And I would like to thank the American Acupuncture Council for this opportunity to speak to you today about facial cupping and GuaSha for neuromuscular facial conditions.
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Hi, my name’s Michelle Gellis and I am a board certified acupuncture physician. And I would like to thank the American Acupuncture Council for this opportunity to speak to you today about facial cupping and GuaSha for neuromuscular facial conditions. Can you go to the first slide please?
So a little bit about me. I am a former faculty member and clinic supervisor at the Maryland University of Integrative Health, and I was there for almost 20 years. And I’m currently on faculty, on the doctoral faculty at Yoan University in Los Angeles, California. And I teach facial and cosmetic
Acupuncture continuing education classes and have been for almost 20 years as well. So the, I wanna start out today by giving a definition for a neuromuscular facial condition. So what a neuromuscular facial condition refers. To is any group of disorders that affects the nerves and the muscles that are responsible for moving the face, our facial expressions, and also any sort of pain or neuropathy, any sort of dysfunction or abnormality that affects the neuromuscular system.
Which involves the communication between the facial nerves and the muscles that control the face. And our face is the only place on our body where the. Muscles are directly connected to the skin and as a result, we can move the skin on our face without having to move a joint or any other part of the body.
And this brings with it some very unique . Issues such as particular conditions, which can affect either one or both sides of our face and some of the more common . Common neuromuscular facial conditions that I’ve seen in my practice over the years are Bell’s Palsy and also any sort of facial nerve paralysis.
You’ll see this frequently, people who’ve had facial surgery or an injury, myasthenia gravis, which is a degenerative condition. Involving the muscles and it is almost always noticeable on the face as well. Hemi facial spasm, which is any sort of twitching or spasming of part of the face, T M J, which involves the temporal mandibular joint.
Trigeminal neuralgia, which is a very painful neurological condition involving the trigeminal nerve and posis, which when we’re talking about the face, typically involves one or both of the eyelids. So today I’m not going to go into depth about . Different modalities for treating these diseases or about the diseases themselves.
But I am going to talk about facial cupping and gua and how and why these two modalities can be a wonderful compliment to other . Things that you might be doing, your body points, perhaps some facial motor points, submuscular needling, scalp acupuncture, things that you might be doing to help the face to get back to normal functioning.
So here is just a couple of photos from some of my classes me teaching facial gu Shaw and facial cupping. So first I’m gonna talk about facial cupping and the benefits of facial cupping. Facial cupping helps to bring blood just like . Cupping on the body helps to bring blood and cheese circulation to the muscles.
Facial cupping helps to bring blood and cheese circulation to the muscles and therefore to the skin, which means that when the extra blood circulation comes up to the skin, it . Increases the fibroblast activity, and this will stimulate collagen and elastin production. So this is more of a cosmetic benefit.
I. But having that extra collagen can be beneficial. Also, if someone has had long-term paralysis and they’ve lost collagen in their skin and their wrinkling of the skin, doing the cupping can help with that. It also relaxes any tight fascial. . Fascia fascial tissue that is on the face. And by releasing and relaxing the fascia, the face can move more smoothly and function better.
Facial cupping and gua can release nerves that have become entrapped on the face sometimes. . Wi woven within the nerve, the muscle sometimes within the fascia. Cupping helps to move stagnant lymph out of the face, which can take toxins with it and helps the. Reduce inflammation, which can help the nervous system of the face.
It also helps with inflammation on the exterior of the skin. If your patient has redness, heat signs, rosacea, eczema can help with that. And also, just like with any cupping that you would do on a patient facial cupping helps to strengthen the vascular integrity of the face.
So this is a cross section of the cheek. And you can see here we have the skin and then some subcutaneous fat. And then below that is this . S what is called the SMA layer. It is the superficial muscular aporetic system, and this mimetic muscle helps to get the signals from the nerve into the muscle, out to the skin, and it is what allows the skin on our face to move below that.
