Tag Archives: Facial Acupuncture

Treating The Face, Healing the Whole Part 2 – Michelle Gellis

So there are quite a few neuromuscular conditions that affect the face, such as Bell’s Palsy, Ramsey Hunt Syndrome, synchronic cys, stroke, TMJ, trigeminal Neuralgia,…

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Hi, my name’s Michelle Gellis. I am an acupuncture physician, and I would like to thank the American Acupuncture Council for this opportunity for me to present to you today on treating the face a multidimensional approach. So today we’re going to do part two. And you can go ahead and go.

So a little bit about me. I’m currently on the doctoral faculty at Jossane University. Before that, I was a faculty member and clinic supervisor at the Maryland University of Integrative Health from 2003 until 2021. I am a published author and contributor to the Journal of Chinese Medicine and I’m a regular columnist for acupuncture today.

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And I’ve been treated teaching facial acupuncture classes internationally since 2005. My book Treating the Face was released in November of 2024. It is a 500 page 15 chapter, hard cover book, and it covers all aspects of treating the face. I’m going to talk mostly about the information that’s in chapter six, and that is neuromuscular facial conditions.

So when we think about facial acupuncture, we tend to think about cosmetic facial acupuncture. But facial acupuncture is really about a holistic approach to not just treating the face. Cosmetically, but also all different aspects of treating the face. So there are quite a few neuromuscular conditions that affect the face, such as Bell’s Palsy, Ramsey Hunt Syndrome, synchronic cys, stroke, TMJ, trigeminal Neuralgia, Ms.

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Whoops. Ms. Ptosis, HEFA spasm, myasthenia gravis, shingles, and facial ticks, just to name a few. And many of these are very unique to the face itself. And. Since I specialize in treating the face, after a few years of doing cosmetic acupuncture, I started getting people calling me, asking me if I could help them with a lot of these neuro conditions.

And through studying and doing a lot of research. I and some trial and error. I learned that the best way to really manage these conditions is through a multifaceted approach using scalp, acupuncture, submuscular needling, facial motor points, facial cupping. And so I’m gonna touch on these, the.

And so Scalp acupuncture is based on neuroanatomy. It is not based on acupuncture points. And you have to measure the scalp appropriately. And there’s a motor area and there’s a sensory area, and the bottom two fifths of each one of these lines, the sensory area is not shown on this picture. The. The bottom two fifths corresponds to the face, and so you would needle this area and stimulate it either with electro acupuncture or with manual stimulation in order to help with either motor conditions such as Bell’s palsy or with sensory conditions such as trigeminal neuralgia.

Facial motor points. This is from an old medical textbook. These are the motor points that have been discovered on the face, head and neck. And in part one of this talk I talked about using motor points for cosmetic concerns, but facial motor points are wonderful for neuromuscular concerns because what a motor point is the most electrically acceptable part.

The muscle where the motor neuron goes into the muscle, and by stimulating it, you can cause the muscle to get back into normal functioning. And the reason why this is important for the face, besides the functioning of opening the lid or closing the lid, the. Skin on the face is directly attached to the muscle.

So if someone’s face is paralyzed and is drooping in one area by getting the muscle back into normal functioning, by stimulating the motor point, the skin itself will. Snap back and be working in a more normal fashion with the muscle. So I do have examples of a couple of motor points. This was a student of mine in class and she had.

Had Bell’s Palsy many years ago and was still having trouble cursing her lips, whistling spitting like when she’d brush her teeth. And so I did the Mentalis Motorpoint and as soon as I put the needle in. Her chin started to twitch and then when I stimulated the point, it really started to jump.

And then after the treatment, she reported that she was able to make a lot of facial expressions that she hadn’t been able to make in the past.

Next example I have is a student in a class I was teaching in London and he had been in a bike accident and he had some neuropathy and a little ptosis on his left eyebrows and. I put this needle and stimulated it. So this is the motor point for the frontals. It’s gallbladder 14.

Sorry, that was so loud. But you could see the needle moving back and forth when, once it was put in the muscle, which meant it was starting to wake up. Submuscular needling is another technique that I use, which involves needling underneath and in some instances through a muscle in order to.

Blood and cheese circulation into the muscle itself. And I have a little demo here, which I.

Facial cupping and GU can also be very beneficial. For neuromuscular facial conditions, as long as your patient can tolerate it. These techniques are very gentle if done properly, and can help with blood and cheese circulation into the face. It can help with any sort of fascial adhesions. That is because over time.

If a muscle in the face isn’t used, the fascia can become stiff, and by using the cups it can help with lymphatic, the lymphatic system of the face, and it’s also very relaxing and very enjoyable for your patients. I am gonna talk really quickly about Bell’s Palsy. Bell’s Palsy is the most common cause of facial paralysis, usually temporary, and it’s caused by a disruption of the facial nerve, which causes either weakened or paralyzed facial muscles.

So here’s one patient you can see. This entire when asked to smile, they can only, she can only smile on one side of her face and the other side is completely paralyzed. This was a patient of mine. I only focused on her eyes, but I asked her to close her eyes. You can see one eye closed and the other one.

She could not close it at all. And then I did some submuscular needling and some acupuncture points and used gallbladder 14 as a motor point, did some scalp acupuncture for the face, and, after one month,

you can see she can close her eyes. Still a little difficult, but she had complete recovery.

