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Constitutional Facial Acupuncture Renewal:
”A Journey to Transformation”
by Mary Elizabeth Wakefield, L. Ac, M. S., and Sunanda Harrell-Stokes, L. Ac.

Introduction:

With over 76 million baby boomers now present in the US population, many of us are redesigning the picture of aging. Born in the wake of World War II, having experienced the Flower Power of the 1960’s, with its accompanying desire for world peace, sexual freedom and union, and now, having just endured the post-traumatic stress of ”911,” these children of the emerging Age of Aquarius, who at present control most of America’s personal income, are not going to accept the rest home scenario in their “golden years.”

People are living longer with reduced incomes, and now, in the aftermath of the World Trade Center disaster, survival fear has also become a constant companion. Conventional models of health care have become less desirable, making alternative methods more attractive, because the latter stress prevention, are less expensive, non-invasive, and foster a dynamic partnership between practitioner and patient – an interactive, shared responsibility. In short, the Baby Boom generation isn’t accepting what their parents considered to be the norm for aging.

You might say that we stand on the brink of a “paradigmal precipice,” involving the transformation of aging, and that the millions of baby boomers are proving to be instrumental in orchestrating this process, if only due to the enormous impact of their sheer number.

AARP (American Association of Retired Persons) has recently begun to publish an upscale magazine, entitled My Generation, designed to address the concerns of this large group of individuals, who are changing the “face” of aging consciousness.

Needless to say, we, as acupuncturists, have a unique opportunity to function as “shamans,” containing the energy between these two worlds, while straddling the liminal threshold of this new paradigm. It can be an extremely exciting time to be practitioners, pioneers and educators in this new field that focuses on “healthy vanity.”

Renewal vs. Rejuvenation

Traditionally, the word “rejuvenation” has been used in conjunction with the facial acupuncture process. This word is derived from the Latin adjective, juvenis, which means “young.” “Renewal,” on the other hand, is defined by most dictionaries as “an ability to make new again; to make new spiritually, to regenerate as in a spiritual renewal or revival.”

Renewal, then, suggests more than mere re-attainment of “youth” as one’s desired goal, but rather a process and journey that involves not only the body, but the mind and spirit, as well. And, contained within this journey, is the possibility of transformation, defined as “an act or process of being transformed, or changed.”

Both in our seminars and private practices, we address this transformational, alchemical opus, and likewise seek to combine the latest technology with ancient wisdom, not only to rejuvenate, but also to renew and transform the essential, original quality and beauty of life.

Therefore, a synergy of methods is employed in our treatments, always addressing the individual patient’s constitutional makeup prior to purely cosmetic considerations.

Methods:

1. Acupuncture (energetic points and muscles)

2. Acupressure (a unique combination of European, Chinese and Japanese techniques)

3. Electrostimulation (both microcurrent and neuromuscular stimulation)

4. Chinese herbal poultices and masks (the herbs can be taken internally, as well as applied topically)

5. Tuning forks and magnets

6. Isometric “facial gym” exercises

Recommendations for appropriate dietary changes, rest, exercise, herbs, meditation and visualization, facial qi-gong, good elimination and sufficient fluid intake are offered. Therefore, each person’s individual needs are addressed holistically, and their transformational journey begins.

Additionally, since art, medicine and music were never separated in ancient China, this “facial renewal” can be viewed as a synergy of creative elements, promoting an atmosphere that nourishes the soul.

The Facial Protocol

Set the Stage

When the patient walks into the treatment room, with their completed intake and release forms in hand, they are greeted by a nourishing ambience – the soft sounds of a Shakuhachi flute, a hint of lavender aromatherapy, and the glow of a Feng Shui candle.

In the changing room, the patient cleans his or her own face. Once they are prepared for their treatment, the practitioner offers them a 5 Element tea of the season, reviews the intake form, inquiring into their medical history, i.e., surgery, medications, any possible contraindications for treatment, and, finally, as to whether they are easily bruised.

Contraindications

It is important to pre-screen the patient during an initial telephone interview, to make sure that they are not contraindicated for facial acupuncture. For example, if an individual suffers from acute migraine headaches, the underlying constitutional issues must be administered to prior to any facial treatment. Any conditions of Fire Rising, either Liver or Stomach, should be noted and addressed prior to facial acupuncture. Menopausal women need their yang well anchored to avoid triggering hot flashes, and the yin should be additionally nourished with herbs.

