Facial Fascia: Appearance and Function



And I am going to talk to you today about facial fascia and what it is and how it can affect your facial acupuncture treatments and how it can affect your patient’s appear.

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Hi, my name’s Michelle Gillis. I am an acupuncture physician and I teach facial and cosmetic acupuncture classes internationally. And I am going to talk to you today about facial fascia and what it is and how it can affect your facial acupuncture treatments and how it can affect your patient’s appear.

So I wanna thank the American Acupuncture Council for this opportunity, and I need to see the first slide.

So what is facial fascia? That is going to be the first thing we talk about today, and after that we will discuss how it affects your facial appearance. and the movement of your face. So it’s not just about cosmetic, but also how your face functions, and then some treatment modalities, things we can do in order to affect the function of the face by treating the fascia.

So facial fascia is composed of two layers, and the first is the superficial facial fascia, and that is On the outer layer, and that is, it’s right underneath your skin and it helps to support your face and hold everything up, and it’s responsible for giving you a youthful appearance and. It also can carry a lot of tension in it and restrict circulation to the face so things can get trapped, whether it’s lymphatic fluid or blood.

And even some of the superficial nerves. Then we have the deep fascia layer, and that kind of forms a girdle and it is called the mass layer, the superficial muscular epi neurotic system. So the superficial layer itself. Has the superficial fascia itself has two layers. It has the outer layer, which is this kind of fatty layer, and then we have the mass layer, which is right here and.

That is what allows us to make facial expressions. It takes the nerve impulses from deep and sends them out to the muscle, which then translates out to our skin.

So the superficial. Fasha layer is what is responsible for our facial expressions. And the deep fascia layer, which includes the fascia of the temporalis because the temporalis is connected to the face the parotid fascia, which goes down into the neck. The periosteum, which works around the part of the skull that connects to the face.

and the septum, the area around the orbit or the eye area. And this is where the deep fascia exists on the face. So here’s a. Pictorial representation of a piece of bone and a muscle and the skin. And the reason why this is important is because our face is the only part of our body where the skin is connected.

To the skin layer is connected to the bone through muscle, which is why you can move the skin on your face without having to move. Any part of your face so you don’t have to move joint in order to move the skin on your face, everywhere else on your body, if you wanna move the skin, one of your body parts has to move.

The skin can’t move Separate from the the body part.

So one of the things that can happen is, so here’s the bone and here’s the fat and the muscle and the skin. And what can happen is, so as the muscle contracts, the skin gets pulled towards the bone and we can get. Kind of wrinkling of the skin, right? If you smile, if you raise your eyebrows, if you pull your eyebrows together, if you purse your lips right, you can purse your lips without having to move any bone at all.

Just by moving the muscle, the ais ORs, and what can happen is, We can get these fossil adhesions, which are like scar tissue. They can happen as we age. They can happen through injury, they can happen through overuse or underuse. And it’s this very fibrous collagen fibers. It’s like if you think about, if you have like a chicken.

And you pull the chicken away from the bone. There’s that layer. It almost looks like really a strong cobwebs, and those fibers can. Trap nerves and blood and other things. And they can cause these adhesions where it can prevent the full expression on our face of different facial expressions, the full movement and.

Like if an individual perhaps had a stroke and things, or Bell’s palsy and things don’t move for a long time, then you have to physically get this area moving because of these muscle adhesions that can form. So here’s the bone. Here’s a piece of bone, and here’s the fascia, and here is a nerve, which as you could see, could get trapped in the fascia and it could prevent the signaling so the muscle won’t even.

The signal that it needs to move because the nerve is trapped or it can reduce. The ability of the muscle to move well, and it can also restrict blood flow. You can see there’s veins that could also get trapped. So here’s a picture of someone with Bell’s Palsy. They’re making a facial expression with the right side of their face, but the left side of their face isn’t moving.

At all, and part of this is due to nerve damage, but it can also be from entrapment

and wrinkles. When we think of wrinkles, we think of something that happens as we age, and in many cases it can be from sun damage, it can be from just the skin getting older, but also if you habitually make an expression and the skin is attached to the fascia. If that fascia is restricted at all, then you can end up with these deep wrinkles.

We see it a lot in people’s far heads and even sometimes around the eyes with crow’s feet or the lips. And also with jowling. , and I’m gonna talk about a couple of ways that we can help with this, but sometimes wrinkles and sagging are reversible just by doing things to the fascia layer. So here we have an example of forehead wrinkles.

Perhaps this person made the expression where they raised their eyebrows a lot. Also, this is when I said jowling. This is what is referred to as a jowl, and it can happen through the aging process. Things loosen and they become a fixed into a new position. Sometimes it’s from excess weight on the face, sometimes it’s from habitually frowning.