So I do offer many different classes on. Facial and cosmetic acupuncture, you might wanna check those out. You can scan the QR code or go to my website, facial acupuncture classes.com and you can find me on social under my name, Michelle Gellis, or I have a Facebook group called Facial Acupuncture.

Very active group. Thank you so much.

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Treating the Face – Healing the Whole- Michelle Gellis

When we’re treating the face, we’re treating the entire person because facial acupuncture impacts not just our appearance, but it affects the function of the face, and it also affects a person’s spirit. So when we think about facial. Cosmetic acupuncture, which is what I’m going to talk about first.

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Hi, my name’s Michelle Gellis. I’d like to thank the American Acupuncture Council for an opportunity to present to you today on treating the face as a whole. And this is part one, so you can go ahead and go to the slides.

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So my presentation today is on a multidimensional approach to facial acupuncture. As I mentioned, my name’s Michelle Gellis. I am currently on the doctoral faculty at Ossan University. I’m a formal faculty member and clinic supervisor at the Maryland University of Integrative Health. And I am a published author and regular contributor to the Journal of Chinese Medicine, and I’m a columnist on acupuncture today, and I’ve been teaching facial inter facial acupuncture classes internationally since 2005.

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This is the cup of my. Book that has recently been published on Treating the Face. It is a hard cover 15 chapter book on all aspects of treating the face. And you can scan that QR code if you wanna check it out. So when people think of facial acupuncture, the first thing that comes to mind is cosmetic acupuncture.

But treating the face is much more than just cosmetic. When we’re treating the face, we’re treating the entire person because facial acupuncture impacts not just our appearance, but it affects the function of the face, and it also affects a person’s spirit. So when we think about facial. Cosmetic acupuncture, which is what I’m going to talk about first.

That works with both the body and the face, bringing blood and cheese circulation up to targeted areas in the face. It stimulates collagen and elast in production, improves the tone of the skin and the of the skin. It enhances circulation and reduces inflammation. So puffiness and increases the natural glow of the face.

So you look rested. You have more color in your cheeks. And additionally, because of the. Nature of the acupuncture points on the face, you are supporting your patients’ overall health, their digestion, their immunity, and their overall circulation. Facial acupuncture can erase five to 15 years off of the face, and it’s great for lifting and treating on a very deep level.

The important thing when you are performing facial acupuncture is to use precision needling techniques, which typically involves training with someone who’s very well experienced, who’s been doing facial acupuncture and teaching facial acupuncture for many years. So how does cosmetic acupuncture work?

Cosmetic acupuncture brings blood flow and oxygen up to the face and it brings nutrients to the skin cells so your skin will look better. It does take about 28 days for collagen to regenerate, and that is increased if someone is older. So you really do have to do a series of treatments. It’s not just a one and done.

And once a person has gone through a series of approximately 12 weekly treatments, then usually they can start to spread their treatments out over time and eventually come once a month or just seasonally for touchups. Cosmetic acupuncture also utilizes motorpoint stimulation, and this can help with the functioning of the muscles in the face, and it will therefore balance.

Overactive muscles. Muscles that are too tight, causing the skin to contract or weak muscles, which can cause the skin to sag. It can help to enhance the jawline, giving a more lifted and supported appearance. And it also helps with the mid-face support. And this all happens through proper engagement of the facial muscles.

So if we just look at the layers of the face, we have the skin, then there’s some superficial fat, and then this mass layer. The superficial muscular AP neurotics, AP neurotic system, which is very unique to the face. We have some retaining ligaments, deeper fat on the lower part of the face, and then we have some deeper fascia and the bones and this mass layer.

Is what enables us to make our expressions because the muscles on the face are connected directly out to the skin. So as we can see, we have bone muscle. And skin. And so what happens is as the muscle contracts, the skin moves, and over time when we’re contracting these muscles, either through smiling or frowning, the skin that’s over the muscle will contract and it will eventually form lines and wrinkles and folds.

So here is someone who doesn’t have a lot of signs of aging, someone who’s a little younger. Then as we get older into our fifties, we can begin to see some signs of aging. And then as someone is progressively older, they’ll start to get forehead lines, bolts and more wrinkles.

In addition to wrinkles from facial expressions, gravity can cause the neck to hang down and jowling, especially around the mouth area and the skin on the cheeks and underneath the neck. The platysma bands start to form the cheeks start to sag.

And different facial expressions related to our emotions will cause different sorts of wrinkles. For example, smiling can cause crow’s feet frowning or being angry can cause these lines in between the eyebrows and cursing the lips a lot. If you were pensive, that’s an expression can cause lip lines.

The forehead is a kind of a zone of anger and frustration. The crow’s feet area, smiling. Sometimes sadness, depending the lips from overuse or estrogen loss can lose their. Plumpness and cause wrinkling the chin, if there’s a lot of fear, the chin can pucker and then jowling and the neck area frequently is a sign of cheat deficiency.

So we have emotions that can cause wrinkles cheap. Blood and body fluid are also related to the skin and how the skin looks. If the chi is deficient, you can get a withered looking appearance. If the chi is stagnant, it can block the flow of blood and fluids. So blood causing discoloration and fluids and cause puffiness, especially under the eye area.

