Tag Archives: Facial Acupuncture

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The Anatomy of Facial Aging

 

 

When we practice, we will start with the Western medical perspective and this lecture we’ll discuss facial anatomy. And then also the morphological changes that occur. The face ages over time.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, my name is Dr. Shellie Goldstein. I’m an acupuncturist specializing in cosmetic facial acupuncture. And I would like to thank the American Acupuncture Council for allowing me to be here today. It’s always a pleasure. Today’s presentation is the anatomy of facial aging. This is actually very important, particularly for cosmetic facial acupuncturist, because although we are practicing traditional Chinese medicine we always need to take into account the anatomy of the face and the way that it changes over time.

So this is. Presentation is almost the foundation of our sense skills and being able to get great results. When we practice, we will start with the Western medical perspective and this lecture we’ll discuss facial anatomy. And then also the morphological changes that occur. The face ages over time.

And then we will touch on Eastern medicine, acupuncture strategies for treating the aging face. And throughout my series with the AAC, we will break these down into smaller formats and address them individually. But today is just an overall of what you need to do in order to, and know in order to understand other lectures.

When we think about facial aging, from the perspective of Western medicine, we’re really talking about this biological process that happens with the resulting of a gradual reduction and the structural component cell function and the Chinese medicine. We think more in terms of the G and the energy and the organ systems.

Whereas from a Western perspective, we’re really going to look at the anatomical features of the face. And then the morphological changes that we see as the face ages over time. And when we think about a young phase that has a normal volume, nice and full with very well-defined contours along the jaw line and the cheekbones, that type of thing.

And then as we age these regional facial aesthetics, these units that we’re talking about begin to change. And from a Western medical perspective, those changes are mainly due to a number of factors, a reception of the bone fat tissue changes. Muscle attenuation or the changes that occur with the muscles of the face.

And then the skin gets thinner. The skin gets flacid. It develops elastosis and then we have ligaments in our face that we’ll talk about. And as those shift, they also reposition the soft tissue that it attaches to. When we look at the facial planes, we look at them and two different systems.

We look at them horizontally, and then we look at them vertically. So horizontally, we talk about the upper face, which includes the hairline and the upper hairline to the inner campus area at the top of the eyebrow. And the mid face is referred to from the inner campus plane to right below the nose. The

And then the lower face is considered right below the nose to the jaw area. And then we look at them from a vertical center line as well. So we have the very center, the vertical center line, and then moving out to the center of the pupil is the next vertical line. And then the third vertical line is right in front of the ear lobe.

So we’d go from upper to middle to lower upper face, maybe. Lower phase. And then from the center line, moving out to the center of the pupil and then directly in front of me. And these are fairly standard. There are obviously some changes that occur with different types of faces. So say a Caucasian face may have a narrow or nasal base and a larger tip projection that intercampus area widens at when compared to other faces.

Whereas in Eastern Asian face is going to have a very somewhat weaker facial structure framework. It’s a little more. Delicate. It’s a little wider, a little rounder. The eyebrows are a little bit higher. The lips are a little fuller. The nasal, the bridge is a little bit lower. And then the flaring of the nasal Alia or exists more with an Eastern Asian face.

And then the Malheur prominence in the mid face. This Malheur area. Right along here is more prominent. Lips are more protuberant and then the chin is a little more pushback or receipted for a Latino or Hispanic face. Typically the bises a zygomatic distance right in here is a little wider. The maxillary protrusion is a little wider.

The nose is a little wider and then the chin is a little more receded. And then an African-American faces much has a much broader nasal. I decreased nasal projection. The Bilac by maxillary protrusion exists where the orbital is a little more pro per ptosis, a little bit lower. And then the tissue is a little plumper, a little bit softer.

The lips are a little more prominent and there’s an increase in facial convexity. So there are so much changes, although we’re still dividing them up and along the same trajectories, both horizontally and for. When the face ages it moves from when you think of a young face, it has a very wide, upper number, upper face and upper mid face, and a more narrow and pointed lower face.

And when we look at the younger face, what we see is our eye goes directly to the upper portion of the face. So we look at eyes, we’re looking at a very high cheap, but when we look at a nice wide area and the upper face and the upper mid face, and then as we age, it moves, the weight of the face actually moves.

It drops. LA drops and then turn becomes more medial. So that in this case, as with the aging face, the weight of the face actually moves down. We start to lose, you can see along here, we lose the definition along the dry area. And the weight of the face moves from say upper and outer. So it up and wide to more medially, and.

This creates a lot of changes in the face. Then what are going to look at that right now? We know we have bone and then above the bone, we have soft tissue and in order to really get effective treatment results, we really need to understand the relationship between Eastern medicine. And the biomedical anatomy with regard to the morphological or the psychodynamic facial changes that were time.

So let’s break these down and let’s look at them as they exist from bottom to top. So deep search deep to the surface. We have bone, the basic structure of our face that holds the shape of our. On top of bone, we have muscle on top of muscle. We have fat and then superficially, we have skin. So let’s look at them.

Let’s look at what happens with bone first as we age bone resorbs, which means that it starts to break down and it breaks down from the openings that exist. So for example, the eyes get a little bit wider. The eye socket gets wider. And we’re looking at this boat. This is a CT image of two females. This one on the left.

She’s between 20 and 40. This is someone who is over 65 on the right. And you can see, and the earlier one you can see a nice squared face, open eyes. Here’s the nasal bone and it’s nice and thick and foam. And look what happens over time. The openings start to open up and get white. The F as the face itself starts to get smaller.

So the openings get wider. The skull itself starts to shrink. So it gets smaller. You can actually see it starting to push down. When the skull starts to push down, what happens? You lose the form. So the mid area, the maxillary area get shorter. The mandibular bone, the mandibular area starts to break down too.

It starts to push forward to, you can actually see this rotation, this inward medial rotation of bone that you see changes in dentation. And so we see the height of the face starts to decrease the eye socket, start to expand. You get temporal hollowing. Here’s the temple there starts to break down and get hollow.

And the piriform, this is the nasal pyriform. This is the openings that we were talking about. The nasal pyriform gets wider and we get the resorbtion of the breakdown of the mandible read in here, along the base, the maxilla on the top. And then this causes changes in your teeth, changes of indentation.

It starts to push for. And then the entire face starts to rotate and protrude. And this is what it looks like. What we begin to see as eye sockets, start to increase the nasal pyriform starts to widen the mandible. And here starts to shorten the mandibular length starts to break, to lengthen and shorten as well.

The nose starts to change and the maxillary area right in here, this angle starts to get change. You start to see changes in the height of everything which pushes the teeth. When that happens, this is what so the darker areas is where the bone is starting to break down. What happens to all of the soft tissue on top.

All of that tissue starts to, it has it’s losing its support. It’s losing its underlying foundation. So in even in a healthy tissue, it’s going to start to stag. It doesn’t have the foundation anymore. So it starts to sag and drop and move medially. As we saw. On top of bone, we have muscles. Now the faces unique, the face has two site types of muscles.

It has superficial muscles and it has deeper. The deeper muscles generally attached, like on the body from bone to bone, our bone to muscle and the deeper muscles in the face are primarily located in the mid face, this mid area. And they’re designed to move bone and it’s attachment. So primarily what we’re talking about.

Is the mandible. The mandible is the only loose bone on the body. Everything else is connected. And so the main purpose of the deep muscle muscles of the face is actually to move bone. And it’s primarily for chewing for moving the mandible back and forth and for chewing. Now the muscles on the superficial muscles are a little different.

We call them the muscles of expression are medic muscles memetic, and these muscles are different than the rest of the muscles on the face and the deep muscle the deep muscles of the face and on the body, them a medic muscles are designed to move other muscles and move the skin. So rather than moving both.

Or bony attachments, they’re going to move muscles and they’re going to move school. They’re very flat and you can see them in this cadaver. There here’s a medic muscle right here. There’s one around the eyes. There’s one here in the cheek area. Here’s one right here and then around the mouth and then the participant muscle along the neck and with age rather than atrophy, they attenuate.

So what does that mean? We think of muscles atrophying over time. And it’s mainly from lack of use, but when you think about the muscles of their face, We use them all the time. We use them with our expressions. We use them when we talk, we are eyes they’re opening and closing all the time. We are constantly using the muscles of our face.

So they don’t they don’t really atrophy. They attenuate. And when we see a tango what that means is they get short. So they move, they reduce in their amplitude of movement and they get stiff and straight. And instead of being nice and flexible and moist and resilient, they start to straighten, they start to stiffen, they get stuck or they reduce an amplitude, so they don’t move as well.

And that limited amplitude of these mimetic muscles leads to a more permanent or more contrasting. Position. Whereas we, if you look in an aging person and it looks like their muscles are frozen, they aren’t moving, they aren’t moving back and forth or contracting and relaxing. They’re stuck in their position.

And when these muscles get thinner and tighter and stiffer or straighter the skin on top of them starts to crease our we start developing a facial asymmetry and when we get wrinkles. So a lot of this is combining the changes in structure and the bone plus the changes or the attenuation of the mimetic muscles of the face.

And then we see systemic changes in the integumentary system. The integumentary system is made up of three layers. It’s made up the subcutaneous or the fat layer it’s made up of the dermis, the mid layer. And it’s made up of the epidermis, which is the very surface area of our standards. What we see when we look in the mirror or when we’re looking at.

Let’s start in the deeper layer in the subcutaneous or that fat layer. We have two layers on the body, the face we have the deeper layer and we have a more superficial layer and they look different. You hear in this cadaver, we can see on the on the surface of the the left side, this is the, it’s a little lighter yellow color, and it sits on the surface.

