Ethical Concerns in Facial and Cosmetic Acupuncture



So as acupuncturists, we are all required to do some ethics training.  Things will come up when you’re dealing with taking care of your facial and your cosmetic acupuncture patients that are a little different than your traditional patients.

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Hi, my name’s Michelle Gellis and I would like to thank the American Acupuncture Council for giving me this opportunity to present on Ethics in Facial Acupuncture. I’m ready for the first slide.

So as acupuncturists, we are all required to do some ethics training. And over the years I have a full acupuncture practice and cosmetic and facial acupuncture practice. And what I have come to know to be true is that frequently. Things will come up when you’re dealing with taking care of your facial and your cosmetic acupuncture patients that are a little different than your traditional patients.

And so I put this I put a course together it’s a two hour CEU course to cover. Facial acupuncture, ethics. And this is an overview of that little bit about me. For those of you who don’t know me. I was on faculty with the Maryland university of integrative health from 2003 to 2021. And I teach facial acupuncture classes internationally.

Here are some of my publications. You can look them up. On my website, which is facial acupuncture, classes.com and there is the NCC a O M code of ethics. Now each state will have its own code of ethics, but since this is a nationally broadcast show, I put up the NCCC Aon, a O M code of ethics just as a guideline.

And in a nutshell, the code of ethics state that you will work within your scope. You will practice integrity and respect, and you will also. Participate in events like this that helped to contribute your learning. And so the topics I want to talk about in the time we have together is an overview of communication.

So the ethics of communication, how do you see. With your patients in an ethical fashion, the ethics of contract. So having integrity between what you say and what’s in writing, how to document with your facial patients and then the ethics of touch when you are when the face is concerned. Under the big umbrella of ethics of communication, our listening skills, which I’m going to talk about in a minute.

And then really that goes to understanding your patients. And this can be unique when it comes to. Facial acupuncture because we have in, or we may have in our heads, some ideas of how we think about aging, but how do your patients feel about aging? What does it mean to them? Where did they get those ideas and letting them communicate to you?

What they are unhappy with as far as their appearance and what they’re happy with and not projecting our thoughts and our ideas on aging and appearance onto our patients. So this all comes back to listening skills. So the Chinese. Character for listening effectively is the ear and the king. So the ear above the king the number 10 or maximum the eye and the number one or single, and then the heart.

And essentially what it means is. When you’re still, you listen with the heart and the ear is worth 10 eyes. Tic not Han had said an hour of mindful listening can change the life of an individual. So what does it mean to be a good listener? When I was teaching at M U H a. Used to give a one hour lecture just on listening skills.

So here are some of the highlights a an Indian philosopher had said that to observe. Without evaluating is the highest form of intelligence. So to be able to be in the presence of our patients without putting our values and judgements on whatever’s going on over there, and then being able to listen to them is.

The most, one of the most important things when we are doing cosmetic acupuncture, it is very human to have our preferences and our opinions, but letting go of the sheds, the expectations, the beliefs, the judgments can be very freeing, both for your patient and for yourself, not interrupting. So putting yourself on.

Just let them talk because every time you interrupt them, you give the message that what you have to say is more important than what they have to say, and it can cause your patients to shut down. Being a little more quiet, providing where you assurance paraphrasing what they said, these will encourage talking, denying.

If your patient says something is a concern to them making light of it or saying, oh, don’t be ridiculous. That’s not a big deal that will cause them to shut down, interrogating them. And this doesn’t mean question asking, it means really bombarding them with questions. To the point where they’re not comfortable.

Advice-giving people come to us for a certain amount of our professional opinions, but too much advice giving patients will shut down and then psychoanalyzing your patients. If you are a therapist that. They should be coming to see you for that. And many states, I don’t know about the laws in every states, but in many states even if you a licensed therapist, you’re not supposed to be doing psychoanalysis in your treatment room, they’re two separate things.

So listen for their feelings, ask them, don’t tell them And what you think or what you feel really get into how they feel about different things. And this will give you information about where and how you should be approaching treatment as far as their eyelids their jowls, their lips really listen to what it is they’re saying.

I’ve had patients come to me with concerns that really weren’t that obvious. And through questioning and listening, I come to find out they had something else going on in their life. And so this drooping, eyelid or thin what they felt were very thin lips a wrinkle or something. Really was not that apparent became a big deal to them because that’s what they were focusing on.

Let them tell their story. Even if you have the same story, keep your story sharing to a minimum, your stories that you share should be teaching stories. This is not a conversation that you’re having with one of your friends. This. About really drawing a picture in your mind of where your patient’s coming from and being able to listen to what it really is they want.

So paraphrase and check in with your patients. Each of the 800 words that we use on a regular basis. Has an average of 17 definition. So if you’re all unclear, check in with your patients, listen between the words. People really want you to hear what they’re not saying. And this can come through with their tone, their body language, let their face be the guide to your understanding of.

What they’re saying, listen to those incomes for in consistencies. Are they telling you how happy they are about something, but they’re all slumped in their seat. Make observations about these types of things. Really getting a picture of what your patients want. Why they are coming to see you.

This all falls under the umbrella of respecting their dignity and in order to set realistic goals and outcomes,

you want to be able to like over pro over. Under promise and over deliver. So when you’re telling them how you’re going to help them with any concerns that they have. Have integrity in what you say, let them know what are realistic expectations and stay within your scope of practice. If someone is asking you to do something, that’s not really in your wheelhouse, just refer out.