The Benefits of Facial “Renewal”

Here some of the benefits are outlined, and the patient is also informed as to realistic expectations for the outcome of the treatment. For instance, the quality of skin and muscle tone can improve, fine lines recede, and deeper wrinkles diminish. This treatment increases local blood and lymph circulation, reduces bags, puffiness and sagging, and constitutionally can help sinus and headache, GYN issues, digestive problems, hypo/hyper-thyroidism, and other health concerns.

“Mirror, mirror on the wall”

At this point, the patient is given a mirror, and is asked what they would like to see changed in their face. The second question always comes as a bit of a surprise, “What would you like to honor in your face?”  The response to this inquiry usually tells us a great deal about the patient.

For instance, if there is nothing that they like about their face, we know that deep issues of unworthiness and self-esteem need to be addressed in the forthcoming sessions. On the other hand, being presented with an opportunity to positively view the face as a mirror of life’s experience prompted one of my patients to say that she liked her eyes and the “sunbursts” around them because they were a testament to her joy.

We encourage an open forum for transformation. Our intention is to remain compassionate, discerning and as non-judgmental as possible during the patient’s journey.

Five Element Hand and Face Diagnosis

The next step is to examine the patient’s physiognomy, which incorporates the ancient Chinese art of hand and face reading. As far as we know, this practice originated in the Han dynasty, in the 3^rd century BC, when shamans, called Fang Shih, went into trance states, and read faces, hands, and body types, using various divination tools, such as I Ching, geomancy, tortoise shells, etc.

The study of this art is comprehensive, and takes at least 8-10 years to master. However, in this setting, along with the Five Element correspondences, Five Element hara palpation and a Five Element wrinkle chart, it is employed as a basic diagnostic technique in order to involve the patients more fully in their process.

By observing certain lines and physical attributes in the patient’s hands and face, one can discern which element or elements they embody. It is important to remember that each individual incorporates within them all five elements, but tends to manifest one or two more prominently than the others.

With this knowledge, the practitioner can treat the patient constitutionally, and have an added understanding of the patient’s tendencies with respect to aging, health and longevity.

Wood-Earth Element Combination

Let us consider, for example, a patient who comes in for treatment with a Wood/Earth element combination:

Wood-Earth Hand

A Wood hand is well-proportioned, and has many small lines on the ventral surface of the palm and fingers. This trait usually indicates poor circulation in the extremities with a dry skin condition. Examining the Earth component of this individual’s hand structure, the practitioner might notice that this patient has a fleshy thenar eminence, and short, triangular-shaped fingernails with hangnails that they have bitten off with their teeth. The flesh on the hands may be either sagging (yin) or firm (yang).

Wood-Earth Face

The Wood face exhibits a prominent forehead that is at least as wide as (or wider than) the cheekbones; there is a slope between the cheekbone and jaw, and the eyes are deep set, with a high superciliary arch. Adding the Earth element into the equation would give them a possible double chin with sagging skin. Therefore, the upper portion of the face would manifest Wood tendencies, and the lower jaw area would experience the “gravity” of the Earth element. Let us continue our journey with the Five Elements to further determine our constitutional treatment.

Five Element Wrinkle Analysis

The Wood patient presents the most allergic landscape of all the Five Elements. This understanding would alert the practitioner to inquire about the patient’s possible sensitivity to topical medications, herbs and cosmetics, and could prevent an explosive reaction to poultices and herbal masks applied during the session.

Complexion-wise, “liver spots,” or hyperpigmentation, deep creases between the eyes, and dark circles under the eyes, which indicate blood stagnation, are typical pathological manifestations for the Wood type. Coupled with the Earth element, the patient might also bruise easily, have tendencies toward sagging skin and a double chin.

Tongue, Pulse and Hara

Since this is a constitutional treatment, we gather data according to Chinese medical principles, as well as through Japanese hara palpation. All previous information assembled is tempered, weighed and balanced through these diagnostic techniques.

Needling the Body

The body is first needled based on Five Element hara palpation, which accorded with our other diagnostic tools.

“Hello, Hara”

The Liver hara (Left, St 25-27) is next palpated to check for tightness, pressure-pain or any “ropey” sensations. Because the Liver hara initially affects the free flow of qi and blood throughout the body, it is usually needled first, if the practitioner discovers that it is tight. With our sample patient, who embodies a predominance of the Wood element, we will assume that “oketsu” (stagnant blood) needs treatment. Needle:

Left, Lu 5 (more lateral than the TCM Lu 5, on the cubital crease, midway between the TCM Lu 5 and Lu  11; 1 cun above or below, depending upon palpation)
Left, Liv 4

Jing Level “DNA” Points

After the needling of the hara, we use the Eight Extraordinary “DNA” points for each of the Five Element personalities. Since we are treating patients constitutionally, and are observing their tendencies in the aging process, it is beneficial to treat at a deeper level to facilitate support for the “essence” of longevity. Only the opening points of the Eight Extraordinary meridians are needled contralaterally to support the jing “DNA” level, not only in consideration of the physical aspects of these vessels, but also the emotional/energetic and psychospiritual levels.