Whereas the deep fat is a little darker in color and it’s deeper underneath the surface of this. Regardless see that as we look at the phase and as we look at the fat in our face, the fat is what provides the structure or the plumping plumpness of. Some people have more than others, as you can see. I don’t have a lie.

But they’re all of these fat pads, we think of them as being all across the face in a uniform position. But in fact, that’s not the case. They are actually separated by ligand implements. So they’re partitioned in sex, sectioned off and held into place with ligaments. As we age changes occur.

And those, the fat we call it descent and deflate, which means that it moves as it breaks down. It starts to lose its form. It lose its integrity and then it moves. And oftentimes it moves under the eye socket. And in this fold between the nose and the corner of the mouth, it’s called the nasal labial fold.

And we see as people get older, This area begins to thick, and it’s not a wrinkle it’s actually partially due to the movement of the tissue and the muscles immediately towards the nasal labial fold. But it can also be due to fat right in here that is moving from the center of the face, into that area.

And it’s also due to just simple loss of fat in the mid-face area, so that we see a flattening or a deflating. In the mid-face area, but then we also have the illusion of being thicker in the nasal Lavia. Also what we see as changes in the upper area, the forehead, the periorbital area, the temporal area.

We start to see a breakdown of fat into this area. And then some of this also lands along the jaw. And that is partially what happens when we start to lose our jaw area are the cut that we see in our general area. We may think that it’s all skin that is starting to fall down. And in fact, some of that may be due to fat, build up along this jaw area that creates that asymmetry from side to side, but also that loss of definition in the jaw area.

On top of the fat layer or the adipose tissue of the deeper areas. We see the dermal layer. The dermal is right here in the middle. And then on top of that is the. And the dermal area is where the health of the cells develop cells begin their growth cycle at the base of the dermal area. And they begin to float up their base.

Then this nutrient of hyaluronic acid and fluid proteins, vitamins, everything that we need in order to create healthy cells occurs on the German. And floats up to the top, moves up to the dermal layer, the epidermal layer, and then spreads off. So not only do we have a number of nutrients and bathing solutions in this dermis, but we also have our our rector Pillai muscles, their muscles that we feel when we get the chills and our, and the hair starts to stand up on our.

I sweat glands, a number of sebaceous oil glands, a number of different vital substances are in the dermal area out of this. It’s composed of a papillary layer, which is a loose meshwork of thin connective tissue. And then the deeper area is the thicker layer of connective tissue. And if you look in this side image, this is connective tissue.

We’ll go into this a little more deeply, but it’s a very loose matrix, a loose structure, whereas the lower areas a little bit. And then on top of that area is the epidermis. The remembering the epidermis is that theory surface layer of the skin it’s made up of a number of different layers, seven different layers.

On the very top are dead cells. They’re filled with keratin. It’s what we slough off and we fully ate our skin. And then as we move deeper to the dermal layer, the cells are a little bit healthier. They’re a little bit plumper. They’re a little thicker. They have a little more, most moisture in them. And then as they move through the dermal cells, move through the dermal layer into the epidermis.

They start to thin out, they start to flatten. They lose their moisture. And then at the very surface is the dead keratin cells. As we age a number of things happen, one is the health of the cells that are floating up from the dermal layer up to the surface, the cell health and the dermal layer starts to change.

We start to lose the water content. They start to be a little thinner, a little drier. So they’re not as healthy as they move up to the surface. Also the structure of the dermis. Remember we spoke about that connective tissue starts to lose its integrity. Collagen and elastin are the main components that hold up the integrity of the dermal layer.

When that starts to become disorganized and break down, we actually lose the integrity of that entire dermal layer. Think of a mattress that’s thick, and as we lie on it over and over, it gets a little bit thinner and. Like we lose the integrity of our mattress. Over time, we lose the integrity of that dermal layer and then cells on the top are thinner.

They are dryer though, less subtle, they’re less plump and the entire area sinks. So here’s the mattress, here’s the sinking of the skin and the mattress. And it looks like their wrinkles been. In fact, it’s just loss of college and loss of integrity and skin aging on the surfaces. Remember that connect that.

In that connective tissue. So connective tissue is throughout fascia is a type of connective tissue and it is the most abundant form of collagen fibers in, in, in the tissue of the skin. There’s fascia on the face, which attaches to the bone, the lining of the one, the periosteum, and it encapsulates and protects the muscles and the deeper layers of.

Tissue. And then there’s a superficial and that superficial, it’s like a thin layer of say sticky film or saran wrap. So it’s a little sticky and it attaches to the muscles and then the muscles attached to the skin. And every time a muscle moves, it causes the skin to move. And that’s how we get our expressions.

And then. All of these are in a horizontal plane and then running in a perpendicular plane are our retaining ligaments. There are a number of different retaining ligaments in the face. Remember they surround and encapsulate fat, but they also are like little plugs. They hold all of the loose tissue.

That’s running in a horizontal plane. They hold it all together. So what happens as they age? They start to attenuate as well. They start to dry out. They start to thicker, they lose their integrity. And as all of the horizontal tissue starts to shift, starts to dry out. Remember turn more immediately the these re retaining ligaments start to move as well.

So again, everything moves medially, and again, we start to lose our Mallory projection, and this is what we. If you look at this is on this end on the, to the left is aging as a young face from the frontal and then side view. As we age, we can start to see shortening in the far ahead, we start to lose or flattening in the mid phase and then loss of definition along the jawline, as you can see.

So let’s look at this. So here is a younger face. Nice to see the height up here. Eyes wide, open forehead. Nice and relaxed. Now look, this is what happens as we start to age, remember everything starts to drop down, move more, more immediately. We develop that nasal labial foam. We develop a long here, the repositioning of fat loss of structure.

Everything starts to fall and then loses it. Here we see this side is a younger face. B is the older face. Can you see how the mid face starts to flatten? We start to see a deeper nasal labial fold. We start to see loss of collagen and elastin, particularly in around the mouth and loss of definition along the job.

I hear it as a. Here’s a younger face. Hirsi is the older face deepening and the nasal labial fold loss of definition. The jaw line, the corners of the mouth start to turn down. This is another conversation about muscles and the effect that muscles have on the phase. Particularly the mimetic muscles.

And then in terms of treatment, how are we going to treat this? We see this changes starting to happen. We see the the changes that are starting to occur. Some that you can change. You can’t really change bone loss. These the, that have already lost some bone. It’s very hard to change, but we can make a.

And we can do that with our acupuncture treatments. So in the link shoe, there are a numerous discussions about needling guidelines specific to the layers of the face, the skin, the flesh between the areas between that flesh and the channels and around the muscles at the local level. In the link shoe, they talk about the skin, the flesh, the muscles, the tendons, and meridians all occupied different places in the body and that different diseases respond to different methods.

And when we talk about diseases in this case, what we’re talking about is. And if illness are aging is superficial, the different needling that we do, it will penetrate and injure the good flesh. If we do not treat it at the superficial layer or we miss it, then we’re not going to get the right results.

So when we treat what we’re treating, as we talk about the superficial layers, we’re talking about the epidermis and the dermis. So when we’re actually treating them, we have to angle the needle in a way that we’re actually treating the epidermis and the dermis. So we’re actually aligning that. Very flat.

When we talk about angle of insertion, what we’re talking about is relative to the skin surface. So we would lay that needle right at the surface of the skin, and we say five to 15 degrees and we can treat the superficial wrinkles. We can treat skin atrophy. Pain. There are a lot of pain receptors in the dermal layer of the skin.

And so we can actually help treat pain by laying that needle in a very superficial layer. We can use it with intradermals. A Japanese style of acupuncture is very good for addressing for our purposes. Introducing. Japanese acupuncture to treat the epidermal and dermal layer of the skin. If we want to move a little bit deeper into the hypodermis or the fat layer, we’re going to angle it a little bit deeper, not much because remembering if you actually place your hand on the surface of your skin, if you push a little bit, you’re already at the bone.

So it’s very superficial, very shallow. So we’re going to angle the needle at a 15 to 20 degree angle. We use it for skin atrophy for any type of fat atrophy or deflating. It’s really good for prevention. For aging on the deeper channels at the muscle. If we want to address the muscle layer, we’re going to name and go that needle on a 45 to 60 degree angle.

Really good for treating muscle attenuation trumps. Muscle trauma or prevention. And then for the bone, we’re going to go right or into treating the meridians. We’re going to go at the angle of the bone, which are the more 90 degree angle. So that’s also great for prevention, any Meridian problem or trauma to the face.

So here’s an example. This is a different protocol or a protocol. This is just an example of how we might use and to the muscles in the neck area at a 45 degree angle. If we’re going to treat the meridians, we might go right into the acupuncture points on the face, a shallow noodling into wrinkles and the, into the dermis and the epidermis treating the muscles, the corrugator muscle.

You can see this deep corgi. Fold, and then 90 degrees into the meridians. And this would be a before and after picture of what you can expect to see, say, and this is a 10 treatment series. So that’s it for today. There again, I have a number of different lectures for you where we take a deeper dive into the individual.

So thank you very much. Again, thank you to the AAC for allowing me to present today. Stay tuned next week for Sam Collins. He’ll be presenting next Wednesday. He’s always exciting. Very interesting to listen to. And see you again. Thank you.

 

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Microneedling Benefits for Your Practice 

 

 

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, my name is Michelle Gellis and I am going to be speaking to you today about the benefits of microneedling for acupuncturists. I wanted to say thank you to the American Acupuncture Council for this opportunity, and we’re going to go to our first.

