For more than two decades, Registered Nurse Kim Renton has been educating aesthetic physicians about one overlooked cause of premature facial aging: the pressure and compression our faces experience while we sleep.
Long before “sleep wrinkles” became a widely discussed topic, Registered Nurse Kim Renton was noticing something many people—including aesthetic professionals—were overlooking.
During her years working in medical aesthetics and training physicians across North America, Kim repeatedly saw facial lines, creases and asymmetries that could not be explained by expression alone. These lines did not respond to neuromodulator treatments because they were not being created by muscle movement.
Instead, Kim believed they were being formed and reinforced by something people did for hours every night: pressing their faces into their pillows while sleeping.
That observation eventually led Kim and fellow Registered Nurse Kathy Young Keefe to rethink the traditional pillow and create the patented enVy® Pillow—an ergonomic pillow designed to reduce facial compression while also supporting healthy cervical alignment.
[Image: Kim Renton RN — CBC studio, 2018]
From Operating Room Nurse to Medical Aesthetics Consultant
fter working in hospital-based critical care and as an operating room nurse manager, Kim began a new chapter in 1999 when she joined Allergan Canada as a medical consultant in its Aesthetics and Therapeutics divisions.
At the time, neuromodulators were becoming increasingly important in both therapeutic medicine and cosmetic aesthetics. Kim supported and trained physicians using these treatments for neurological and muscular conditions, including blepharospasm, cervical dystonia, facial nerve disorders, hyperhidrosis and focal spasticity.
As cosmetic uses expanded, she also helped educate medical professionals in treatments for expression-related facial lines, including frown lines, forehead wrinkles and crow’s feet.
Kim was at the forefront of a rapidly evolving area of medicine—one that required both an understanding of facial anatomy and an artistic eye for balance, movement and proportion.
Learning from Pioneers in Medical Aesthetics
During her time with Allergan Canada, Kim had the opportunity to learn directly from Canadian physicians Dr. Jean Carruthers and Dr. Alastair Carruthers, widely recognized for their pioneering work in the cosmetic use of botulinum toxin.
Their training helped establish early standards for the safe and effective use of neuromodulators in medical aesthetics. Kim carried that knowledge forward as she began teaching other qualified medical professionals how to assess and treat the aging face.
[Image: Kim leading hands-on medical aesthetic injection training]
Training Medical Professionals Across North America
In 2003, Kim helped establish KAPPS, one of the early hands-on medical aesthetic training companies in North America.
At a time when advanced injector education was still limited, KAPPS provided intensive practical training in the art and science of neuromodulators and facial fillers.
Over approximately six years, Kim trained hundreds of medical professionals across North America. Her work extended beyond teaching injection techniques. She helped practitioners understand facial anatomy, tissue movement, volume loss, symmetry and the different reasons facial lines develop.
As her future business partner Kathy would later say:
“If you are a successful professional injector today, chances are you were either trained by Kim herself or by someone she trained.”
The Wrinkles That Injections Could Not Fix
Through her work with thousands of patients and medical professionals, Kim began recognizing an important distinction.
Many facial lines are dynamic wrinkles, created by repeated muscle movement when we smile, frown, squint or raise our eyebrows. These expression lines may respond well to neuromodulator treatments because reducing the underlying muscle movement can soften their appearance.
But Kim was also seeing lines that followed completely different patterns.
Some appeared vertically or diagonally across the cheeks, temples, forehead and eye area. Others were more noticeable on one side of the face. They did not correspond with the usual direction of facial muscle movement, and neuromodulator treatments had little or no effect on them.
Kim began asking a different question:
What if these lines were not being created by facial expression at all?
Recognizing the Effects of Facial Compression During Sleep
Kim’s observations led her to examine what happened to the face during side and stomach sleeping.
When the face is pressed into a traditional pillow, the skin and underlying tissue may be compressed, stretched and folded. For someone who returns to the same position night after night, this pressure can repeatedly reinforce the same creases.
These lines are now commonly described as sleep wrinkles or sleep lines.
Unlike dynamic wrinkles, sleep wrinkles are created by external mechanical pressure rather than muscle contraction. This helps explain why treatments designed to relax facial muscles do not necessarily correct them.
Kim also noticed that some patients required more filler on one side of the face than the other to achieve a balanced result. Facial asymmetry is natural and has many possible causes, but repeatedly sleeping on one side may contribute to uneven tissue compression and displacement over time.
In some cases, a beautifully completed aesthetic treatment was being placed under the same pressure again as soon as the patient returned to their habitual sleeping position.
The treatment could address the visible line or volume loss—but it could not stop the nightly compression recreating it.
Not Just Wrinkles—Tissue Shift and Facial Asymmetry
Kim’s concern extended beyond surface creasing.