We have and it’s invested in various tissue and surrounded by fat, and then below that we have a facial nerve. Then in some areas of the face, on the fattier parts of the face, we’re gonna have more fat and then more muscle. This is a picture of a fass of fascia. If you’ve ever taken let’s say chicken and you’ve pulled it apart, that really tough fibrous stuff that you have to cut with a scissor to get the meat off of.
That is fascia and what can happen, especially if there’s paralysis. But sometimes just with aging, the fascia can become very stiff. It can get moved into a place where it really shouldn’t be. It can pull down and . Nerves can get trapped in there by doing facial cupping and facial guha. You can help to break up some of these adhesions and allow for more free movement in the face.
The cups, when you’re doing facial cupping there’s certainly a lot of options for cups out there. The ones that I like are glass cups. They’re much smaller. You could see the size. I use these two sizes depending on where I’m working on the face. But the cups are . Glass. And the reason why I like glass over silicone or any of the other materials, plastic is one of the most important things when you’re doing cupping, is that the cups can glide.
You don’t wanna leave marks on the person’s face. You don’t wanna leave cupping marks. So it’s not like cupping other places in the body where the person is gonna be left with cupping marks. The cups have gotta be able to move and they have to be able to grab enough of the tissue to make a difference.
So they have to be large enough to actually get in there and get that blood and tissue moving, but not so big that they’re too big for the face. So these are the two sizes that I like. And then the rubber part of these . Cups. It fits well in a hand and is easy to squeeze if you’re doing a lot of facial cupping during the day.
If the cup is too hard to squeeze, then it could be very difficult. Your hands can get sore and no one wants an acupuncturist with sore hands, . The Guha tools that I like are made out of Jade and they have different edges on ’em. And when I talk about Guha in a second, I’ll go over that, but there’s like a use shaped section.
There’s a little nobby section on the tops, and then the sides are flat for working on other parts of the face. , there are some contraindications with facial cupping and gua. You do wanna be cautious if your patient has very high blood pressure that’s not controlled well. It can bring a lot of blood and she and energy up to the face and the head.
If the person is on anticoagulants or just has a condition where they. Bruise easily. This could be an issue because even though you’re trying not to make any marks on the face, I. When you’re dealing with the face, the skin is thinner, the tissues are more delicate, the vessels are thinner and more delicate.
So this is something you need to note. If the patient suffers from frequent severe migraines, then facial cupping and gu. Again, brings a lot of energy up to the face and head. It can be an issue if they have a pustule acne. You don’t wanna be running the cups over that. If they’ve had any sort, I. Of treatment done on their face, microdermabrasion, lace, or Botox fillers.
This is a big conversation and I go through, in, in my classes, I go through all the contraindications and all the different types of fillers, but basically in a nutshell, for the purposes of today, if they’ve had any sort of treatment done on their face. , their skin and their face has to be healed.
And in order for you to start doing cupping and you never wanna do cupping over an area where there’s been a neurotoxin like Botox ’cause it can make it wear off or move it. The, for facial herpes, I have never personally had . A person breakout, but it’s certainly a possibility. And then if they’ve had recent dental work or any sort of facial surgery, you want to be gentle maybe some light cupping, but definitely not using guha tools over the area.
So the symbols that I use in my cupping instruction for the slides that you’ll see, I have an X that I use for suction and release, and O if you’re just suctioning and then a line if you’re dragging the cup. So in this example, when you start out, and I’m not going to go through all the steps of facial cupping, but I’m going to give a few examples.
So the first thing you do is you’re going to do a lymphatic drainage. So you would take the cup and you would suction and release down the neck. When you get to around kidney 27 under the clavicle, then you’re gonna drag the cup. Over to the lymph node, which is right around lung two, and you would do this like three times and then you would move to the next area.
I always work on one side of the face and then the other when I’m doing facial cupping. The next would be a suctioning, and then dragging the cup over different parts of the face that have been affected by the paralysis. Now, if the person is having facial pain, like trigeminal neuralgia, you would not want to be doing cupping over the areas that are tender.
In this example, , If the person had Bell’s Palsy, you would be working the cups along the stomach line to help with any facial movement in those areas. In this picture I’m showing you can suction and release and you can drag the cups around the lips, stopping at different acupuncture points and stimulating them, and this is good.