Over here. As this is a picture of me, for those of you who don’t know me and today as I mentioned, we’re going to be talking about the benefits of microneedling and micro needle noodling. What it is the use of tiny needles to beautify the skin. And this can be like a microneedle pen or a microneedle Derma roller, and, or what’s called a hydro roller or a Hydra needle, which is a little device where you put liquid in and you.

Infuse it into your skin directly. So all of these different devices are very modern ways of beautifying the skin, but they are based on the Chinese principles of using needles to beautify the skin, which is something that’s been done for thousands of people. And it is not just so it is preventative as well as it is restorative.

And it doesn’t just work on the outside. Microneedling if done by an acupuncturist will work on the inside as well. The principles and the practice of microneedling is almost identical to practices that we already have of either circling the dragon to treat a scar or some sort of just chromia in the scan or.

Intradermal needles or a seven star hammer, like a plum blossom needle for things such as hair loss and other skin concerns. And seven star hammers are used in Chinese medicine to treat blood stagnation, neuropathy, scars, and alopecia, but we can do the same thing with some of these other more modern.

Devices. So here is a photograph of a, what we call a dark spot or a liver spot. And Yeah, little wrinkles that might form around the lips or in the nasal labial area. Typically we will take small intradermal needles and insert them with tweezers, superficially to bring blood and Xi to the area. We can also thread larger needles and doing things like this helps to release.

Stagnation, any sort of fascial adhesions, which can cause the skin to fold and wrinkle and help to encourage the growth of healthy cells. So these are things that we can do with regular acupuncture needles. But this can also be done with a Derma roller or with a micro-needling pen. And this will mimic the, these are modern ways of mimicking some of these ancient techniques.

When I teach microneedling in my classes, I do. So as part of a holistic TCM practice, I incorporate my five element. I’m a traditionally trained five element acupuncturist, and I incorporate it as part of my. Overall system of health and wellness. So I do my diagnosis either your five element or TCM Dyke neurosis, and then you would use body points to help to build the cheap yen blood move stagnation, move, stagnant, fluid, stagnant sheet, stagnant blood.

And this is all in service of treating the outside because in order to treat the inside, you have to treat the outside and vice versa in order to treat the outside, you have to treat the inside. Here is a map of the face. And one of the principles of our medicine of course, is the connection between our skin and our internal organs.

And this is actually mapped out on the face as a microsystem where different parts of the face, when you treat them, it affects. Different organ systems.

So what are some of the things you might use microneedling for in your treatment room for a cosmetic. Purposes, it can be used for fine lines, acne scars, loose skin, and large pores, crows feet, lip wrinkles, any sort of dark spots or melasma things like stretch marks and even hair restoration. Many people have suffered post COVID hair loss and microneedling can help them.

So how exactly does it work and what does it do? From a Western standpoint, when you puncture the skin, when you make little holes in the skin, your body is stimulated to build its own collagen. Plus if there’s any products you’re using, like I showed this little Germa stamp here. The Hydrus stamped.

You can put fluid in here and infuse it directly into the skin. If you are, even if you’re just Derma rolling, or if you’re using a microneedle pen, you put your products on and then when you. Use these needling devices, these microneedling devices, it helps to infuse it because many of the products that we use, we put them on our skin and they never get absorbed.

So what are some of the benefits of microneedle Lang versus maybe some of the Western treatments, some of the more invasive treatment. That people are having done, whether it’s fillers or toxins, such as Botox with microneedling this very little downtime, it’s very low risk. It’s very effective.

There are many clinical studies many clinical studies that have been done. If you go to my website, which I’ll show you at the end. If you go to my website, you can see many articles that I’ve linked to and blog posts that I’ve written on this. So it’s very low risk. It’s very effective and it allows your body to produce collagen.

Naturally it can help with stretch marks, acne scars can decrease hair loss, encourage new hair growth. Like with eyebrows. As we get older, we lose the tails on our eyebrows can help with. Wrinkles on the neck and within cosmetic acupuncture, the neck can be a really difficult area to treat. So when you’re dealing with the neck, those fine lines around the lips crow’s feet.

So areas that would require a lot of small needles, the microneedling devices can address those. It is not painful or most cases it’s not painful. And the results last a long time. So the needles create these little micro channels and then a micro channel stimulate a healing response and collagen and elastin are produced.

And when that happens, the skin becomes firmer. Any depressed scars, start to gradually. Diminish, and this will help to smooth the wrinkles over time. You can do microneedle laying on your face, your neck, your scalp, your stomach, your thighs, your arms, pretty much anywhere on the body. You don’t want to do it inside the orbital rim on the red part of your lips or Ani, any mucus membrane.

So here’s just a little refresher. Here is a cross section of scan. And when we’re microneedling, we are just working right in this top layer here, the epidermis and the collagen induction therapy. As I mentioned, works on the wound healing responses. There is this all. Inflammatory reaction that happens.

And then the body recognizes it’s been injured and it makes nice new, healthy skin. So here’s a, just an example. This would be with a Derma pen, but it looks very similar with a Derma roller dermis stamp and you can see how it creates temporary little. Micro wounds or microtraumas, and then the body heals itself.

So if you’re already doing cosmetic acupuncture, like what are the differences and what are the similarities? So with micro needle, Lang you’re working very much on the skin level, the fine lines, any depressed scars, you don’t want to go over raise scars. With the nano needle. So there are little nano needles that you can get for the microneedle pen, which you actually can use inside the orbital rim and on the red part of the lab.

And the results happen fairly quickly. There’s a little downtime depending on how deep you go. And then the results are very long lasting up to five years with cosmetic acupuncture, your really working with the underlying causes of aging. You’re going much deeper till the muscle, the fascia you’re working with the blood and the cheek.

And it’s much better for the sagging skin jowling and your patient is going to need 12 to 24 treatments with microneedling. It’s four to six treatments and there’s no downtime with cosmetic acupuncture. So what can you expect? This is someone before treatment, during treatment and after treatment, they really should just be a little pink.

Like they have a sunburn, there should be no bleeding. Germer rolling. However can be done in your office. Or you can sell your patient a Derma roller and. Have them take it home and with proper instruction, they can do self care between treatments, which is really great. So here are some before and after pictures of a microneedle laying, this was with the microneedle pen.

So here are acne scars, and then you can see these fine lines around the crow’s feet around the eyes. And this is actually a picture of me. This was before I had done any microneedling on my eyebrows and this was after. And you can see not only is my entire brow thicker, but I have new growth in here where I didn’t have much of anything going on before.

And I don’t have any eyebrow pencil or eyebrow mascara going on here. You can see my eyebrows now. So I’ve been microneedling my eyebrows for about six months now. And I started to notice a change after about eight weeks. It was quite astounding. How do you set up your pricing? Let’s say you were already doing microneedling.

You already know all of this stuff, but you’re not quite sure about pricing and maybe how to market it. So the way that pricing is set up, typically with microneedling is. You’re going to charge per session. And depending on where in the country you are treating is how you would market your per session treatment and your packages.

Now one way that you can find out, what is a good price where you live is to maybe call some of the Medi spas and see what they’re charging. The caveat to that is I always do full body acupuncture along with my microneedling. So I put the body points in and I put, if I’m going to use numbing cream, I put the numbing cream on.

And then I come back in and take the numbing cream off and I do my microneedle. And so my patients tend to be on the table for about a half an hour. And so you want to price accordingly? Taking into account the fact that you are giving them an acupuncture treatment as well. And also depending on where you’re practicing in the country, you have to check with your local acupuncture board and make sure it’s okay for you to do packages, but you can also do a package because most people are not going to be satisfied with treatment until they’ve had at least four treatments spread out once a month.

Some other pricing options are to maybe only do the brows. Some people only want their mouth area done. Now with microneedle Lang you could do someone’s brows and then give them a. Cosmetic acupuncture treatment afterwards with the mouth area. What I have done with my patients who have a lot of lip wrinkles instead of using a lot of intradermal needles is I’ll put the numbing cream on I’ll do their body point.

And then I do any lifting points, points around the eyes, forehead, things of that nature. And then I come back in, take all the needles out in the fairs, take off the numbing cream and I do the microneedle and around the mouth, you can also just do neck and chest. You can do the back of the hands.

Microneedling is very effective for the back of the hand. And I don’t know if you can see my hands I’ve been, I am right now as of this recording, I am 60 and I hit don’t have any of those dark spots on the back of my hands. And I credit it all to microneedling because I started out many years ago when I was in my four days doing a Derma rolling on the back of mine.

Whatever CRM I used on my face, I put her on the back of my hands and then I would roll it in and then I would wash my face and it just helped everything absorb. So the vitamin C serum that I used really got absorbed very well. And I really feel like it’s helped my neck and the back of my hands and my overall.

Skin health doing the DerMarr walling. And then during the past year, I’ve started microneedling all myself with the microneedle pen as well. Also you can do knees and elbows, which Or another place where people tend to age along their elbows around their knees. And if someone has stretch marks, so these can be like standalone treatments and you can just decide how much you want to charge.

I’ve given you an idea of what I charge in my treatment space. And but you want to check around and see what’s going on with. As far as the microneedle pens, what you want to look for in a device is something that has a minimum of 14,000 RPMs. And that’s the speed. So when you’re turning it on, they have.

I could get my camera here. They have different levels and whatever speed you set it at when it’s at the highest speed, it should be a minimum of 14,000. This one goes to 18,000. Also, you want to look for that? The tip is a bayonet tip, which means that instead of just a little point of tip, it has a couple of connectors that you can put right in, turn it having a pen that comes with a couple of batteries is great.