So let’s take the liver, for example. If we’re looking at the liver system, we can see that stagnant liver blood can cause liver spots and liver blood deficiency can cause the skin to be dry. And liver cheese stagnation can sometimes manifest as anger and frustration, and this can show up in between the eyes.

So there’s a lot of different ways with our medicine to treat the emotions. A five element. Treatment. If you’re trained in five element, acupuncture can help to balance the organ systems and the emotions. Additionally, using the entry exit points on the face can be very beneficial for opening the face up, getting a smooth flow of Qi between the face and the body, between the Z and the.

Also allowing for a balancing between the organs, facial motor points can be very beneficial for treating the face, especially expression lines. And there are many muscles on the face and neck, as you can see. Some of them are listed here. This is not. A comprehensive list, but this is these are the muscles that we frequently use motor points for when we’re looking to treat some of the emotional manifestations.

Some of the, of some of the expressions. So here for example, we have the expression of anger. So here we have a relaxed face, and here we have an angry face, and you can see how the muscles get contracted. And by using the motor points or the different muscles, which are the motor points are located. The most electrically acceptable part of the muscle.

So you treat the motor point and it treats the muscle and it allows the muscle to get back into normal functioning. And this can help with not only the manifestation, the external manifestation of the emotion, but it can treat the muscle, it can treat the acupuncture point. Which helps to treat the whole person.

Many motor points on the face are acupuncture points.

This is actually an image from my book. This is from a chapter called The Anatomy of Expression. And it’s a little easier to see here. Side by side, a person making the expression, and then a split view of a relaxed face with the motor points and then the contracted muscles on the right.

Facial Gus Sha can be very beneficial for treating the skin, helping to work with fascial adhesions and tension in the face can help to sculpt the face. It’s very relaxing to the patient. It’s very calming to the spirit. I really love Jade Guha tools. I find that they tonify the skin and they help to nourish the blood.

Facial cupping is also a wonderful technique. These small glass facial cups. That are easy to squeeze, are wonderful for treating the face. And of course, when you’re doing facial cupping or facial gua, you never wanna leave any marks on the face. So if you’re going to do either one of these techniques, protocols, please get properly trained.

And everything that’s happened to us in our life gets etched on our face. Our fla, our face reflects our life story and needling the face helps to release stored trauma and can really transform the she on a very skin level. Related to what we do, but in no way a deep level or a spiritual level treatment microneedling using a device like this, a microneedle pen with microneedle cartridges. This can treat very skin level conditions on the face and on the body chest. Back and other parts of the body as well.

And here’s an example of microneedling. You can see on a very skin level, some wrinkles around the mouth. And then after a few treatments the wrinkles are gone. So if you’re interested in learning more about facial acupuncture. There’s a QR code there for my website, facial acupuncture classes.com, and you can find me on Facebook into Instagram, LinkedIn, and TikTok.

Under my name, Michelle Gellis and I have a Facebook group called Facial Acupuncture. Thank you so much.

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Microneedling Neck and Hands – MIchelle Gellis

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Hi, my name’s Michelle Gellis. I am an acupuncture physician, and today I am going to be presenting on microneedling for Aging Hands, neck and Chest. So a little bit about me. I have recently published a hardcover 500 page book on treating the face. So you might wanna check that out. And currently I’m on the doctoral faculty at Yoan University, former faculty member and clinic supervisor.

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At the Maryland University of Integrative Health for about 18 years. I’ve been published several times in the Journal of Chinese Medicine, regular columnist at acupuncture today, and I’ve been teaching facial acupuncture classes internationally for about 20 years. So today I’m talking about a couple of specific topics within the general heading of microneedling.

So I’m gonna be talking about microneedling for the neck, chest, and hands. So I’m gonna go over the benefits of microneedling, how it works, contraindications, some special considerations when you’re microneedling the hands, neck and chest. And then some technique techniques. So why would we do microneedling?

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Microneedling is a great alternative to injectables, things like Botox and fillers and surgery to address things like fine lines, acne scars, loose skin, large pores, crow’s feet, lip wrinkles. Skin discoloration, like dark spots, stretch marks, and even hair restoration. So what does it do exactly?

How does it work? Microneedling stimulates your body’s own collagen production, the micro. Stimulate your body to produce collagen, and it also increases the absorption of any product that you will put on your skin by up to a thousand percent. And in my book, I have pages and pages of references to studies and white papers that have been done on microneedling and how it affects the skin.

I. So the benefits are, there’s very little downtime. It’s very low risk, highly effective, and the collagen that’s produced is your own collagen. So it’s very natural. It’s. Relatively comfortable. There’s very little pain and the results can last up to five years from a series of treatments. There are some indication contraindications.

You don’t want to do microneedling on people that are on blood thinners. People that are undergoing chemotherapy or radiation, people that have really any kind of moderate to severe conditions that are open or oozing that might require medical care, psoriasis, eczema, active acne, that’s pu warts, other things like that.

If you’re not sure, look it up. Speak to your patient’s doctor. Have them speak to their doctor before you start microneedling over any skin condition if your patient has keloids or if they are pregnant. These are all contraindications. So real quick education of the skin. This right here is the stratum corneum.

And so this hole piece right here is the dermal layer and the epidermis. And right at the base of the epidermis is this layer called the stratum basal, and this is where the stem cells. That produce new keratinocytes are formed. So you really don’t even need to get down into this dermal layer, which is where the blood vessels are.

