densification in lower limb area were qualified. They were exposed to a single, 3-minute facial manipulation®. By means of a thermal-imaging camera, changes in the temperature of the body in the examined area were evaluated. The body's temperature evaluation was carried out 8 times: before the treatment, 5 minutes after the treatment, and, next, 6, 12, 18, 24, 36, 48 hours after the treatment. The average surface temperature of the treated area before mobilization was 33.4°C. A statistically relevant increase in temperature was already observed 5 minutes after the treatment (increase of 0.5°C; p<0.001). However, the highest temperature was observed 24 hours after mobilization (increase of 2.4°C). The difference between the first and 7 other measurements was statistically relevant (p<0.001). The statistically relevant increase in temperature under the influence of fascial manipulation® in the treatment area can confirm the occurrence of inflammatory reaction.

Botulinum toxin in the management of myofascial pain associated with temporomandibular dysfunction.

Critical evidence on the therapeutic efficacy of botulinum toxins (BTX) is still lacking for most pain conditions. The aim of this review was to evaluate the therapeutic efficacy of BTX in the management of temporomandibular myofascial pain. Electronic databases PubMed, EMBASE, Scopus, Web of Science, and gray literature were searched for randomized clinical trials until February 2018 to answer a focused question "What is the effectiveness of botulinum toxin in the management of temporomandibular myofascial pain?" Two independent reviewers performed the study selection according to eligibility criteria. A total of seven studies that met the eligibility criteria were included. Two studies showed a significant improvement in temporomandibular myofascial pain, and one study showed equal efficacy of BTX in comparison with facial manipulation, while the remaining studies did not report any significant difference between BTX and control group. Due to heterogeneity in the methodology and outcome assessment, a meta-analysis and recalculation of risk could not be performed. Based on our findings, the therapeutic efficacy of BTX was unclear. Randomized controlled trials with better methodological criteria need to be carried out to evaluate the real effectiveness of BTX.

Potential Surgical Exposure of the Parapharyngeal Internal Carotid Artery by Endonasal, Transoral, and Transcervical Approaches.

Objectives Endoscopic and endoscopic-assisted approaches to the parapharyngeal space have been reported; however, their potential for vascular exposure has not been previously assessed. This study aims to compare the potential exposure and control of the parapharyngeal internal carotid artery (ppICA) via various approaches. Design and Main Outcome Measures Ten cadaveric specimens were dissected bilaterally, exposing the ppICA via endonasal, transoral, and transcervical approaches. Length of the exposed vessel and potential control were assessed (feasibility and time required to place an encircling suture). Results Endoscopic transoral and transcervical-transmandibular approaches expose a significantly longer segment of the ppICA (6.89 and 7.09 cm) than the transoral and endonasal approaches. Vascular control was achieved via endoscopic-endonasal, endoscopic-transoral, and open techniques in 121.6, 64.8, and 5.2 seconds, respectively. Conclusion Histopathology, goals of surgery, and familiarity of the surgeon with each technique may ultimately determine the choice of approach; however, this study suggests that exposure of the ppICA by endoscopic-assisted transoral approach is comparable to that of a transcervical-transmandibular approach. Vascular control was feasible under elective circumstances. However, the difficulty varied widely, potentially reflecting the challenges of controlling an injured ppICA. However, one must note that active bleeding obscures the surgical field in ways that may impair ppICA control. Furthermore, the results may not reflect clinical scenarios where tumor distorts the surgical field. Nonetheless, the study suggests that, in properly selected patients, the endoscopic-assisted transoral approach avoids problems associated with unsightly scars, mandibular osteotomy, and facial nerve manipulation, whereas, the transcervical-transmandibular approach offers the swiftest vascular control.

A differing bidirectional impact on the recognition accuracy of facial expression.

This study explored a bidirectional impact on the recognition accuracy of various facial expressions deriving from both the observer and sender in a sample of Chinese participants. A facial manipulation task was used to examine the ability of an observer's facial feedback to modulate the recognition of various facial expressions. Furthermore, the effect of a sender's facial expression with an open or closed mouth on recognition accuracy was investigated. The results showed that only recognition accuracy of a sad facial expression was influenced simultaneously by bidirectional sources from a sender and observer. Moreover, the impact of the unidirectional cue of a sender's facial feature (i.e., mouth openness) on happy and neutral faces was found to influence the recognition accuracy of these faces, but not the observer's bodily state. These findings indicate that the bidirectional impact derived from an observer and sender on facial expression recognition accuracy differs for emotional and neutral expressions.