And then if the battery does. Being able to screw it off and have a plug-in attachment is wonderful as well. Look at the warranty and make sure that the settings are easy to read that there’s a guide on it. And that you can tell. Where you’re setting the needle depth. So you’d be able to easily adjust and see the needle depth and also.

That it comes with a good user’s manual product support. And ideally it should have some marketing material that come with it. So you don’t have to go through the process of printing out brochures, coming up with information for your website, et cetera. And training, making sure that you get properly trained on whatever device you’re using is very important as well.

And so this is just talking a little bit about the side products. When you’re looking at products, you want something that is organic, so it doesn’t have chemicals in it. You will have patients that are vegan. They’re not going to want animal products or something. That’s vegan, something that’s easily absorbed.

And has properties that brighten the skin, nourish the skin, won’t clog the reporters, something that reduces inflammation, the products that I use have arnica and CBD. And and you want some after-care products for after you’ve done the treatment? I have arnica and aloe. Product that I give to my patients.

And then you want it to be slippery if it’s not slippery enough that you’re going to get drag on your device. This AccuLift skincare is my company, and I mentioned you can go to my website. AccuLift skincare.com for. Information on microneedling in general, you don’t have to be a customer.

There’s many blog posts and many pieces of information about microneedling in general. And I also teach cosmetic acupuncture classes. This is my website, facial acupuncture classes.com. All of my classes are recorded and they. Carrie CE use. I think that is my last slide. Next week we have Yair Maimon and he will be presenting for the American Acupuncture Council.

And I want to thank AAC again for having me on again, and I will see you again next time.

 

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Cosmetic Facial Acupuncture Theory and Treatment for Enhancing Dermal Collagen

 

 

And today we will be talking about cosmetic facial acupuncture theory and the treatment for enhancing dermal collagen.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi everyone. Thank you for joining us today and thank you to the American Acupuncture Council for producing and hosting this presentation. My name is Dr. Shellie Goldstein. And today we will be talking about cosmetic facial acupuncture theory and the treatment for enhancing dermal collagen. So let’s go to the slide.

Great. Okay. When we talk about enhancing collagen, and then we talk about cosmetic facial acupuncture, if this is really not a new topic, it’s based on the principles of my run, my. Rung needs beautiful appearance. And it is a holistic regime that was practiced throughout Asia for centuries. It was designed to promote systemic health and wellbeing delay, the visible signs of aging.

And it was a combination of acupuncture and herbs that were either topically applied or ingested. And that as the story goes, it was designed for emperors to keep their concubines looking beautiful and health. And for emphasis to maintain their youthful and raving appearance. But honestly, I believe that there were variations of this service of my wrong regimes utilized in most households throughout Eastern.

The today’s modern application of ancient. My rung is similar and slightly different. We generally use it today as an alternative or an adjunct to patient neurotoxins, volumizer, or other enhancing appearance enhancing services that are mostly familiar in our Western culture. I call what we do. Modern application, a tight, healthier, tighter, brighter, natural look, and feel.

And that is truly what it is when we, as a cosmetic facial acupuncturist, that one of the advantages of specializing in any type of profession is that our patients come in with a certain subset of complaints. They’re fairly common and throughout there’s, there are certainly some changes, but for the most part, Our patients come in and they talk about wrinkles increasing across their forehead, around their eyes.

They talk about eyelid ptosis, which is that drooping of the upper lid onto the eye itself, swelling or darkness under the eyes, possibly wrinkling or creasing between the brows and around the. And then in the cheek area, they talk about wrinkling in the cheek area, skin laxity, which is a loose pitted appearance, a nasal labial fold.

That’s the fold between the corner of the nose and the corner of the mouth. And then around the mouth and along the jaw. And they complain or talk about wrinkling or creasing around the mouth. Particularly the smokers creases above the lips and creasing horizontal creasing below the lips, marionette lines. Marionette lines are the lines that form between the corner of the mouth and the edge of the jaw area.

It’s a perpendicular line. And then the horizontal line is called the mental crease and it’s right underneath the lower lip. And then loss of definition along the jaw area. And then in the net, patients will talk about their skin being lax or platysma abandoned collectivism, abandoning, or these little bands that you see running in a vertical fashion along the neck area.

And then from a dermatology perspective, acne, rosacea, hyper dyschromia, which we often hear of is sunspots. When we treat with facial acupuncture, cosmetic facial acupuncture, there are both visible changes that we see and then internal changes so visibly. And this is our topic for today is toning skin laxity.

And we’ll talk about these more throughout the year, but today we’re going to focus on skin laxity. Other changes that you can see with cosmetic facial acupuncture treatment are saw. Softening of deeper wrinkles, eliminating of fine wines improvement in muscle tone, correcting and healing skin problems that we discussed, even in skin, texture, color, and luster and enhancing the overall appearance and vitality of the.

And then internally, because we are working from the inside out as facial acupuncturist will see an improvement in muscle integrity, a thickening of finning, a trophic tissue, which will ties in today’s presentation and improvement and the physical, mental, and emotional wellbeing of the individual themselves.

As we are adjusting channels, organs and other systemic impacts. When we talk about facial aging in our Western culture, we are often times used to immediate gratification. So when we are talking with our patients and working with our patients, we need to be really honest about what it is that we can actually do.

And I speak to my patients like this. I say, although the. Aging as part of the aging process, you’re not going to stop aging. It’s normal. It’s part of the intrinsic and extrinsic mosaic of aging itself. But what we can do is we can delay those signs of aging. And when we treat you with one treatment, we can see short term benefits lasting maybe three to seven days, and then generally.

When we perform this in a series of treatments, averaging 10 to 12 times per once a week, we can see longer benefits lasting between four and 16 weeks. And then we’re going to maintain the results or the benefits of your treatment with monthly maintenance treatments. And that’s approximately one time a month.

Now they may be a little bit confused as to why they’re not getting longer treatments or longer. Longer effects from our treatments because we are used to immediate gratification with longer term, say three months to six months with neurotoxins and maybe even longer with volumizes or filler. So I explain it to them as what we’re doing is we’re taking your face to the gym.

And we talk about going to the gym and the benefits of going to the gym as a cumulative effect. So you can’t go to the gym. And pump up and then expect to see large muscles, right? What you get is tired and a little bit sore. You’re not going to get tired or sore from facial acupuncture, but the concept is we are treating a giving a series of treatment to make an internal change that will last throughout time.

And ultimately you feel healthy and you feel better as well. In 1996, the first landmark study for facial acupuncture, measuring the efficacy. Yeah. Was in the international journal of clinical acupuncture. They took 300 cases. This wasn’t treated in China, that it gave them patient will acupuncture 10 treatments, one time a week.

And the patients noted a 90% market effect in terms of their subjective experience of the treatments. The benefits it’s said was there was an improvement in skin texture, stint, color, skin elasticity. Wrinkle reduction and overall rejuvenation. And also they noted that these results were not just confined to the face, but also included work from the practitioner’s point of view to address the entire body, the organ system, as well as the face.

So ultimately what we’re doing is Chinese medicine. We’re treating the body to sustain the changes on the face for appearance. And the reason why we are working in that vein is because we are traditional Chinese, Eastern medicine practitioners. And it’s because we still are applying the concepts of channel theory.

We are looking at cosmetic facial acupuncture as a whole systems approach towards diminishing the signs and symptoms of. This means that we, when we are support, when we are treating with facial acupuncture, we are treating and supporting the entire patient. That’s foundational because even though the wrinkles and the other facial concerns are the chief complaints, we are looking at it from a holistic perspective, and we know that the conditions on one’s face, the conditions that they’re talking about.

Skin laxity muscle tone. And that type of thing is really directly related to their internal health and overall well. When we treat with facial acupuncture, we’re not just working with the face as practitioners of Chinese medicine. We know that we need to consider and address all of them, energetic Meridian pathways and all of their corresponding organ systems.

And we treat them in the same way that we’re treating other conditions with acupuncture. We address those imbalances in those internal systems, digestive, circulatory, reproductive, neuromuscular, whatever it is and in doing so we are from the inside helping to diminish those visible signs of things. When we talk about these concerns, skin, laxity, wrinkles, muscle Capone, skin, dyschromia, et cetera.

We call those the symptoms. Those are just the symptoms of that underlying pattern is disharmony. And when we treat, we’re going to treat the root cause first with body points, and then we’re going to treat the symptoms. So we. Points on the extremities. And then, and along the torso, first, we do our diagnostics.

We treat the patient for their underlying condition. We apply acupuncture points on the legs, the arms torso, and then we address the symptoms or the facial concerns with points on the face. And then we take them out those needles out in the opposite direction. And that point selection on. Body is specifically related to the underlying pattern disharmony and the points selection on the face can be either on the Meridian, off the Meridian or around the associated channels.

And this is what we’re going to address today. When we think about acupuncture points, we know that acupuncture points are located in areas with higher concentration of superficial nerves. We know that there are a higher concentration of blood vessels around those points. And we know that there are neuromuscular attachments where those vessels and nerves penetrate the deep of the muscle fascia.

What we also know about points, acupuncture points in the body is that when we stimulate the acupuncture points, that sensation is transmit mid. From the peripheral nervous system to the central nervous system by the dorsal root ganglion. We also know that due to Nur, or when we look at neuro imaging, we know that there are acupoint stimulation is activity in the brain areas that is associated with that local area that we actually put the needle in.

But it also transmits into more distal areas, not on the knee, the point of needle insertion. This is important because when recently we’ve discovered that we have interstition when we first were looking at bodies and we would dissect cadavers and we would open them up and we would pull out this sheet of sticky film.