So just by staying in the epidermis, you can stimulate the growth of. New fibroblasts and collagen. So the way the fibroblast stimulation works is these needles puncture. This would be like the head of a microneedle pad, puncture little holes into the skin. They heal very quickly, but they damage the epidermis, and the epidermis heals itself with new healthy skin.

So when we’re doing microneedling, we are going to use different depths for different parts of the face and the neck. And the neck and the chest are very sensitive. The skin on the neck in particular is very thin on the chest. It’s a little thicker. But you really wanna dial it down when you’re working on the neck itself.

So when you’re microneedling, you want to take into consideration the depth of the. Skin, the thickness of the skin that you’re needling and how deep you want those needles to go. Because on a microneedle pen, the needles go up and down and they’re going to penetrate into the skin, and there is a dial on microneedle pens showing you how deep the needles are going to go.

As I mentioned, skin on the neck and the chest can be very sensitive and thin. It can be crepey on the chest. There can be a lot of dark spots on the chest. On the neck, you can get loose and wrinkled skin. So here is an example of an aging neck, and you can see how thin and delicate the skin is here, and then when you’re working on the chest, you get these deeper wrinkles and folds and a lot of sun damage because the sun, when we’re out, the sun is going to hit our chest.

A lot of times we put sunscreen on our face, we put on our hat, but our chest is exposed. So this is an example of what a patient might look like before microneedling and then after, just so you can get an idea, they’re going to be red, but they, there shouldn’t be any bleeding when we’re talking about the hands.

The hands as people’s. Hands get older, they can get very bony veiny, and the veins can be right up at the surface. Their hands can be very sensitive. The skin can be very thin, and because the hands and the feet are so far away from the heart. The healing capacity, there’s the blood flow to the hands and the feet isn’t as good as the rest of the body.

So you can have some reduced healing capacity. So you wanna be very careful not to go too deep. So for a patient like this, when you’re working, you wanna make certain to avoid any prominent veins and to pay attention to any dark spots. I. This was a patient of mine came to me for three or four microneedling treatments, and this is what they looked like before and this is what they looked like after their third treatment.

I had just. Treated them. And I had dabbed at this spot right here, but you can see this spot here is almost completely gone. And just overall the skin on the hand looks much healthier. Little bit about the protocol. You wanna make sure if you’re working on their hands, that the patient washes their hands.

And if you’re working on the chest, you can use a neck. You can use a makeup remover wipe with some rubbing alcohol on it to get that clean. You wanna make sure you put gloves on. And if they would like numbing cream, you can put numbing cream on. I usually recommend like a 5% lidocaine cream, and then you’re going to let that sit for about 20 minutes.

You remove that either with a cotton pad or a makeup remover, white and. Then whatever area you’re working on, you wanna make sure to spray it or wipe it with alcohol, and then you’re going to apply your serum. I recommend hyaluronic acid serum. The product that I use is made by. A company called AccuLift.

It has vitamin C, hyaluronic acid, and collagen. And then you’re going to adjust the depth of the pen and the needle lengths and the speed of the pen according to how deep you’re going to go, depending on the thickness of. The patient’s skin. You’re going to use an up and down technique, and if you’re working on the hands, you’re going to go up and down.

So you’ll be going like this, you are not gonna go across the hand this way. And then if they have any spots, you would use a stamping technique and again, avoiding any prominent veins. For the neck, you’ll be working up and down and on the chest you can go up and down and left to right and use a stamping technique.

When you’re setting up expectations for your patients the results can take. Up to two weeks to see any sort of improvement. And I recommend four to six weekly sessions and the appointments are one month apart. So I’m sorry, not weekly sessions, four to six monthly sessions, and if they wanted to come in for some nano needling, which is a much more superficial.

Needling. It’s more of an exfoliation. They can do that after their skin is healed. So usually within a week. And they do need to know if they’re using any prescription products that they will absorb more quickly. When you’re setting up expectations for your patients, you wanna take into account their skin type, their age, lifestyle, diet.

How much sleep they’re getting. Water, they’re consuming what their skincare routine is, their genetics. Talk to them about their family and how they aged. Of course, your TCM diagnosis, I always include, I. And acupuncture treatment with my microneedling. And any blood, she yin deficiencies, excesses, stagnations, things of that nature.

Some of the possible side effects could be some pinpoint bleeding, redness, itching, burning, a little skin irritation or some pigmentation that should say changes. You also wanna send your patient home with some take home instructions. Let them know they could be red Peel flake for about 24 out 12 to 24 hours and schedule their next appointment for a month out. Soothe their skin with either aloe and Orica blend again. AccuLift has a calm spray. It has green tea.

And aloe and tica and CBD and some other things that are very calming to the skin. They shouldn’t put any makeup on the day of, stay out of the sun. No exercise because sweat can irritate the area, use very mild soap. And after the treatment they should start on a skincare routine. So this is what a microneedle pen looks like.

You have needle cartridges wall charger, batteries, extra batteries, and that way you can plug it in. It should come with instructions and a nice long cord. I recommend a minimum of 18,000 RPMs on the speed for the needles to go up and down for it to be effective and that you should purchase a medical grade pen.