Mood congruity and episodic memory in young children

Although mood congruity effects on episodic memory have been reported extensively in adults, they have not been reported for children younger than 10years. The current research investigated mood congruity effects in story recall using an embodied approach to mood induction involving a facial manipulation task with 3- and 4-year-old children. Participants held a chopstick or a popsicle stick in their mouths in a way to either produce or inhibit a smile while they listened to a story featuring happy events for a happy character and sad events for a sad character. Children’s mood ratings before and after mood induction indicated that mood became more positive in the smile condition, with no change in the no smile condition. Children in the smile condition, but not in the no smile condition, remembered more about the happy character than the sad character in the story. These results extend mood congruity effects to 3- and 4-year olds, suggesting that at this age representations of emotion interact with basic memory processes. Moreover, the efficacy of reenactment of sensorimotor components of emotion in modifying mood is consistent with embodied representation of emotion during early childhood.

A novel videographic method for quantitatively tracking vibrissal motor recovery following facial nerve injuries in rats

BackgroundPrevious studies of vibrissal movements employ either optoelectronic recording techniques in the head fixed rodent, or videographic recordings in freely moving animals. However, both approaches have shortcomings for quantitatively tracking the process of vibrissal motor recovery. New methodA critical feature of our videographic method is to measure tagged vibrissae movements while leaving all others intact in body restrained rats without head fixation. Thirty two adult rats underwent facial nerve manipulation and testing. All animals underwent baseline preoperative whisking testing. In the experimental groups, the right facial nerve was either crushed, or transected and sutured. In the control groups, the left facial nerve underwent either sham surgery, or transection denervation. Whisking function was measured for the ensuing 2 to 12 weeks. Data were analyzed for whisking recovery. ResultsBaseline preoperative whisking testing showed that majority of free whisking on the both sides is synchronous and symmetric, which allows us to compare vibrissal motor data between intact and manipulated side after facial nerve injury. As expected, the recovery of whisking function following crush is better and earlier than that with transection and suture. Comparison with existing method(s)To our knowledge, this novel videographic method is a significant simplification over currently employed optoelectronic recording techniques and videographic methods. ConclusionsOur novel videographic method may be a powerful tool to investigate motor recovery from facial nerve manipulation in the rat model.

When you smile, you become happy: Evidence from resting state task-based fMRI

Simulation studies on emotion have shown that facial actions can initiate and modulate particular emotions. However, the neural mechanisms of these initiating and modulating functions are unclear. In this study, we used resting-state functional magnetic resonance imaging (fMRI) and task-based fMRI to explore these processes by examining spontaneous cerebral activities and brain activations under two conditions: holding a pen using only the teeth (HPT: facilitating the muscles typically associated with smiling) and holding a pen using only the lips (HPL: inhibiting the muscles typically associated with smiling). The resting-state fMRI results showed that compared with the HPL condition, significant increases in the amplitudes of low-frequency fluctuations were found in the right posterior cingulate gyrus [PCG; Brodmann area 31 (BA31)] and in the left middle frontal gyrus (MFG; BA9) in the HPT condition. These findings might be related to the initiation of positive emotions (PCG) and to the control and allocation of attention (MFG). The task-based fMRI results showed that the inferior parietal lobule, left supplementary motor area, superior parietal lobule, precuneus, and bilateral middle cingulum were active when facial manipulation influenced the recognition of emotional facial expressions. These results demonstrate that facial actions might not only initiate a particular emotion and draw attention, but also influence face-based emotion recognition.

Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region

Advances in the field of skull base surgery aim to maximize anatomical exposure while minimizing patient morbidity. The petroclival region of the skull base presents numerous challenges for surgical access due to the complex anatomy. The transcochlear approach to the region provides adequate access; however, the resection involved sacrifices hearing and results in at least a grade 3 facial palsy. An endoscopic endonasal approach could potentially avoid negative patient outcomes while providing a desirable surgical window in a select patient population. Cadaveric study. Endoscopic access to the petroclival region was achieved through an endonasal approach. For comparison, a transcochlear approach to the clivus was performed. Different facets of the dissections, such as bone removal volume and exposed surface area, were computed using computed tomography analysis. The endoscopic endonasal approach provided a sufficient corridor to the petroclival region with significantly less bone removal and nearly equivalent exposure of the surgical target, thus facilitating the identification of the relevant anatomy. The lateral approach allowed for better exposure from a posterolateral direction until the inferior petrosal sinus; however, the endonasal approach avoided labyrinthine/cochlear destruction and facial nerve manipulation while providing an anteromedial viewpoint. The endonasal approach also avoided external incisions and cosmetic deficits. The endonasal approach required significant sinonasal resection. Endoscopic access to the petroclival region is a feasible approach. It potentially avoids hearing loss, facial nerve manipulation, and cosmetic damage.

Hearing preservation surgery for vestibular schwannoma: experience with the middle fossa approach.

In the early 1960s William F. House developed the middle fossa approach for the removal of small vestibular schwannomas (VSs) with the preservation of hearing. It is the best approach for tumors that extend laterally to the fundus of the internal auditory canal, although it does have the potential disadvantage of increased facial nerve manipulation, especially for tumors arising from the inferior vestibular nerve. The aim of this study was to monitor the hearing preservation and facial nerve outcomes of this approach. A prospective database was constructed, and data were retrospectively reviewed. Between December 2004 and January 2012, 30 patients with small VSs underwent surgery via a middle fossa approach for hearing preservation. The patients consisted of 13 men and 17 women with a mean age of 46 years. Tumor size ranged from 7 to 19 mm. Gross-total resection was accomplished in 25 of 30 patients. Preoperative hearing was American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Class A in 21 patients, Class B in 5, Class C in 3, and undocumented in 1. Postoperatively, hearing was graded as AAO-HNS Class A in 15 patients, Class B in 7, Class C in 1, Class D in 2, and undocumented in 5. Facial nerve function was House-Brackmann (HB) Grade I in all patients preoperatively. Postoperatively, facial nerve function was HB Grade I in 28 patients, Grade III in 1, and Grade IV in 1. There were 3 complications: CSF leakage in 1 patient, superficial wound infection in 1, and extradural hematoma (asymptomatic) in 1. The overall hearing preservation rate of at least 73% and HB Grade I facial nerve outcome of 93% in this cohort are in keeping with other contemporary reports. The middle fossa approach for the resection of small VSs with hearing preservation is a viable and relatively safe option. It should be considered among the various options available for the management of small, growing VSs.

Infectious Complications of Bio-Alcamid Filler Used for HIV-Related Facial Lipoatrophy

Human immunodeficiency virus (HIV)-related facial lipoatrophy is a devastating adverse effect of antiretroviral therapy. At this time, the most viable treatment option is cosmetic surgery with synthetic fillers. Bio-Alcamid has many advantages over other fillers, and has become widely used. The objective of this study was to determine the incidence rate of infectious complications associated with Bio-Alcamid facial filler in patients with HIV-related facial lipoatrophy (FLA). This retrospective study identified patients who had received treatment with Bio-Alcamid, and reviewed their long-term outcomes. Two hundred sixty-seven patients with Bio-Alcamid were reviewed. Infectious complications were documented in 56 (19%) patients. The incidence rate of infection was 0.07 per patient-year of follow-up. Among patients with infections, the median time from first Bio-Alcamid treatment to infection was 32 months (interquartile range, 21-42). We did not find an association between the development of infection and the level of immune suppression by HIV. Surgical drainage in addition to antibiotics was required for the majority of patients. Potential risk factors for infection include severity of FLA and a preceding history of facial manipulation, including Bio-Alcamid touch-up treatments, cosmetic surgery, facial trauma, and dental work. Bio-Alcamid treatment of HIV-related FLA was associated with a high rate of infectious complications, often presenting years after treatment. Antibiotic prophylaxis should be considered in patients with Bio-Alcamid prior to dental work or facial manipulation.