Substance and we would throw it away. Guess what we’ve been throwing away has recently been discovered as a very important structure in our body. It’s called interstitium and it is a fluid filled cavity that contains connective tissue, fascia, and fluid. And you can see this in the demonstration.

This is an, a. This top area is a microscopic expansion of what’s underneath and you can actually see that there, this whole area is the interstitium. So it’s made up of fluid fill barriers, and then it’s made up of these little structures that are more split support structures called connective tissue and fat.

Guess what? Within that fascia, we have college and college in is the primary fascial component of that connective tissue or on the face. We’re going to call it fascia. And that college in actually has an electric. Signaling component to it. It’s called college and Paz electricity, collagen fibers have this mechanical or electric property.

And it’s actually the basis for communication from the insertion of the needle throughout the fascia and into the, not just the local areas, but more general areas as well. And when we alter that college in, when something happens like aging and that college and those college and fibers get altered, it’s going to change the physiological response as that stimulation moves out into other areas of the face.

And in fact, what we’ve been looking at recently is that therapeutic efficacy of acupuncture, why acupuncture works may be linked to this, maybe linked to the ability of needle insertion in an acupuncture point to radiate outside of that local area and flow through the interstitial tissue, into other areas or other neighboring structures of the face or in the two.

Here’s what fascia looks like. You can look at the bottom, it looks like sticky film or some type of saran wrap that actually does two purposes. Either wraps around substances to protect them or connects them such as on the face from say the muscles to the upper layers of the skin and under repeated or intense stress that fascial tissue changes.

And it becomes disorganized and it decreases in flexibility and it loses its ability to signal. And if you look at this image right here, this is what college in stress looks like. This is how it changes from a more. Area, if you think of your face and you think of this area of the face and a younger person, it’s much more plump, but this is what that disorganization of college in fibers decrease in flexibility, decrease in an electric signaling and ultimately tissue breakdown.

So we’re going to look at how to change that. Here’s what it looks like in an image. And here is the superficial area or this top of the skin. On the top of our face. And as we age, it moves from the bottom, which is nice, organized, thick banding of co of college and tissue to disorganize broken down college and fibers that then create a pitting area in the surface of this.

When you think about a mattress, you think about a brand new mattress. It’s nice and full it’s, nice and plump. And as we sleep in that mattress in the same position over and over years and years later, it starts to form a little pit. That’s the same thing as the pitting effect that happens in our skin, that little dumpling or the little.

Drop in the mattress is what we see on the skin. And we start, we call that college in breakdown. And when that happens, skin has no place to go. So for the purpose of this today’s lecture, the loss of college and underneath the surfaces of skin causes that pinning and causes that skin to dry.

Now with an acupuncture needle, we can actually make a change. So when you know that acupuncture needle and creates a natural wound healing cascade to release growth factors to stimulate the production in deposition of college men in the dermal layer skin, what is that? When you look at the skin, there are the very top layer is called the epidermis and the very, very top layer.

What you look at when you look in the mirror or you look at somebody else’s called the stratum corneum and then underneath the epidermis is the dermis. And the dermis is actually the integrity or the health of that, of our skin tissue, a healthy cell. Start at the bottom of the dermis and make their way up to the top and float up to the top.

As the cells float through this tissue, the integrity or the volume of this dermal layer is supported by colleagues. And collagen and another T is elastin, but we’re not going to talk about that right now. So you can see this thick area in the top corner. There is our college and fibers and the very, very thin ones are called elastin.

And the little dots that you see are called fiberblast fiber blast. Are actually what needs to be stimulated in order to make collagen in the skin tissue and there’s research, particularly by a man named does Fernandez who has done a lot of work with Derma rolling or skin piercing with acupuncture needles.

And what he’s found is that when you place a needle into the skin you create a microtrauma in the tissue and that might . In this cascade of information to fibroblasts, I’d say, make college and into the fibroblasts, just make as much healthy colleges as they can possibly make. So it changes it from being that on uniform clumped appearance of college and underneath the tissue to lay a Ficker, as you can see a thicker line.

Of college and in the upper dermal layer and throughout the dermal layer as well, to support the upper layer of the epidermis. And we do this with needles. We do this with short needles because let me go back remembering the different layers of tissue and layers of tissue in the body. This layer, this dermis epidermis dermal layer is really the very, very surface.

Of the skin of the face. Because if you think about the pace and you just take your finger and touch your face well, before you know it your own, do you feel that before it, between the skin, the upper layer of skin and bone, you have muscles, you have connective tissue, you have nerves, you have. Your circulatory system, you have fat, there are so many layers that are between the surface of the skin and the bone.

So when we are treating this dermal layer, we actually have to have very shallow insertion. And we do that challenge insertion with small short needle. My favorite. And and also the favorite of many of the other practitioners that treat with facial acupuncture for appearance enhancement are serum.

Serums are always great needles. They, and what I like about them is the safety quality about them. Their medical grade stainless steel used around the needle shaft. They’re triple polished and clean cleansed with ultrasound and. Alkaline acid or water to remove foreign substances, and then they sterilize them.

And then the honing of them they’re specifically rounded to reduce damage in the skin tissue, because remember we’re working on paced people’s faces. There are a lot of nerve endings. There are a lot of capillaries and vessels. And so we want to use the best calling the needles that we can possibly use in order to get maximum results.

And Siron also has a line called J 15 that are specifically designed for cosmetic patient acupuncture. And on the other side I tend to use the 40 twos and 40 fours. Although some people use forties, this in this area, the one set up about, I liked. Another great line is called dong Bancorp.

Their DVCS are made specifically for low loss of LMS. This is another option. They are also well-made and compliance with the world health, our organization in the U S and then FDA approved and throughout Europe in England. Because they are the largest manufacturer of acupuncture needles in the world.

They’re much more economically priced. They’re basically a fifth of the cost of this here and needles. Many practitioners will use these needles on the body and then they’ll use the on. There’s another company that I really like in use in that called Acue fast. And what I like about them is they’re environmentally friendly.

Their packaging is biodegradable and the plastic material is recyclable. Again, they are Korean made spring handled with surgical stainless steel, their machine sharpen. There’s another, they’re just another great needle. In order to eliminate some AQI trash, they come 10 needles in a package and a bliss and a vacuum seal pouch, and they sell the tube separately.

So in some of these treatments with that, I’m going to show you or the system, you may not need a tube. And so that book, optional tubes are different. And then the other types of needles that we use to penetrate the very surface of the skin, it is the intradermal needles, either the straight intradermal needles that run in a horizontal position for insertion and a horizontal manner.

These were invented in Japan and then the press needles, go in vertically. Those were come from. There are many types of intradermals. This is a really good line. It’s called thrive. Great needle. Hard to get because they come from England. They’re triple Pall, double polished, and there’s three.

Different sizes, the gold, the copper, and the silver again, just another example of a really good line. So those in you who are from the UK are watching from another country. This, you can see I’ve put on. Bottom the links in order to purchase them, or cammo here in the U S CRN has another, the spine next intradermal needles, I think is acupuncture.

We’ve used these most of the time. And again there, what’s interesting about them is that heat sealed blister pack. And then the little ring holder, you definitely need to use tweezers with them and they make them in certain different sizes with the. PO box of a hundred needles. DBC has started to make another intradermal needle.

That’s interesting as well. Again, five needles in a foam pack, and there’s a new one coming out. This is not on the market yet, but it seemed to be there in their first line of production this year. Ella piss. I liked them a lot. But they come in there again, the high, same quality at that as serum upholds their integrity of their production, of their needles.

They come in five needles in a blister pack. What I like about them is that they’re short. But they also have handles so that you don’t need to use tweezers. For those of you like me who are somewhat uneasy, need a tweezer compromised. And then there’s always the pie. Next introduce dermal is a single press tax press tax are great.

Not all states will let you leave a needle in there, patient. So you need to make sure to contact her, find out what your regulations are. Within your state to see if you can actually leave these in your patient when they’re not in the office. And again, they come in different diameters as well. So let’s get to the treatment.

When we are treating our patients, this is what we’re looking at here. You can see in the, before, this is the image that we were looking at before you take any of those needles that you want to use, and you can treat them either on the acupuncture point S either The point rate lateral to the corner of the mouth stomach for depending upon how you can see the skin pitting, you may want to go a little bit higher, but just remember that in order to get the beneficial effects, you don’t need to be on the point.

Exactly. So what I might suggest is say, needling stomach for me again. You’re going to do your normal intakes and discover your patterns of disharmony. So if you look at this, you’ll find most people who have this pitting that have some type of a spleen deficiency. Either. We explained us digestive disorder or something like that, because if you’re looking at the stomach Meridian, it runs right through this area.

And how many people as we’re aging, don’t have some type of digestive. Disorder. So remember your spleen, remember your stomach, treat the underlying pattern of disharmony and then come back and we’re going to go back and treat this spleen area. So say stomach for, and then take your smaller needles and you can slide the.

At a 10 to 15 degree angle. Now that’s very superficial. That’s almost like Japanese acupuncture where you’re actually angling them almost parallel to the surface of the skin. So you can take those needles either the intradermals or the the half inch, and just slide them into the area of deepest pitting.

You can also write in here in the integral. And the nasal labial fold, just slide them right in there. And then that’s and then this is what I did. And then after treatment 10 treatments, you can actually see. A much bigger difference. If you have other questions about those, you can certainly let me know.

I know these are are these recordings are available and you can always contact me just to let you know that I have partnered with the Pacific college of health sciences. We offer a program called facial applications for cosmetic, and he has met, which is a much more in-depth program that you can access in the way to.