The weight of the head pressing the face into a pillow can place significant pressure on the delicate tissues of the cheek, eye area and jaw. Over time, habitual sleep position may contribute to differences in the appearance of the two sides of the face.
She began educating medical professionals about the relationship between:
- Repeated facial compression
- Folding and stretching of the skin
- Tissue displacement
- Habitually favouring one sleeping side
- Sleep lines that do not follow facial muscle movement
- Uneven facial volume and asymmetry
At first, the idea was often met with scepticism. Most people accepted that sun exposure, facial movement and the natural loss of collagen contributed to visible aging. Far fewer considered what happened to the face during seven or eight hours of sleep.
But the patterns Kim observed were difficult to ignore.
[Image: Slides from Kim’s sleep-wrinkle training presentation, circa 2007]
Prevention Became the Missing Piece
Fillers could restore lost volume and soften deeper creases. Neuromodulators could reduce the appearance of expression lines. But neither approach prevented the face from being compressed into a pillow every night.
Kim reached a clear conclusion: when it came to sleep wrinkles, prevention needed to become part of the conversation.
The usual recommendation was simple—sleep on your back.
Back sleeping generally places less direct pressure against the face, but that advice is not realistic for everyone. Sleep habits are often developed in childhood and can be extraordinarily difficult to change. Many people naturally return to side sleeping even after making a determined effort to remain on their backs.
Side sleeping may also feel more comfortable for people who snore, experience nasal congestion, are pregnant or simply cannot sleep well in a back-sleeping position.
Kim recognized that a useful solution could not depend on turning every side sleeper into a back sleeper.
The traditional pillow itself needed to be reconsidered.
Two Nurses Rethink the Traditional Pillow
Kim joined forces with fellow Registered Nurse Kathy Young Keefe to develop a practical solution.
Kathy brought nursing experience in plastic surgery, burns, craniofacial surgery and intensive care. She also had a deeply personal appreciation for posture and alignment after undergoing scoliosis surgery as a teenager.
Together, Kim and Kathy understood that reducing facial compression could not come at the expense of the neck.
A pillow might be marketed for beauty, but if it left the cervical spine poorly supported or forced the sleeper into an unnatural position, it was not a complete solution.
Their new pillow would need to:
- Accommodate both side and back sleeping
- Reduce direct pressure against the face
- Support the head, neck and cervical spine
- Avoid forcing the sleeper into an uncomfortable position
- Address facial compression without sacrificing healthy alignment
Their goal was not simply to create a beauty accessory.
They wanted to redesign the traditional pillow from a nursing and ergonomic perspective.
The Development of the enVy® Pillow
After approximately two and a half years of research, development and prototyping, Kim and Kathy created the patented enVy® Pillow.
Its distinctive OFF-Your-Face™ design was developed to give the face more space during side sleeping while maintaining support beneath the neck and head.
Rather than placing the cheek, eye area and jaw against the broad centre of a traditional rectangular pillow, the sleeper can position the face closer to one of the pillow’s contoured facial relief areas.
The pillow also includes two neck-support heights, allowing users to choose the side that better suits their body proportions and sleep preferences.
As Kim explains:
“Pressing your face into a pillow for hours every night can contribute to lines, sagging and asymmetries caused by repeated tissue compression and shifting.”
The resulting design brought together the two concerns that had guided Kim and Kathy from the beginning: facial compression and cervical support.
[Image: Tissue compression against a traditional pillow compared with the enVy® design]
More Than an Anti-Wrinkle Pillow
Although facial compression inspired the original concept, enVy® was never intended to be a pillow that focused solely on wrinkles.
The head, face, jaw, neck and spine do not function independently. A change in head position can affect cervical alignment, shoulder comfort and the amount of pressure placed through the jaw and facial tissues.
The enVy® Pillow was therefore developed as both:
- An anti-wrinkle and facial-compression pillow
- An ergonomic cervical-support pillow
Its patented shape has since been used by side and back sleepers seeking reduced facial pressure, more comfortable neck support and a better-balanced sleep position.
The enVy® Pillow is produced under enVy® Pillow Co.’s Health Canada Class I Medical Device Establishment Licence.
Researching and Educating About Sleep Wrinkles
Kim continued to write, speak and educate medical professionals about sleep wrinkles, tissue compression and facial aging.
Her work has included peer-reviewed articles such as “Treating and Preventing Tissue Shift and Wrinkles Caused by Compression” in the Journal of Aesthetic Nursing and “Assessing Lines on the Aging Face” in the Plastic Surgical Nursing Journal.
Kim and Kathy also presented “The Truth About Sleep Wrinkles” at an international congress in Warsaw in 2014.