Facial Nerve Function in Postoperative of Glomus Jugulare

Objective: Describe the facial nerve function (FNF) in preoperative and postoperative time of patients with glomus jugulare tumors trying to correlate the relationship with functional outcome with epidemiological variables (age and sex) or variables related to the tumor (extent, location, and relationship to the facial nerve and internal carotid artery). Method: Retrospective review of 53 patients with glomus jugulare submitted to surgical treatment (1987 to 2010) in Edmundo Vasconcelos Hospital. The FNF was analyzed preoperatively and at initial PO (until 7 days), PO of 6 months, and PO of 1 year. Results of FNF were compared with tumor aspects and epidemiological features. Results: In a preoperative time we observed FNF decreased in 11 patients (20.75%) in which the average of facial function by House Brackmann scale degree was 2.54. Most of those (7%-63.64%) scaled as HB II. Intraoperative findings demonstrated anatomic invasion in 5 patients. In the immediate PO time (1 to 7 days) a decrease of facial nerve function in 83.02% of the patients (avgHB = 3.32) was noted. In PO of 6 and 12 months, some degree of FNF was observed in 32 (60.37%/avgHB 2.09) and 25 (47.17%/avgHB 1.86). There was no observed relation ( P &lt; .05) between kinds of facial nerve manipulation or epidemiological features with FNF with in 1 year postoperatively. Conclusion: FNF is a common feature in PO of patients with jugulare foramen tumors, and its recovery is expected for the majority after initial PO time. For the group of patients with preoperative compromise of VII nerve, poorer outcomes were were observed.

Rodent Facial Nerve Recovery after Selected Lesions and Repair Techniques

Measuring rodent facial movements is a reliable method for studying recovery from facial nerve manipulation and for examining the behavioral correlates of aberrant regeneration. The authors quantitatively compared recovery of vibrissal and ocular function following three types of clinically relevant nerve injury. One hundred seventy-eight adult rats underwent facial nerve manipulation and testing. In the experimental groups, the left facial nerve was either crushed, transected, and repaired epineurially, or transected and the stumps suture-secured into a tube with a 2-mm gap between them. Facial recovery was measured for the ensuing 1 to 4 months. Data were analyzed for whisking recovery. Previously developed markers of co-contraction of the upper and midfacial zones (possible synkinesis markers) were also examined. Animals in the crush groups recovered nearly normal whisking parameters within 25 days. The distal branch crush group showed improved recovery over the main trunk crush group for several days during early recovery. By week 9, the transection/repair groups showed evidence of recovery that trended further upward throughout the study period. The entubulation groups followed a similar recovery pattern, although they did not maintain significant recovery levels by the study conclusion. Markers of potential synkinesis increased in selected groups following facial nerve injury. Rodent vibrissal function recovers in a predictable fashion following manipulation. Generalized co-contraction of the upper and midfacial zones emerges following facial nerve manipulation, possibly related to aberrant regeneration, polyterminal axons, or hypersensitivity of the rodent to sensory stimuli following nerve manipulation.

Nimodipine and Acceleration of Functional Recovery of the Facial Nerve After Crush Injury

To establish whether nimodipine, a calcium channel blocker, accelerates or otherwise improves functional recovery of whisking after facial nerve crush injury in the rat. Thirty rats underwent exposure of the left main trunk of the facial nerve followed by a standard crush injury and subsequent quantitative facial movement testing. Animals were randomized into an experimental group (n = 15) and a control group (n = 15). Four days prior to facial nerve manipulation, experimental animals underwent subcutaneous implantation of a nimodipine-secreting pellet. All animals were tested preoperatively and on postoperative days 2, 8 to 17, 20, 22, 24, and 31 using a validated, quantitative whisking kinematics apparatus. Whisks were analyzed for amplitude, velocity, and acceleration. Animals receiving nimodipine demonstrated significantly better whisking on 5 days (postoperative days 9, 11 to 13, and 20) compared with control animals (P < .001, P = .003, P = .009, P = .009, and P = .009, respectively; 1-tailed ttest). Overall, the nimodipine-treated animals showed earlier recovery compared with the untreated animals. We demonstrate that nimodipine improves recovery of whisking after facial nerve crush. This finding corroborates the semiquantitative findings of others, and provides complete whisking kinematic data on its effects. Given the low adverse effect profile of nimodipine, there may be clinical implications in its administration in patients experiencing facial nerve injury.