For patients who have any sort of disharmony around the mouth, whether it’s neuropathy or any sort of tension in the mouth, and this can help to release. The orbicularis oris muscle for issues with the eye, things like ptosis, any sort of drooping with the eye, or any sort of inability to open or close the eyes.
You can work gently inside the orbital rim. You don’t wanna point the cup at the eyeball, but gently working around. The orbital rim in order to bring energy into this part of the face. And the orbicularis oculi if the person can’t raise their eyebrows or if the person has a lot of tension in their eyebrow, in their forehead, if they’re having any sort of
Twitching in this area. Then you can go to yin to and suction and then drag the cup up to do 24. Do the same with you Y up to gallbladder 15 and then San Joo 23 up to stomach ache. Next is facial gu sha for facial Gu Shaw. The benefits are that by doing the gu sha on the face, it helps to clear wind, which is part of the metal element and can help with the skin metal and skin, and can also clear the wind, which
Is involved with facial ticks. Also, it helps to expel fire and invigorates the blood. Harmonizes the blood. The Jade gu sha tools are wonderful. They are very much a part of Chinese medicine. I. Only use Jade on the face for this reason. Works with stagnant blood and also helps with microcirculation and does this by causing some microtrauma, which again helps with collagen production.
So here is that tool I was talking about. This is a Jade guha tool and has different corners, this U shape and then flat sides, and then these massage corners. For specific acupuncture points, the technique that you’re going to use are very large scraping strokes, so you’re going to do it gently, evenly, and steady.
I tell my students, you go for the gu, but not the Shah. You don’t wanna bring up all that redness. They’re not going to look like they’ve had Guha, but it will . If you work in one direction other than in between the eyebrows, you can go a little more vigorously, but you are going to release some of those fascial adhesions, really get into the muscles, stimulate acupuncture points, and this is wonderful for young.
Younger patients, needle phobic patients, people who really need to be treated on their face, but are a little reluctant to have needles put in their face. So here’s an example of what it might look like if you were doing gu guha. Now, when I do facial guha, I use two tools and you’re going to put, for the cupping and guha, you’re going to put
Oil. The oil that I use that I like is all organic and vegan. It has C, B, D and Arnica in it, and it allows the tools to glide well without clogging pores. So you’re going to start at l i 20 and you can. Massage there, and then you’re going to move the tools along the sides of the face, and this will break up any sort of stagnation or disharmony that’s going on within the muscles.
And really invigorate the blood and the chi in that area. Same for the eyes. You can massage a bladder two and then use the U part of the tool around the orbital rim and around the braille. I really like, especially for wrinkles between the eyebrows, but . Even if your patient is just having a lot of tension in between their eyebrows, really getting in there with the in tongue, can I.
Relax, the corrugator muscle, the procerus muscle. It allows everything to ease up. It’s great for your patient’s mental health and my patients that have come to me with various sorts of neuromuscular facial conditions from Ms. Myasthenia gravis Bells. Even ptosis, this really can allow the face to relax and when the face is relaxed, it can function better.
I. One of the last steps that I do is I take the flat sides of the Guha tools and I work all along the temporalis muscle and the trigeminal nerve, the facial nerve they can all . Have some disharmony and dysfunction if the temporalis muscle is tight or tense, if someone has T M J or if they have trigeminal neuralgia and you really can’t get in there and work on their face, you can still work on the temporalis.
Relax the temporalis and this will relax their face and their jaw. The very last step that I do is I turn my patient’s head to the side. I start at the base of the Oput and I work all the way down right to the shoulder, right down the trapezius, pressing fairly hard in one direction, and this will release the back of the neck, which releases the occipital frontals, releases the face, and it really is a very relaxing way.
To end treatment for your patients.
If you have any questions about anything that I talked about today, you can put them below and you can also go to facial acupuncture classes.com. My classes are listed there and there’s also a Contact us button, which you can use. So I want to thank the American Acupuncture Council again today, and if you missed any part of today’s recording, you can go to the link and catch us there. .