American acupuncture council does require that you get training. In cosmetic acupuncture by someone who they have deemed appropriate to teach you cosmetic acupuncture is not just something you can learn. By yourself by watching YouTube videos or just making stuff up. There are certain country for indications and precautions and guidelines for cosmetic acupuncture.

So respect the dignity of the patients who come to see you. They need to understand that this is a safe space, that if you were going to use any before and after photos, it would only be done with permission that you are going to check in with them every step, along the way. Everything that happens in the treatment room is confidential and really keeping appropriate boundaries.

Also things like gender and race diversity. People’s sexuality. So much of this is tied into our appearance and have that in mind when you’re talking to people when they’re discussing a body part, certain races of people have we all have different face shapes and. Certain individuals might want their face to look more Caucasian or less Caucasian or their eyes to be more round or less round.

These are all things we can actually work with, but again, use the listening skills, understand what’s going on for this person. And it will guide you. With your boundaries and how you are communicating, setting realistic expectations is really important. There’ve gotta be verbal expectations on the phone written expectations.

When you’re talking to the patient, you write down what it is that they’re expecting, and then you have to communicate to them. How many treatments might this? What might the results look like and be clear and honest about this. There are a lot of things that go into setting these expectations. And when I teach my cosmetic acupuncture classes, we go through quite a bit of there’s quite a bit of learning around.

How can you determine what the outcome might be? And some of those things are your patient’s diet, their lifestyle, their genetics, their actual chronological age, their constitution type from a five element TCM perspective, their TCM diagnosis, and then their history. Have they spent a good part of their lifeline out in the sun.

So this is all part of the big picture because not everyone is going to get the same results. General rule of thumb is people are going to come once or twice a week. And then you reevaluate after six to eight treatments. And. For most individuals, they are going to be looking at 12 to 20 weeks of treatment and then maintenance people are going to continue to age for someone who’s younger or has less signs of aging.

They may need fewer treatments and it goes the other way as well. So how do you talk to your patients? Cottage medic acupuncture. What can you do? How does it work? This is a pretty extensive list, but it’s certainly not comprehensive. And that is, it works with your body. I always do body points.

When I do cosmetic acupuncture, it works with the face. It brings blood and cheat to the area. It increases circulation. It helps your digestion. And if a person has had a facelift and they are fully healed, like a year out, it can help their face lift last longer. And improved digestion immunity, circulation, and is going to carry nutrients out to the skin, helps to create collagen and elastin in the areas where needles have been inserted.

But it does take a minimum of 28 days to produce collagen. So it’s not a one and done and. There are things that contribute like facial expressions. And as I mentioned, lifestyle, that can cause a lot of these conditions or signs of aging. And if the person continues to do it, it can take a lot longer.

So when you’re talking to them, you set the realistic expectation. You find out from them what they would like to accomplish. You go through your TCM diagnosis and if they’ve had any outside treatments done, they must speak to that person to find out when it’s okay for them to have acupuncture and everything should be documented.

Everything that they say. If they’ve had Botox, any sort of surgery on their face. Injections lasers, peels, all of that stuff should be documented. And then what it is they would like help with and what your treatment plan is, and then go over it with them.

As far as contra-indications major ones should be screened for on the phone. Things like high blood pressure migraines debilitating or severe health conditions seizure disorders, epilepsy, hepatitis coronary disease, some of the. Or red flags. You wouldn’t even begin with the patient. Others. You can still have them come in, but you would have to discuss a treatment plan with them.

And it may be that you have to treat them for the condition for a while before you start the cosmic. Acupuncture, cosmetic acupuncture can make Botox wear off. You cannot do cosmetic, or you should not do cosmetic acupuncture on individuals who were pregnant. And just because of the way cosmetic acupuncture brings energy up to the head, it can bring on.

Migrants as far as documentation, of course, I’ve mentioned notes, how and when to take photos is important. We don’t have time for that here, but it’s an important conversation. You can visit my webinar for the expanded version, but I do recommend strongly that you take before photos. And then privacy.

Any previous procedures, how to know if they’ve had certain things done and then how to talk to your patients about it regarding touch when you’re working on the face Lillian bridges have. Said that treating the face is trauma work. And whenever you’re working on someone’s space, there is because all of our emotions are stored in our face.

There is the possibility that things will get released at sometimes resolved, but there’s the emotional aspects of the face. And then any sort of. Deformity scars, acne scars. If they’ve had skin cancer, car accidents, these types of things are shown that we don’t cover our faces up. So when you’re touching someone’s face, when you’re working with their face, be mindful of all of these things.

And I always do a follow-up after the first time I meet with a patient. I contact them within the next day or so. Although bruises are in my experience, fairly uncommon they can happen. So you want to find out how they’re feeling, how the experience was. Did they get any bruises? And I always talk to them about that ahead of time.

So there’s no surprises. So you have to prepare your patients upfront for any Contra indications. And always screen them for the precautions. And here is a list of all of the courses that I offer. They are all offered as recorded webinars. And I also have live hands on training throughout the us, Canada, the UK and Austria.

So I hope that was beneficial. And let’s see. I can see who we have next time. Ah, next time is Sam Collins and thank you so much. And thank you to the AAC for this opportunity to present.