Functional Assessments of the Rodent Facial Nerve: A Synkinesis Model

Rodent whisker movement has been used as a tool, after facial nerve manipulation, to quantify functional recovery. We have recently established a method to study functional correlates of aberrant regeneration of the facial nerve. Our objective was to establish normative parameters for both spontaneous and induced whisking and blinking behavior in a large group of normal rats. Prospective animal study. Eighty animals underwent quantitative facial movement testing to measure simultaneous vibrissal movement and ocular closure for each side independently. Right and left C-1 whisker positions were continuously recorded for 5-minute sessions, and changes in infrared detection corresponding to eye closure were continuously recorded. Whisking and blinking were elicited by delivery of olfactory stimuli (10 s scented airflows) and corneal air puffs. Whisks were counted and analyzed, and eye closures were counted. Whisking amplitude, velocity, and acceleration were consistent with literature values. Air puff delivery elicited an ipsilateral blink 99% of the time, a contralateral blink 18% of the time, and changes in or initiation of bilateral whisking 70% of the time. Olfactory stimulus delivery prompted a change in whisking behavior 83% of the time, and eye closure 20% of the time. This study establishes normative data for assessing cranial nerve VII-controlled facial movement in four separate facial regions. We demonstrate the capability and tendency of animals to move their orbicularis oculi muscles independently of and simultaneously with their midfacial muscles. This model provides an excellent tool for the study of aberrant regeneration after facial nerve injury in the rodent.

EXPOSURE OF THE DISTAL CERVICAL SEGMENT OF THE INTERNAL CAROTID ARTERY USING THE TRANS-SPINOSUM CORRIDOR

Exposure of the most distal portion of the cervical segment of the internal carotid artery (ICA) is technically challenging. Previous descriptions of cranial base approaches to expose this segment noted facial nerve manipulation, resection of the glenoid fossa, and significant retraction or resection of the condyle. We propose a new approach using the frontotemporal orbitozygomatic approach to expose the distal portion of the cervical segment of the ICA via the trans-spinosum corridor. Six formalin-fixed injected heads were used for cadaveric dissection. Two blocs containing the carotid canal and surrounding region were used for histological examination. The ICA lies immediately medial to the vaginal process. The carotid sheath attaches laterally to the vaginal process. With use of the trans-spinosum corridor, the surgeon's line of sight courses in front of the temporomandibular joint, through the foramen spinosum, spine of the sphenoid, and vaginal process. Removal of the vaginal process exposes the vertical portion of the petrous segment of the ICA. The loose connective tissue space between the adventitia and the carotid sheath is easily entered from above. Incision of the carotid sheath exposes the ICA without disruption of the temporomandibular joint. Control of the cervical segment of the ICA can be critical when dealing with cranial base tumors that invade or surround the petrous segment of the ICA. This novel technique through the trans-spinosum corridor can effectively expose the distal portion of the cervical segment of the ICA without causing manipulation of the facial nerve and while maintaining the integrity of the temporomandibular joint.

Fonoaudiologia e estética facial: estudo de casos

OBJETIVO: caracterizar as modificações presentes no comportamento facial após tratamento fonoaudiológico proposto para face, através da comparação das medidas da projeção do sulco nasogeniano ao tragus pré e pós-tratamento fonoaudiológico MÉTODOS: a população foi constituída de 10 professores atendidos no Hospital dos Servidores do Estado de Pernambuco de ambos os sexos, e com idade entre 33 e 63 anos. O processo de coleta de dados consistiu de protocolos de anamnese e avaliação, protocolo de desempenho, além do registro fotográfico. Foi realizada a medida da projeção do sulco nasogeniano ao tragus. Durante dezesseis sessões foram trabalhados exercícios isotônicos, isométricos, isocinéticos, massagens, manipulações faciais, equilíbrio funcional estomatognático, além de orientações aos cuidados faciais. RESULTADOS: foi constatada uma redução das medidas da projeção do sulco nasogeniano ao tragus em ambos os lados, observando-se também um notório equilíbrio entre os lados direito e esquerdo. CONCLUSÃO: o programa de tratamento proposto para face reduziu as medidas da projeção do sulco nasogeniano ao tragus e proporcionou um equilíbrio entre essas medidas.