The less expensive pens that are sold online usually are for home use for single person use. Professional pens have anti backflow technology and they are meant the pen is meant to be used for long-term use on many patients. And then the needle cartridges go in the sharps container afterwards.

So this little snippet I just showed you was a little piece of a much bigger class. I teach a four hour microneedle in class and a bunch of other classes live and recorded. You can check them out@facialacupunctureclasses.com. And any of the products I’ve talked about today, you can find@uluskincare.com.

Thank you so much, and thank you to the American Acupuncture Council for this opportunity

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Treating TMJ with a Multifaceted Approach Part 2 – Michelle Gellis

And today I am doing part two of a two part lecture on treating TMJ with motor points, scalp acupuncture, and submuscular needling.

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Hi, my name is Michelle Gellis. I’m an acupuncture physician and I teach cosmetic and facial acupuncture classes internationally. And today I am doing part two of a two part lecture on treating TMJ with motor points, scalp acupuncture, and submuscular needling. So if you can go to the first slide,

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I previously was a former, I’m a former faculty member and clinic supervisor at the University, Maryland University of Integrative Health. I was there for almost 20 years and I’m currently on the doctoral faculty at Yoson University. I’ve writtenly written. I’ve recently written a book on treating the face.

It is a comprehensive guide, covering everything from the five element treatment of the face to cosmetic acupuncture, treating neuromuscular facial conditions, facial cupping, gua sha, microneedling, red light therapy, and many other. So you might want to check that out. So last time I spoke about TMJ and its etiology, its symptoms, treatments.

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As far as some Western medicine theory and TCM theory, and today I am going to go over a multifaceted approach to treating TMJ because it is a very common condition that we will see in our patients. The underlying theory in my treatment protocol is that neuromuscular facial conditions such as Bell’s palsy, TMJ, myasthenia gravis, and others can best be treated using a multifaceted approach.

So today we are going to talk about three of those. Scalp acupuncture, Facial motor points and submuscular needling. Scalp acupuncture is actually a fairly modern technique in our medicine. It’s only been around since the 1950s and really became popular in the 1970s. And we use our needles to stimulate different areas of the scalp, which stimulate different areas of the brain, which control different parts of our body.

And it is not based on acupuncture points. It is based on neuroanatomy and it makes it Very beneficial for treating the face because frequently when people have certain conditions that are very painful, it’s hard to do localized treatment. But by treating the scalp, we can affect. the face. So there’s three main areas that we would look at when thinking about treating, using scalp acupuncture to treat the face.

And that would be the motor area, the sensory area, and the foot motor sensory area. And depending on the condition, whether it’s more motor function or sensory meaning pain or neuropathy, you would choose the particular area. So again, it’s based on neuroanatomy. Basically, on the homunculus.

So looking at this, the face takes up a really large section of the brain area. So this is motor and this is sensory. And you are going to be needling horizontally through this loose connective tissue. So we have the scalp, the clo, the skin rather, the close connective tissue, the aponeurosis. And then we have the loose connective tissue, which is where we would be.

needling. So the landmarks that we’re going to be looking for are the glabella and the occipital protuberance. So we need to measure the scalp and we usually do that with two hands. And so you would look at the glabella and the occipital protuberance, and then you would draw an imaginary line between the two, and when you find the midpoint, you go back 0.

5 centimeters, and that is going to give you your your vertical line this way, and When you’re deciding on your horizontal line, you want to start at the midpoint of the eyebrow. So you are going from the midpoint of the eyebrow to the occipital protuberance. That is going to be you’re starting here 0.

5 centimeters back and you go right to the hairline when you measure from the midpoint of the eyebrow to the occipital protuberance. So this is the motor area and the bottom two fifths. So we have five fifths. The top one fifth is your lower extremities. So we’re not concerned about that middle two fifth, the upper extremities.

And so that would be the hands and the arms, and then the face and the head would be the right here, this section right here. That is the bottom two steps.

Another technique that we can use is submuscular needling. Submuscular needling is a technique that we use when we need to or want to relax an atrophied muscle or overly tense muscle and it is really beneficial for long term paralysis or if someone has a lot of tension in an area and there are several muscles on the face and head that we can use submuscular needling for, but TMJ, the ones that we’re going to focus on are the temporalis and the masseter.

So here you can see the temporalis and the masseter. And what you would do is you would take. half inch acupuncture needles and you would thread them around the edge of the temporalis and underneath or through, if you can’t get underneath the masseteer. And by doing this, it brings blood and qi flow to this area.

So here’s another close up of what that might look like. It doesn’t really matter what direction the needles are going. As long as you stay right on the edge of the muscle and the easiest way to find the border is you bite down and where you have your patient bite down and you can feel the front of the edge.

of the temporalis, and then you are just going to, once you find the front edge, then you can follow it around on the temporal fossa, and this will go all the way back behind the ear, and you would just thread the needles all around horizontally along the edge of the muscle. And it looks something like this.

And then for the masseter, the easiest way to find it is ask your patient to bite down and it will pop out. And then you are going to place needles right underneath from the origin to the insertion. Right underneath the muscle and some people the muscles very thick and you might be going right through the muscle and it looks like this

some additional ancillary treatments that you could add in are to use some points to help relax your patient like Shen Men, you can also In the auricular area there’s a TMJ point that you can use and lower jaw, so you would look those up on an auricular acupuncture chart and for if they’re having sensory issues like pain, you would do both sides for scalp acupuncture.