Contact us is this phone number and email below, and it’s not, we’ll be learning my techniques. We’ll be learning other techniques with other leaders in the field, such as Matt Callison, Mary Elizabeth, Wakefield, Michelle Gellis Deandra Courtney, Carrie Hart. A lot more. This program allows financial aid will be as available classes begin January of 2023.

And then again, if you have other questions, you can follow me on Instagram. Or Ann or contact me@infoathamptonsacupuncture.com. So thank you again. Thank you for the American Acupuncture Council for allowing me to present today and also please join in next Wednesday too. With Chen Yen. She’ll be presenting at the American Acupuncture Council and hope to see you again.

Thank you. Goodbye.

I do have a question. Is it there is one question, Elizabeth, thank you. The, yes the course that is being offered as a hybrid program. So the didactic component of it is online. And then there five days of hands-on clinical learning offered once or twice a year.

Do I recommend patients take college and it really depends upon the college in remembering that college in is a large protein. And it may, or if you are explained to you deficient with terrible gut problems, you may or may not be able to absorb it. That’s the clinical and the written information or that, or the more.

Therapeutic information. However, that being said, I take collagen in every day. I use a company called Vital Proteins and honestly, I see a difference in my skin. Yes and no, I hope that answers your question.

 

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Treating Neuromuscular Facial Conditions

 

 

 

So today’s presentation is an overview of a multifaceted approach to treating neuromuscular facial conditions.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, everyone. I want to thank you. And the American Acupuncture Council for hosting me. Thank you for coming today. And if we can go to the first slide, I’m going to go ahead and hop. So today’s presentation is an overview of a multifaceted approach to treating neuromuscular facial conditions. My name’s Michelle Gellis and I teach facial and cosmetic acupuncture classes internationally.

And one of the. Things that I do in addition to just the cosmetic is I treat individuals that have various neuromuscular facial conditions that are affecting them in some way. So what exactly is a neuromuscular facial condition? Essentially a neuromuscular facial condition is any condition that affects the face, either the facial movements or any sort of sensory issues such as if someone has neuropathy or pain and some examples of neuromuscular facial conditions.

And certainly some of these are not. Just, they don’t just affect the face, but for many of these conditions, the most noticeable or troublesome part of the condition can be the part that affects the face. So Bell’s palsy, Ramsay hunt syndrome. Synkinesis stroke, Tam J trigeminal neuralgia. My esteem, gravitas, ptosis, Ms.

Shingles, and hemifacial spasm.

When I approach treating and the, of these conditions, the part that affects the Fest. I, what I have learned over the years in practice is that using a multi-faceted approach. Which I will describe is the best way to really take care of the issues and especially issues that have been around for a long time and to make your treatment long lasting.

These conditions such as Bell’s palsy and. TMJ can have a major impact on the face. And so there are again conditions that have to do with more muscular movement. And then there are ones like trigeminal neuralgia, which have pain. So the modalities that I use in order to. Treat. When I say a multi-faceted approach, I will use scalp acupuncture, facial motor points, submuscular and intramuscular, needling, facial cupping, and Derma rolling.

And some of these modalities can be used in conjunction and some are better for certain conditions and some are better for other condition. Scalp acupuncture is a fairly new series of techniques that we use in our practice. It’s only been around since the 1950s and it became popular in the 1970s and essentially you’re stimulating areas of the brain that correspond to.

Functions, whether they’re sensory functions or motor functions and it’s based, it’s not based on acupuncture points, it’s based on neuroanatomy. And it is really fabulous for treating any sort of neuromuscular condition, but specifically for neuromuscular facial conditions. And if you look at the homonculus if this is a cross section of the brain and you look at the homonculus, you can see the area for the face takes up the bottom two fifths.

If you were to break it up into two feds, two fifths, and one fifth, the face takes up a huge area of. The brain and the way scalp acupuncture works is you take a needle and you insert it into the loose connective tissue and you thread it into the new loose connective tissue corresponding to the area of the scalp that you would be working on.

So here is a map. Of a couple of the different areas. So we have the motor and sensory area of the scalp on one side of the head. And then this bottom two fifths here is where you would be needling in order to affect the face.

And I’m just going to talk through this video. Let me get it going. So this is me demonstrating how to put the needle into the scalp. First, you have to measure the scalp and the bottom two fifths is what you’re going to be needling until.

So this so the motor areas in front, the sensory area is behind it. And this part of the scalp can be sensitive. So you have to be careful when you’re needling and it’s helpful if your patient is sitting up and then you want to work very quickly. You don’t want to be too tentative when you’re going in.

And I’ll, you can either use a one handed method or a two handed method. I use a one hand for the insertion in the beginning, and then sometimes I’ll use two hands to push it down. And then once the needles and you’re going to stimulate it and For that, there are a lot of contraindications and precautions and scalp acupuncture is a very wide field.

It requires specialized training, but it went, especially when combined with some of these other modalities can really affect a tremendous change for some of these neuromuscular facial cues. So the next is our official motor points. So motor points are something that have been used. Actually I found some information back in the late 18 hundreds in a medical book.

A medical doctor had mapped out some of the motor points, but most recently people like Matt Callison and other researchers have really. Built on this foundation and have used motor points on the body, especially to restore muscle from.

So what exactly is a motor point? A motor point is essentially in a nutshell, the most electrically excitable, part of the muscle where the motor nerve bundle is attached, but it’s not a trigger point trigger points or something different, but it’s And frequently, many of the motor points that we’ll use on the face are also acupuncture points.

So it makes it easy for us to feel. And if a facial muscle is in spasm, if it isn’t moving properly, if it’s overly tense or overly relaxed, then by needling the motor point, it will cause it’s like a reset switch and it will cause it to get back into its normal functioning. As I mentioned, motor points are not trigger points, or.

Typically areas along the muscle that can be sensitive when you push on them. But motor points are something entirely different. And as I said many motor points are also acupuncture points, which is great for us. So here’s an example of a motor point, and this is the motor point for the frontalis muscle.

And. Coincidentally. It is also gallbladder 14. And by putting a needle into gallbladder 14 and stimulating it, it can help. If someone has ptosis, if they can’t raise their eyebrows, it can also help if they’re having some eyelid drooping. And another motor point. This is a quick video of a motor point for the mentality, and this was I’m going to play it and talk at the same time.

So this was a student of mine in. Class I was teaching, she had Bell’s palsy many years ago and she still was missing some muscle movement in her chin. So I went ahead and I needle the motor point for the mentality muscle. And try it one more time. You can see the needle. It when I stimulated.

The her chin started to move and Twitch, and I have a lot of these videos. You can see it moving right there. I have a lot of these videos. On my Facebook group, it’s called facial acupuncture. And on my Instagram page, I have a lot of, I do a facial acupuncture tip of the week and some of them are cosmetic and some of them are neuro.

That’s a good place if you want to see a bunch more of this stuff. So some examples of motor points. For example, if a person cannot smile, there are four main muscles that are affected the zygomaticus major, which draws the angle of the mouth upward and outward. This Acumatic is minor, which elevates the upper lip.

The LaVey levator labii superioris, which elevates the upper corner of the mouth and the resource, which retracts the angle of the mouth laterally. So by knowing which motor points to use, you can help someone who has lost their ability to smile.

The next thing is submuscular needling and. This is something that is uniquely suited to help with a lot of different disharmonies of facial and neck muscles. And essentially if a muscle, much like motor points, if a muscle is not functioning properly, that. You can needle either underneath the muscle or through the muscle and it will help to bring blood and she back to the muscle.

And it’s great for people who have had long-term paralysis. And when I teach my class, I go through all the different facial muscles. The big few are the corrugators, the frontallis, the temporalities and the massive tier. And you would needle from the origin to the insertion. So for example, this is the frontallis muscle.

You would thread needles on either side, just like this. Underneath the edges of the frontallis muscle. And you just put them in, you can stimulate them a little if you want, but you want to try to get underneath the muscle. It is a lot less painful if you do, if you’re working with a bigger muscle, like the massive tear, you might not be able to get underneath it.

So you would be needling through. But the, this is how you would needle. So underneath the muscle on either side, and this is what this would look like. And again, I’m going to talk through this. The first thing you have to do is measure the muscle. And the best way to do that is Asher patient to raise their eyebrows because the muscle is on either side of the eyebrow and when they raise their eyebrows, you can see the skin right over the muscle will wrinkle, and then you are just going to needle, right?

Underneath the edge of the muscle

are you usually use to. And that helps get my angle of insertion. Correct. And then I will press down on the skin to get it way underneath the muscle. Again, I’m not treating wrinkles. This is not cosmetic. This is a way of bringing muscle function back into the muscle.

And then I’m going to. Once I’ve done one side. So here I’m showing if you angle to date, you’re not going to be able to get underneath the muscle. If you go to superficially, you won’t be able, you’ll just be hitting this.

So once you’ve done the lateral side, then you’re going to come in and you would do the medial side

and I’ll do, depending on their forehead, I’ll either do two or three on each.

This is just for one, our brow or one side of the frontallis. If you were treating Bell’s palsy, then you would just treat the effected side.

And if you were needling the temporary Ellis, this is what that would look like.

The next thing is facial cupping and guash Shaw and facial cupping and gua SHA is designed to bring blood and treat cheese circulation to the skin and the muscles. It helps to relax tight facial muscles. And facial tissue, it can move out stagnant, lymph and toxins. It helps the lymphatic system to function better and that the lymphatic system is functioning better than the whole face will function better.