And When I was young, my mother used to say to me, Don’t make that face. It’s going to stay that way. And there was actually a lot of truth to that. A lot of our facial expressions get etched on our face over time.

So what are some of the treatment modalities that we can use in order to affect this fascia? On the face. One very effective treatment is facial cupping. Now, facial cupping is something it’s a skill that you would need to learn. It’s not like cupping on the back. You don’t want to try to use your glass cups and cup the face the way you would’ve back, or a neck or a shoulder or a.

Facial cupping uses small cups. and they look like this. And you would use these small cups and oil and you would glide these cups across the skin. You don’t park the cups and you do it in such a way that encourages lymphatic drainage. And works with the anatomy of the face. And this is a cupping set that is made by Oculus Skincare.

And so there’s a slightly larger cup and a smaller cup for different types of wrinkles and. Rubber part is very easy to squeeze so you can squeeze and move and release and squeeze and move and release, and really keep that chi and energy going. Facial Guha is also another technique that we can use.

And here are some facial guha tools. You can see that they are these are made out of Jade and they’re specially shaped to work around the gel. The cheeks to work along the temporalis and underneath the chin, across the clavicle. Lots of places where we can get these adhesions and by. This kind of physical movement of doing the cupping and then the guha afterwards.

You help to keep the lymphatic system of the face moving, the blood and the chi moving, and also to really get in there and break up those fas adhesions, especially with the guha tool on the forehead. You can spread the wrinkles and you can really get in there and break up a lot of that tension and that tight fascia.

So this is a picture of me just doing some gua along the jaw, jawline, sculpting the face, helping to lift everything up.

And the next technique that we can use, which is very beneficial for submuscular needle, for treating facial fascia is submuscular needling. and this is a technique where you would work on different areas of the face. And I teach a whole class just on submuscular needling, and it involves taking your needles and getting.

Underneath the muscle. So you’re really getting underneath these memetic muscles. I’ve lost my mouse. Where’d they go? You get underneath the memetic muscles. And you’re going to needle right through and down. And this can help get into the superficial fascia and then into some of the deeper fascia depending on which part of the face you’re working on.

And you would insert a few needles. Underneath the muscle, depending on what part of the face you’re working on. So I have a quick video that I’ll show in a moment, but you can use this to work. Underneath the mace here, you can use this to work along the attachment points for the pla. You can work into and underneath the anterior digastric.

You can work underneath the corrugator muscles. You can work underneath the frontals muscle. Pretty much any muscle were on the face where you have access to the margins of the muscle you can get underneath there. And this can really effectively break up some of those fossil adhesions, which is really quite wonderful.

And let’s see. I don’t know if you’ll be able to hear this, but you can see it and I can talk through it.

In needling, the frontalis muscle, the. Way that you isolate the muscle is you ask your patient to raise their eyebrows. Go ahead and raise your eyebrows. Okay? And then, so this is the frontals muscle and you can find the border of the frontals muscle. And the way that you needle is you’re going to go.

From the origin to the insertion, so you find the borders up here in the insertion is here. And typically what I do is I will put in usually three needles, and then you get right underneath the muscle lateral on either side and. I will put in two needles on the medial side, and when you’re needling, what’s important is that the angle of the tube is the angle that the needle’s gonna go in.

So if you go like this, it’s gonna go too deep. If you go like this, it’s going to be too shallow. I use. My thumb or a finger to help to guide the needle. So you wanna keep your fingers out of the way when you’re actually inserting. That way you can get to the correct depth right underneath the muscle.

That’s lateral side. Then you’re going to do the medial side, and usually two needles. Suffice. And I do the one side and then I do the other side and I’m using half inch noodles. You can use one inch noodles depending on how big your patient forehead is, so you just get all the way down underneath the muscle.

And isolate the muscle and needle right underneath it, and this, you would just leave the needles in for anywhere from 15 minutes to a half an hour. And this is especially helpful. Let’s say your patient has Bell’s Palsy or some sort of facial paralysis. You can do it on both sides. You can do it on one side, wherever the muscles are affected.

This is just a list of some of the classes that I teach facial and cosmetic acupuncture, facial cupping. A lot of what we talked about today is from my treating neuromuscular facial neuromuscular facial conditions class. I do some self care for acupuncturists safety ethics, microneedling. And a lot of the techniques that we use for cosmetic acupuncture can also be beneficial for treating neuromuscular facial conditions like osis.

Or if someone’s had a stroke, TMJ and vice versa. A lot of times when you’re working with a neuromuscular facial condition that your patient might have, it also helps to benefit the Movement of their face and therefore their skin will look healthier and more vibrant. So I think that’s everything.

I wanted to thank the American Acupuncture Council again, and next week we have Matt Callison and Brian Lao, and I hope to see you again next.