And if it’s just one side, if it’s motor issues, you would just do one side and then cupping and Gua Sha can also be very beneficial. and submuscular needling of the massetere, temporalis and there’s also some auricular muscles that you can see right here in this picture. These are the auricular muscles.

You could also needle under those and in some individuals that is very beneficial. Why does it keep doing this

and also the motor points for the masseteer and the temporalis. So the facial motor points, the motor point for the temporalis is just anterior to gallbladder a. Okay. And it is on the temporalis muscle and you would just go anterior to that and you can needle that and stimulate it a little bit. And then there are two motor points for the masseter and one is stomach six is a motor point.

And then just below stomach seven, in line with the earlobe, there is another motor point. And you could needle both of those on the affected side or on both sides and stimulate those. And all of these used in combination can really be very beneficial to helping to relax the face, relax the jaw, relax your patient.

If they have TMJI cover this in great detail in my classes and there is my website, facial acupuncture classes.com. And you can also follow me on Facebook, Instagram, TikTok. I have I have a Facebook group with over 8,000 acupuncturists in it. There’s always a lot of conversation going on and I. Teach classes internationally so you can check out my schedule.

Thank you so much.

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Treating TMJ with a Multifaceted Approach Part 1

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Hi, my name is Michelle Gellis. I’m an acupuncture physician and I teach cosmetic and neuromuscular facial acupuncture classes internationally. I just completed my first book. It is called Treating the Face and it is a comprehensive guide. It’s a hardcover book. It’s a comprehensive guide to treating the face, both for cosmetic and neuromuscular Conditions.

I’m currently on the faculty at Yosan University on the doctoral faculty. And prior to that, I worked at, I was on faculty at the Maryland University of integrative health from 2003 until 2021.

Sorry, I having trouble getting going to the next slide. There we go. So these are the different chapters in my. book and it’s a full color book and some of the images that will be in today’s presentation are from my book. So today we’re going to talk about this is part one of a two part lecture on treating TMJ.

And today I’m going to go over the definition, the etiology, and using facial motor points to treat TMJ. And then in part two, I will go over using scalp acupuncture and submuscular needling to treat TMJ. So what is TMJ? TMJ is short for temporomandibular joint pain. It is also kind of part of TMD is another way of referring to it for temporomandibular disorders, and these are any issues that arise from any jaw pain, jaw problems that come from the muscles surrounding the jaw and can cause problems opening and closing the jaw.

And the temporomandibular joint, or TMJ. for short, is the actual hinge joint that connects the mandible to the temporal bone of the skull. So we’re going to go through, as I mentioned, the definition, and then we’re going to talk about motor points. is the temporal bone right here, and this is the mandible.

And here is the joint that we were discussing. And here’s a blow up of that. So you can see where this condyle goes into the temporal bone and there’s a disc here and there’s various nerves that are attached to it. What can happen through grinding the teeth? or injury or stress, which can cause tension.

People can develop temporomandibular joint pain or TMJ for short.

TMJ can manifest as many different things, not just in the jaw area. People can have pain behind their eyes, different issues with their eyes. They can have limited ability to open their mouth, clenching, grinding. They can have sore teeth. They can get headaches because of the location of the temporal muscle.

They can have issues with their ears, vertigo, dizziness, ear pain neck pain, and of course pain in the jaw and clicking and popping of the jaw. So as acupuncturists, we can do some local treatments with acupuncture and treat the channels that are involved. And so some local points might be stomach five, stomach six, you might treat gallbladder four, SI 19, Sangio 17, Tai Yang.

And then using some distal points, like large intestine 4, which is a command point for the face and jaw. Sand jaw 5, gallbladder 41, which are the master couple point of the young way my. And if they have constrained liver qi and they’re grinding their teeth, you could do liver three and liver four and you can combine some other points such as gallbladder 34, which can help to supplement liver three.

But one of the things that I have found in my practice to be really beneficial when treating TMJ are facial motor points. Facial motor, what facial motor points are, they are the most elect, they’re located in the muscle. They’re the most electrically excitable part of the muscle where the motor nerve bundle is attached.

And specifically, it’s the skin region where the muscle is most accessible to electrical activity. excitement at the lowest intensity. So you can actually measure them. Motor points are not trigger points, trigger points, or tender points, or ashi points, that when you press on them the person is tender.

And fortunately for us, when we’re looking at the face, many motor points are also acupuncture points. When you’re trying to figure out what motor point to use when treating the face, you have to determine what muscles are affected, and then you would look at the motor point on the face. That muscle.

When needling motor points on the face, it’s a good idea to use some ornicogel and a very thin needle. You don’t want to be using a really heavy gauge needle because stimulating the needle could possibly cause some bruising.

Here is an image I took from an old this is an old medical text and they actually outlined all the different motor points on the face and neck. This is from the late 1800s, which I thought was very interesting. Motor points have been used for quite some time. Here is a picture of a nerve and going into the muscles.

So we have the sensory nerve and then we have the motor nerve and the motor point. is, as I mentioned, the most electrically excitable part of that muscle.

There are many motor points on the face. We’re not going to talk about all of them. We’ll just be focusing on a couple, because when we’re thinking about TMJ, the muscles that are involved are going to be the masseter. and the temporalis.