It helps with inflammation and it will help to strengthen the vascular integrity of the face. And it can help with any sort of nerve entrapment, especially if facial fascia has trapped some facial nerves. So here’s a cross-section of the face and the face is the only part of our body where our skin is attached to muscle.

And so the functioning of the muscles and the nerves that. Make the muscles work is very important because if the muscles not functioning properly because of nervous and trapped, then the skin is not going to move and you won’t be able to fully smile. So here’s a picture of that bone, muscle skin on the face.

And this is a picture of fascial adhesions. So the fascia is this stuff it’s like when you have chicken. Pull the scan off that stuff that looks like spiderwebs. So it really helps to release a lot of that in the face. And facial cupping is not like cupping on the body. You don’t leave the cups. You Stimulate different acupuncture points on the face and the cups are meant to move.

And this is just a slide from one of my classes where I’m showing gliding and then suction and releasing down the neck into the lymphatic drainage area. And. Also Derma rolling is something that can help to stimulate the channels. Like our channel rollers that we might use on the body. Derma rollers have these tiny little needles on them and.

You can stimulate the channels on the face, stimulate the cheap and your patients can buy a Derma roller from you and you can teach them how to use it. And then it will stimulate they can do this at home in between treatments. So what are some of the. Neuromuscular facial conditions that that we’ve, we can work with that I’ve worked with.

I mentioned in the beginning Bell’s palsy, stroke, TMJ, trigeminal neuralgia, Ms. Ptosis hemifacial spasm. And I have enough time to just talk about one and I’m just going to talk about Bell’s policy, which is the most common form of facial paralysis. And typically it just affects one side of the face.

Usually it’s temporary, but. The people that come to see me have had Bell’s palsy frequently. It’s been years. They still don’t have complete movement of their face. They’ve tried everything and then they come for acupuncture. It can affect blinking opening and closing the eyes, facial expressions, hearing taste, the salivary glands.

And that I say hearing it can affect their hearing. So I use a multifaceted approach. I’m going to do my body points. I’m going to do face points and depending on their underlying conditions, what’s going on with them, of course, I’ll treat them constitutionally and then bringing the multi-faceted approach in I’m going to do.

Motor points on the scalp. So the lower two fifths on the opposite side, I might use your Shan, men and face points just to calm the patient, treat their face, and then have them do some exercises. Look at their face, have them try to move different parts of their face, figure out where the paralysis is.

And then do facial motor point. And possibly some submuscular needling to get these parts of the face, moving cupping and wash eyes. Great. Derma rolling is gray. And you’re going to want to see the person two to three times a week until they get the movement back in their face. So I. Teach a cosmetic and neuromuscular.

Acupuncture facial acupuncture classes. My website is facial acupuncture, classes.com and some of the products that I was showing the cups, the washout tools at Derma rollers microneedling devices are@akeelaskincare.com. And these are my social media links. I do have a bunch of live classes coming up and all of my classes are also recorded.

That is the end of my slides. And I, again, I want to thank the American acupuncture council for giving me this opportunity. Next time is Sam Collins. And I believe he’s next Wednesday. I can’t see that right there, but it is next week. So you want to check in with that he’ll be streaming live and do we have time for Q and a or.

People on that we can open it up to where there any questions,

crickets. Okay. I’m not seeing any questions in that chat box, so I am.

Not now, I guess there’s no questions now. Okay. Thanks again to the American Acupuncture Council. And if you need to reach me, you can just drop me a line at visual acupuncture classes.

 

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Cosmetic Facial Aging: What’s Lurking Below the Surface?

 

 

The title of today’s presentation is cosmetic facial acupuncture. What’s working and lurking below the surface, and I am a cosmetic facial acupuncturist.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Thank you for the American Acupuncture Council for inviting me here today. It’s really an honor and a pleasure to be here and thanks to all of you who are here and watching and listening and participating.

I appreciate you being here and I hope that you enjoy this presentation today. So I am from Florida. And happy to be here. So let’s go. We’re going to start the PowerPoint presentation. The title of today’s presentation is cosmetic facial acupuncture. What’s work w lurking below the surface, and I am a cosmetic facial acupuncturist.

So I’m going to help you to see what’s lurking below the surface. Here we go. So cosmetic acupuncture. It’s really a form of my rung. It’s an ancient, traditional form of healing based on the concept of beautiful appearance. And in China, we’re in, when we talk about beautiful appearance, we’re not talking about just the inside, but we’re talking about acupuncture and herbal medicine.

That was notably used by the ancient Chinese emphasis and anchors to keep their concubines looking beautiful and healthy. And it was practiced in Asia for centuries as part of a holistic regime to both enhance beauty and to delay the visible signs of aging. And it was also designed to promote systemic health and overall wellbeing.

Today, cosmetic facial acupuncture is one of the most popular specialties among acupuncturists in this country. And I was part of a 2014 NCC AOM acupuncture, facial rejuvenation needs assessments. And in that survey, we asked a number of questions, reaching out to all of the members of the NTC AOM organization.

And based on the feedback that we received, we found out that 62% of the patients of these acupuncturist, patients inquired about acupuncture for appearances. That’s a lot of people. And when I asked myself the question both for the, from the perspective of the patients, but also from me as a clinician’s perspective, why do people come for cosmetic facial acupuncture?

They come for prevention. They come for a desire for a natural alternative. That’s more congruent with their belief systems because times have changed now. And I find that my patients are much more interested in something that’s a holistic or natural alternative, as opposed to say surgery or some invasive procedure.

But also this I thought was particularly interesting and it has to do with the patient’s conflict about aging. What happens when someone begins to age? What happens on the inside? And what I’ve realized is that as we age, we start to change both in relationship to ourselves and in relationship to.

Ourselves when we’re dealing with others. So for example, in our twenties and thirties, what are the primary goals or what are the primary objectives or things that are important to people in their twenties and thirties? They’re interested in their social life. They’re interested in their careers.

They’re seeking partners their lifestyle, their homeless. At that age, there aren’t a lot of visible or physical changes. So it’s not really in the forefront of their perspective about themselves or the things that they’re concerned about. As we begin to age and move into the gen Z generations or decades of our forties and fifties, we start to shift our priorities, start to shift our relationship to ourselves and to other begins to share.

We are a little more invested in our career. Our partner may be starting a family or having a family. We have friends, and this is when we first start to see those visible and physical changes. And then as we move into our later years, sixties and up, this is when those visible changes are very visible and much more.

We’re much more affected by them. And this is when we start feeling our relationship about aging and re-examining ourselves and re-examining our life. Good looking at well, what have we accomplished? What haven’t we accomplished? Am I happy with myself? Am I do I feel like I’ve given enough or received enough in my life and all of these questions bring up what we call either a life crisis, or a big change in our life.

And it’s somewhere between this fifties and sixties. And it’s well-documented, we know it as say our life transition. It’s a period of questioning. Our identity may be challenging. Our self-confidence this typically occurs from about 45 to 65 years. It lasts about one to two years and clinically it’s described as a psychological unraveling brought about by events that highlight.

Our person’s growing age, inevitable mortality and perceived life, a Cod accomplishments. It’s when we start thinking, okay, I might be on the other half of my life, I may have lived. Longer than I have left to live. And it really, I don’t know for those of you who have gone through that are in it now it’s quite can be quite traumatic.

And it often spurs this desire to make drastic changes in our, in their current lifestyle or in our current lifestyle. And a lot of that comes from the urge to recapture our youth or to hold onto what we perceive as our. And for some people, this is exciting. It’s an opportunity to really look at themselves to really self evaluate, to see our insight, look at our insights, maybe a self-exploration and reassessing and reappraising, and there’s an enthusiasm behind it and it challenge and it’s a very exciting.

Part of our life, let’s say that’s not always true for others. For others. It can be a time of confusion. Emptiness. Meaninglessness or restlessness, maybe we’re not happy with what we’re thinking. Maybe we’re not happy with ourselves. Maybe there are some things that we feel like we have not accomplished or places where we felt like we felt short, fell short in our lives and it’s disturbing.

But then there are others and this is really sad, it’s so challenging and it’s so fraught with turmoil that it can lead to depression. It can lead to anxiety. It can lead to disillusionment self-doubt self-loathing. And a lot of these people have a kind of a shallow or not a strong sense of themselves or not as strong.

Since of their confidence. And so when, and they’ll rely on the superficial aspects of themselves, their looks their social life to actually validate who they are as a person. And when those things that you’re look start to Duane or not be up to what we thought we should look like what’s left.

There’s not much left. And it’s actually very upsetting and very difficult for ourselves and for our patients. And particularly in our Western culture, we are a very youth driven culture. And when we are faced with. No longer looking like the youthful person that we think we should be. It throws us into turmoil.

And from a clinical perspective, we know that although our patients are seeking treatment for appearance enhancement, they’re coming in for their wrinkles, there’s their skin or whatnot. We know that it’s not just that superficial make-over that they’re looking for, but there’s this deeper, emotional and spiritual healing that needs to be attended.

And this is the beauty of our medicine as acupunctures. And particularly as a cosmetic facial acupuncture, as big as acupuncturist, because our treatments are both physical. They treat the psycho emotional and they treat the spiritual component, especially when we’re looking at it from the principles of Chinese med.

And when I say according to the principles of Chinese medicine, what am I talking about? I’m talking about the balance of yin and young cheap blood fluids, the meridians organs and all of the systems that are involved. So for example, when we look at the pair organ systems and all of their attributes, From the perspective of the heart, the small intestines, the pericardium, and the San chow.