Their work helped bring attention to an idea that was once frequently dismissed: the position of the face during sleep can influence the formation and reinforcement of certain facial lines.
Today, sleep wrinkles and facial compression are discussed much more widely within medical aesthetics, dermatology, skincare and consumer wellness.
The Pillow Nurses Enter the Dragons’ Den
Kim and Kathy introduced their invention to a national audience when they appeared on CBC’s Dragons’ Den in 2015.
During their memorable presentation, the two nurses demonstrated what happens when the face is repeatedly compressed against a pillow. Their photographs of a “smushed” sleeping face helped make the effects of nightly compression immediately understandable.
They received three offers but ultimately chose not to accept a partnership.
The Pillow Nurses were invited back to the Den in 2018 as part of a feature on unforgettable pitches from the show.
Their appearances introduced the concept of sleep wrinkles to a much broader audience and helped establish enVy® as an early innovator in the anti-wrinkle pillow category.
[Image: Kim Renton and Kathy Young Keefe presenting the enVy® Pillow on CBC’s Dragons’ Den]
Continuing to Innovate
The enVy® Pillow has continued to evolve since its original introduction.
Today, it is made with a responsive 100% natural latex core, selected for its resilient support, breathability and durability. Unlike slower-sinking memory foam, natural latex responds quickly as the sleeper changes position throughout the night.
Kim and Kathy have also expanded their focus from pillow shape to the sleep surface itself.
Current enVy® pillowcases and sleep textiles combine premium materials such as 22-momme Mulberry silk and TENCEL™ Lyocell with Canadian-developed biofunctional textile technologies, including COPPER, HYLA and ZINC options.
Independent laboratory testing and continued material development remain central to the company’s approach.
Although the materials and technologies have advanced, the philosophy has remained remarkably consistent: sleep products should thoughtfully support the body, the skin and the sleep environment.
Advancing the Conversation on Sleep Wrinkles
Creating the enVy® Pillow was only part of Kim's mission. She also believed it was important to educate both healthcare professionals and the public about the role facial compression during sleep may play in visible aging.
Kim has authored peer-reviewed articles, including "Treating and Preventing Tissue Shift and Wrinkles Caused by Compression" published in the Journal of Aesthetic Nursing and "Assessing Lines on the Aging Face" published in Plastic Surgical Nursing. These publications explore the relationship between sleep position, facial compression, tissue shift and the aging face.
Together, Kim and Kathy also presented "The Truth About Sleep Wrinkles" at the World Congress in Warsaw in 2014, helping bring greater awareness to the role sleep position can play in facial aging among aesthetic professionals.
Today, awareness of sleep wrinkles and facial compression has grown significantly, but Kim's message remains unchanged: while many factors influence how our skin ages, reducing unnecessary facial compression during sleep is one practical step people can take to better support both their skin and their sleep.
The Solution: A Sleep Wrinkle Prevention Pillow
After 2.5 years of research and development, Kim with her business partner (a fellow nurse with background in plastic surgery, burns, cranial facial surgery and a personal history of spinal surgery) designed and patented the first Anti-Wrinkle Pillow of its kind. Patents are currently in Canada, USA and Europe .
The enVy Pillow is a chiropractic ergonomic pillow with a Class I Medical device designation by Health Canada and designed to keep you off your face when you sleep on your side… decreasing the amount of tissue compression and shifting we experience while sleeping (see photo below).
“Pressing your face into a pillow for eight hours every night can lead to lines, sagging and asymmetries caused by tissue shift and compression” - Kim Renton RN, Co-creator of the enVy pillow.
The pillow is designed to off-load unnecessary weight from your head pushing your delicate facial tissue into your pillow while you sleep. It can soften and prevent sleep wrinkles depending on the depth and severity of the wrinkles and complements any and all facial rejuvenation and enhancements. Additionally it has been well received in the health and wellness arena for relieving headaches, neck pain, TMJ pain etc.
The Nurses Enter the Dragons’ Den
The enVy™ pillow has been featured twice on Dragons Den, first in 2015 when the two nurses turned down 3 offers to partner because the other 2 Dragons said NOT TO! And then returned to the Den in 2018 when they were asked to come back as one of the unforgettable pitches on the show. The now infamous photos of the two nurses demonstrating what happens to our smushed faces when we sleep on them every night has been shared across social media platforms. Their appearance was a great way to showcase the pillow which continues to become the Anti-Aging Pillow of choice across Canada and the USA and offered by over 400 clinics as an amazing value added to any treatments and procedures.
Kim continues to educate and speak on the effects of sleep on our skin health and well being and, together with Kathy, are always finding new and innovative ideas to make their products even better. The enVy Pillow complements the handiwork offered by the many aesthetic and wellness professionals who carry this medical device in their practices.