So here’s the temporalis muscle as you can see, and here is the acupuncture point gallbladder A. The motor point for the temporalis is just anterior, it’s one cun anterior to gallbladder A, and you would use a perpendicular insertion. The goal is to go into the muscle, but not through the muscle. The temporalis works with the massetere.

Here’s the massetere to move the mandible up and down and by when a person has TMJ, the temporalis can get very tight and by releasing this motor point, it can relax the entire side of the head and face. and jaw.

Another muscle with motor points that we would use for TMJ is the masseter and here is an image from my book of the masseter and then the it has two motor points and one of them is small intestine, six. And the other one is just below stomach seven, it’s just inferior to stomach seven, and it is level with the earlobe, and you would needle this about a half to one soon deep, because you’re going through the flesh and the fatty area of the face right here.

And this is really wonderful for jaw pain as well. Now this is demonstration of what can happen when you needle a motor point properly. This is not the masseteer or the temporalis, but it was a good display of what happens when you needle a motor point. So, I wanted to show this. Where’s my Ah, there we go.

So this person had had Bell’s palsy and they had a lot of trouble pursing their lips and so this is actually muscle on the chin and you can see when I stimulate the needle, see if I can get that to go again, when I stimulate the needle This is in the mentalis. When I stimulate the needle, how it really jumps, it’s already moving on its own.

And then once I stimulate it, it really causes the muscle to jump.

So next time we are going to talk about other ways of treating TMJ using scalp acupuncture and submuscular needling. And I want to thank the American Acupuncture Council for this opportunity. You can go to facialacupunctureclasses. com and let’s see, I have a slide here. Sorry. You can go to facialacupunctureclasses.

com and you can learn more about some of the classes. That I teach. Thank you so much.

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Microneedling for Acne and Acne Scars – Michelle Gellis

So why microneedling for acne? Microneedling is something that is historically been used for cosmetic concerns and when you’re thinking about acne and acne scars microneedling, the only thing that it’s been FDA approved for is for treating acne scars.

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My name’s Michelle Gellis, and I am an acupuncture physician. Hi, my name’s I specialize in facial and cosmetic acupuncture, and today I am going to be doing a presentation, a short presentation, which is part of a longer class that I teach on microneedling for acne and acne scars. So you can go to the first slide.

A portion of this webinar is taken from my book. Let’s see if I can get in the middle. It’s called, thank you. It’s called Treating the Face, and it is a comprehensive guide on treating the face for health professionals. Everything from cosmetic and neuromuscular acupuncture to facial cupping and gua sha.

And there is a chapter on microneedling. So many of the images today are from that. And this is just some photos from the inside of the book. So why microneedling for acne? Microneedling is something that is historically been used for cosmetic concerns and when you’re thinking about acne and acne scars microneedling, the only thing that it’s been FDA approved for is for treating acne scars.

And I’m going to explain that in a moment, but it can also help with acne itself. So what are some of the benefits for microneedling for acne and acne scars? So microneedling can help with the scar itself, it can help with the discoloration, and it can also help with the skin texture. Microneedling will break down the scar tissue.

for the acne scars and it encourages healthy skin regeneration and it helps with the hyperpigmentation, which is a darkening of the skin that can happen when you have had acne. And overall, it will improve the skin tone and the texture making the scars less noticeable. A little bit about acne and there’s different types of acne.

So here is a normal sebaceous gland and hair follicle. And what can happen is the pore of the follicle gets infected with bacteria, and if the skin is healed over it, then you have a white head. If it’s open and oxygen gets to the bacteria, then it becomes a black head. If it gets infected, then you can get this redness around the white head, and If it is inflamed and infected, then you can get a large area of redness, and this is called pustule.

There are also different types of acne scars and boxcar scars. Scars are more of a square shape, ice pick scars are round and deep, keloid scars are raised, and rolling scars are when you have scars that run into one another. What microneedling does is it controls So the little injuries that are, cause when you do microneedling, it stimulates collagen production.

stimulates the skin’s wound healing responses, activating these fibroblasts, and these fibroblasts produce collagen, elastin, and to repair the skin. Microneedling. Also creates little microchannels in the skin, so whatever products you may be using get better absorbed. Here is a picture of a cross section of skin.

Here is the and this is just the epidermis, so the outer layer of the skin. These are all the dead cells on the top. And this is called the stratum corneum, and down here at the bottom, this is the stratum basal, and these are where all the new skin cells are produced. And so when you microneedle, you are both helping the stratum corneum to be exfoliated and you’re reaching down past the keratinocytes down into the stratum basal where the new fibroblast cells create healthy collagen.

So there were many different microneedling devices. There are a dermaroller, which is a non mechanical device where you just roll these little needles on the skin. There’s also a Dermastamp which you stamp onto the skin and you can fill this with serum or different products. And these are really meant for in home use to treat the skin at home.

This is a microneedle pen and this microneedle pen has different speeds for working on different areas of the skin. And it also has different depths. These are little needle cartridges. that connect onto the pen that go into the skin and I offer a four hour training on using a microneedle pen for wrinkles, hair loss and also for acne and acne scars, so how to actually use a microneedle pen.

the pen. So here are some before and after photos of acne and acne scars. This one was microneedling and this one was just using a derma roller. So some of the contraindications are if someone has actual acne. active pustule acne, you don’t want to be microneedling over that. If there’s any sort of infection going on, you don’t want to microneedle over that.