We know that as a system, they rule the blood vessels well in our world as cosmetic facial acupuncturist, we’re looking at complexion, we’re looking at fine lines, broken capillaries, rosacea, that type of. From the spleen and the stomach, we know that system oversees the muscles and the muscle, the health and integrity of muscles.

That’s the same for facial acupuncturists. We’re looking at the facial muscles and the integrity or the attenuation of the facial muscles every time. We know from our Chinese medicine, that the lungs in the large intestine oversee one skin or the concept of skin and in our world, what we’re looking at is skin quality, texture, poor size acne, rosacea.

That. And then we also know from our Chinese medicine knowledge that the kidneys and the bladder oversee the bones and aging, the entire concept of aging. And so a lot of conditions that are involved, premature aging bone fragility, bone resorption on the face. We’re looking at the kidneys and the bladder.

And then this is the kind of the one that’s a little bit different, but we know that the gallbladder and the liver oversee. Ligaments and tendons will in our world. What we’re thinking of is not so much ligaments, intendance, but the smooth flow of cheer, the way that the muscles contract relax.

And when that smooth flow gets loss, what we begin to see is the skin on top of the muscles of the face, begin to crease and fold, and that begins the development of bringing. From a psycho-emotional perspective, we’re looking at the five elements. We’re looking at the fire earth, metal water wood perspective.

And we know that fire has to do with one’s ability to socialize their healthy socialization whether they over socialize under socialized, that balance that occurs in the fire element. The. Is about how we digest our thoughts. It’s about our ideas and it’s about self-esteem from a metal perspective, we’re looking at lungs grief, the way that we breathe in, breathe out, letting go the ability to let go of the old and bring in the new and the inability to do bringing grief, resentment, or regret. From the water perspective or the kidneys again, we’re looking at acceptance and fear. How are we aging? Are we okay with aging? What do we anticipate? Can we accept it? Is it fearful? Is it so fearful that we actually get paralyzed and depressed? That type of. And the wood element being delivered and the anger, it’s about the inability to actually make those changes, leading to frustration, bitterness, resentment, lack of hope, change remorse, all of the emotions that go with the frustration or the inability to actually let go and change.

So as practitioners, we are balancing both the physical and the imminent. And what’s interesting for a facial acupuncturist is our ability to correlate those facial features with the systems of the water wood, fire earth, and metal are the five elements and the organ systems. And we can actually see on the face, those changes that occur both on the physical and the emotional perception.

So let’s look at wrinkles. If you look at the different aspects of the face, starting with the upper forehead, that’s ruled by the kidneys around the eyes and the lower portion of the forehead is the liver. The lungs really ruled the cheek area. The spleen, stomach and digestion around the mouth in between the eyebrows.

The kidneys are the ears as well as the upper forehead and the lower aspect of the chin. And when there is an emotional disharmony within those organ systems, it can show up as wrinkles. It can show. And changes in skin coloring. It can show up in terms of say dyschromia or pitting in this tissue.

And so as facial acupunctures, we actually learn how to look at the face, diagnose the face, both from a physical and an emotional perspective. And then there’s also an emotional map. This is from Lotus Institute, Lillian. And she has actually outlined the direct emotions that occur within those features, whether it be wrinkles, skin pitting, flattening changes in color of the skin.

Is the skin a little white or pale meaning frozen or is it red? Meaning there are signs of. Yeah, when we treat, we definitely need to treat all of the emotions. We need to treat the emotional component as well as the physical. And when we are looking at those underlying pattern disharmony, we see that the wrinkles that the skin color.

So that the flattening or trajectory of the face those are just the symptoms. What we’re really looking for are those underlying pattern that as harmony and that we differentiate with our signs and symptoms through our poults and our tongue. And then we treat the superficial or the root. Which is the the wrinkles as the symptoms.

So for example, we’re going to look at ours signs and symptoms, tongue called that type of thing. And we’re going to discover whether it’s liver cheese, stagnation, frustration, repressed, anger, and we’re going to treat that with body points and then the branch, the wrinkles that show up, particularly if we’re looking at, say the liver around the forehead we’re going to treat those with these.

So here’s an example. This is a patient of mine and he was a 44 year old male. He was looking for acupuncture treatment to enhance his facial appearance. And his chief concern was what we’re calling disfat satisfaction with the forehead and glabellar area, the glabella areas that crease in between the forehead.

Sometimes it’s a single crease. Sometimes it’s a multiple crease you can see in this patient. That’s a very deep crease on one side. And then a smaller crease rate by the inner campus of the eye on the other side. So even though this patient had bilateral headaches, he had a history of carpal tunnel syndrome.

He had asymptomatic mitral valve prolapse and periodic lumbar pain. Those were erotic. But he wanted treating was this creasing between his forehead. So we spent a lot of time talking about it. We spent time talking about the physical component of it, the underlying patterns of disharmony. And then we reached into the emotions, the frustration and anger for him about aging, because the peer pressure for him to look youthful was hi the standard was so high in his world that he just couldn’t get past it. He did not like himself. He was so frustrated, anger, angry about it. So we had to trust both of them. And we did we came well. I came up with a liver cheap pattern with blood stagnation and congestion in the gall Meridian validated by the tongue and pulse.

The treatment plan was to harmonize. And then we decided we were going to do this for 10 weekly treatments and then reevaluate. So I chose some points. I showed somebody points to reflect the treatment that I was doing face points to actually subsidize the underlying pattern disharmony. And then I did some of your points.

I always use your points. I think they’re really. Okay. And so this is the before and after this is what happened after country meets. And as you can see, there’s a significant difference for those of you who do practice facial acupuncture, some of these changes may be more obvious to you, but even for someone who doesn’t.

Visible difference. The first change that you see as the softening in the creasing between the glabellar region, but look at his whole face, look at his entire demeanor. Can you see? And the before picture. In the heel Muslims angry, his face has pulled in his jaws. Clenching his face is very tight. And then in the after 10 treatments, you can see his face is so much more relaxed.

He’s more comfortable with himself physically and also emotionally as well. So this is just one example of many ways that we are treating, not just the. Superficial, because if I had just treated deliberately stagnation, if I had not addressed what was going on underneath, I may have seen a difference.

I don’t think it would have been the significant and it certainly wouldn’t have been within the timeframe that needed that we were given. I gave ourselves. But again, just to reiterate and validate the significance of not just treating the surface, but really treating the physical, the emotional, the spiritual, and using that with our pattern underlying patterns as harming.

Using surface points to treat the face and pulling the whole thing together. So it, again, not just one one aspect of it, but particularly in facial acupuncture, because when you think about the face and when you think about the orifice as the face, your eyes, your ears, your nose, your mouth, we are the face picks up everything.

It’s the first line of defense. And we know that we hold all of our emotions and our muscles and the fascia and tissue and the face is the first place that we hold everything. And one of the last places that we’ll re let go, because in order to make big changes, you have to actually resolve the emotions that go with it.

You have to resolve the underlying trapped trauma that’s in there. And so this is actually makes it extraordinarily rewarding for them. As a facial acupuncturist, because when I can make a change, not just a visible change and their surface, but when I can actually affect them on an emotional and a psychodynamic level, I feel like I’ve done a really good job.

Just to say, for those of you who are interested in learning. This program is that I teach is part of the Pacific college of health sciences. It’s called the facial applications for cosmetic enhancement or the face program. And you, it’s wonderful because we’re not just bringing in me, but we’re bringing in all the known leaders of today’s world.

Their classes are start once a year in January and there’s information for our, you, for those of you who are interested. I can also follow me on Instagram or if you want more information, I can certainly give you more through my website. But just want to say that this has been such an amazing and rewarding profession for me because I really feel like I’ve helped people to not just look better and feel better physically, but to actually.

Age in a way that they are comfortable and more productive, both in terms of who they are for themselves, but also just to make a small difference in who they are in relationship to the world too. So thank you very much. And I appreciate. Being here. And then also before I entertain questions, I want to say that there’s another pro wonderful presentation.

So stay tuned next week for a Sharon Weizenbaum who will be presenting as well. And I have to just say that the quality of presentations through the American Acupuncture Council is really it’s dependence. And thanks again for having me here today, Alan. I appreciate.

Are there any questions from anybody?

I actually had a question about the gentleman whose face you worked on. Was he literally a happier person as a result or that didn’t really make him any happier in the long run. Thank you for asking that. Not only was he a happier person, but the the stress that he was feeling and the trauma around.

Feeling like he was getting judged by his peers dissipated. And in other words, he didn’t care as much. What other people thought about him, which is pretty amazing. Yeah. Last question then we’ll wrap up. Because I’m really was curious about, do people become addicted to the treatment in other words? Oh, wow.

This was great. And now, people become addicted to facial surgeries when they’re doing surgeries or body surgeries that just keep wanting to change and change. Is that something that you find in working with people? I it’s, yes. It’s different. I, and I know exactly what you mean. When people are addicted to facial surgeries the addiction.

Is that is wanting to look better and better, but it doesn’t change. What’s on, under what’s going on underneath, which is a self dissatisfaction. And that’s what the addiction is. The addiction is based on needing to. Look better because they’re not satisfied or happy or content within a, with this, what people get addicted to as a they look better.

But they feel better about themselves. And it’s the feeling better that becomes the addiction similar to say meditating, you feel like you’re a better person in a few meditate. There’s something that happens to you and you, your relationship to yourself within the world becomes a more peaceful place to live.

It’s the same with this type of acupuncture, a you look better, but also more importantly, you become at peace with yourself. And when you are at peace with yourself, not only you’re you a better person for yourself, but you’re a better person for others.

Nice.