If the person is pregnant, you don’t want to be using a microneedle pen. You could do some derma rolling, but the biggest concern is infection and introducing any sort of infection. So you would want to make You were microneedling with a derma roller or a derma stamp that your device was clean and sterile.

With a microneedle pen, the cartridges are thrown out, but since you’re going deeper, you do run more of a risk of infection. Other contraindications are keloid scars, any sort of bleeding disorder, any sort of skin condition. or if the person is using Retin A or Tretinonin this thins the skin and can be a contraindication.

Other contraindications are if the person has open wounds or cuts, any allergies to any of the ingredients in the numbing agent that you might use or the serum any sort of autoimmune disorder. And, or if they have active cancer or they’re going through radiation therapy.

Some precautions that you would use are to make sure, as I mentioned, that your tools are sterile. And you might also want to do some patch testing, especially if the person has darker skin. And you want to avoid any overly sensitive areas, especially areas where the skin is very thin, the red part of the lips.

inside the orbital rim. As I mentioned do a patch test and avoid any areas where there’s pustule apnea, rosacea, or broken skin. When you’re thinking about different types of skin that might be better suited to microneedling, you want to think about the Fitzpatrick scale. So that’s how dark someone’s skin is.

So darker skin types are more prone to Inflammation sorry, post inflammatory pigmentation. So you would want a patch test if someone has dark skin. And then you would adjust the needle depth and frequency for sensitive or any reactive skin types. So what this boils down to is really doing a thorough consultation to meet the person’s individual needs.

As far as results, typically people come once a month and results are typically seen within three to six treatments. And during the time the person is getting treated, they should avoid using any retinoids, exfoliants, whether it’s a physical exfoliant like a scrub or a chemical exfoliant like alpha or a beta hydroxy acid.

They should not have any exposure to direct sunlight for 48 hours after the treatment. When you’re doing, whether it’s microneedling or dermal rolling, you want to use some sort of a serum when you’re doing your treatment. And then post treatment you want to have something such as aloe, arnica, something that will soothe the skin.

And when you’re treating the skin during the treatment, having something with Peptides, hyaluronic acid, vitamin C, collagen, these are all good ingredients to have when you’re doing the micrometaling. So the hyaluronic acid will hydrate the skin, and it also helps post procedure. The vitamin C helps to brighten the skin, and as I mentioned, you want to avoid any kind of harsh chemicals.

So the first thing that you do is you clean the skin, and then you have to prepare the skin. That might mean putting on a numbing cream if the person wants numbing cream. And then you are going to start in the less sensitive areas. Possibly on the forehead and then work your way down work in different sections.

And this will give, so instead of trying to do the whole face at once, you work in a small area and you don’t wait for the skin to get pink before you go to the next area. Okay. You would treat the area like four times in each direction and then move on to the next area. You can always go back. It is a light to moderate pressure and really the device itself will do the work.

You don’t have to press too hard because that can cause trauma to the skin. And I’m sorry for my slide, really formatted it looks like. Some of the words got cut off.

Typically for acne scars, superficial scars will respond well to depths between 5 to 1. 0 millimeters. Deeper scars like those ice pick scars or the boxcar scars require 1. 5 to 2. 0 millimeter especially if they’re on the chest or the back. I would probably say more 1. 0 to 1. 5 and see how that works when you’re working on the face.

As far as the frequency for active acne, you are going to work every four to six weeks, very shallow depth, and again, don’t treat any active pustules or you don’t want to spread the bacteria. and you want to use an anti inflammatory serum and acne targeted serums and treatments afterwards. If it’s a scar, same thing every four to six weeks, you’re going to go a little deeper depending on how severe the scar is.

And as I mentioned, they should notice a difference within three to six weeks. months of treatment. Once the desired results are achieved, they can come in for maintenance every three to six months to maintain the skin health and they should be doing care at home with products. After the treatment, gentle cleansers, avoid sun exposure, use your serums.

They should cleanse with a mild non fragrance cleanser, and a hydrating serum. So some of the things that might occur afterwards and so redness, swelling, peeling or normal infection is very rare, but it is certainly a possibility. But typically, you get mild redness, peeling, swelling, which subside within 24 to 48 hours.

Something that’s great is if you can combine the microneedling with other therapies, either within the treatment or in the case of acupuncture, you would alternate. So what I do with my patients with acupuncture, is I will give them three weekly acupuncture treatments during the month, facial acupuncture.

Then on the fourth treatment, I will do microneedling. And so I work the microneedling in. Red light therapy can be used or LED therapy can be used, especially the blue light because that helps to kill the bacteria. of the acne and putting these things in combination can really yield the greatest benefits.

It’s very important that you document everything, keep a record of all the treatments, including the needle depth, what products were used, and the client’s symptoms. responses or reactions, and make sure to schedule the follow up so you can monitor the progress. Always use before and after photos so you can document the changes because people don’t always notice the changes.

And then by doing the patient education, you can ensure the best safest outcome for your patient. So this is my social my website is FacialAcupunctureClasses. com. I’m on Instagram and Facebook under my name Michelle Gellis and I hope to see you in class sometime.