For example: for the Wood/Earth combination person, we might use these opening points:

This is Kiiko Matsumoto’s Infinity treatment that opens the belt meridian, drains the channel, and regulates any GYN or digestive problems.

Ying Level “TCM” Points

This is the ying “TCM” level, and related elemental points are included in the Constitutional Facial Acupuncture protocol.  Here, each practitioner will use their own diagnostic tools to address the patient’s constitutional signs and symptoms:

Facial Herbal Protocol

Please note that it is possible to use the Chinese herbal facial poultice prior to needling the body, to relax the patient, and to save time in the flow of treatment.

This poultice literally serves as a “meal” for the skin, neck and décolletage, lifts the qi and the yang, and nourishes the blood and qi; it can also support the sinews, clear heat and dampness and nourish yin. This formula is based on the ancient tradition of the Chinese “herbal soup” or Four Ingredient decoction, “Si Wu Tang,” and contains the following basic elements:

bai shao (Radix Paeoniae lactiflorae); dang gui (Radix Angelicae sinensis); shu di huang (Radix Rehmanniae glutinosae conquitae), chuan xiong (Radix Ligustici chuanxiong)

Western herbs are combined with the Chinese herbs to counteract the effects of poor nutrition, pollution and stress. This formula nourishes the cells of the facial tissue while it moistens and tonifies the skin. Additional Chinese herbs are added for special skin conditions like acne, “liver spots,” eczema or rosacea to clear heat, dampness, and toxins.

A reusable cotton mask is dipped into the warm herbal decoction and topped with a warm gel mask.  This poultice is usually left on the face for 7-10 minutes.  This prepares the patient’s face for needling and rehydrates the skin; when customized, it will address other skin issues.

Needling the Face and Ears

After completing the herbal poultice and body needling, it is time to needle the ear, according to the constitutional Five Element analysis. In our sample case, the Wood/Earth person’s ear could be needled, very simply, as follows:

Right, Liver
Left, Spleen
Bilateral, shenmen

There are many approaches to needling the face; most practitioners use the basic principle of needling upward and outward, using only acupuncture points, without a working knowledge of the muscles and their functions. This is wonderful for bringing qi and blood to the face (along with other benefits), but does not effectively tone the muscles or seriously impact sagging tendencies. Other techniques use acupuncture points for tonification and sedation, involving the antagonist and protagonist of the muscles.  Yet another technique, involves the use of the motor points of the muscles via the acupuncture points.  This method creates a powerful lift to the face and neck, and the patient can feel the results of this process for several days after the treatment.

According to Alex Tiberi, “motor points are places where the nerves enter the muscles, and this procedure causes the nerve endings in the muscles to fire, which is essential to local facial acupuncture treatments. If the muscles are flaccid or sagging, this action will cause them to become more toned and strengthened. It serves to reset the spindles in the muscle, fortifies a weak muscle, and restores balance to muscles that have become too contracted.”

In needling the face, a synergy of techniques is employed, that always incorporates muscle functions via the acupuncture points and also addresses each patient individually.

Continuing with our example, the Wood/Earth person’s face, one might find a Liver “frown” line between the eyebrows, a hyperpigmentation spot on the right cheek, a droopy nasolabial fold or “smile line” and the beginnings of a double chin and crepey neck.

For the Liver line: spread the patient’s skin to see if the line remains; if it does, the line needs to be threaded up superficially under the skin, because it has lodged itself in the dermal layer, which affects the collagen and elastin level.

We can also use the tonification and sedation techniques for the corrugator muscle:

Sedate (15 minutes): yintang
Tonify (2 minutes): yuyao

Or, one might treat the motor point of the corrugator muscle by threading UB 2 toward yuyao, while looking for a slight grabbing sensation. The practitioner should be advised that both approaches may be used, i.e., the muscle may be treated and the line threaded, if necessary.

For the “liver spots” on the right cheek, we could “circle the dragon,” either with 1” red Seirin needles with tubes, ½” red Seirins, or with intradermal needles. The incorporation of the “painless” Japanese needling technique would certainly be appreciated by most facial acupuncture patients.

Droopy Nasolabial Fold

Once again, spread the smile line to see if the wrinkle is in the skin or not. If it is, thread the smile line superficially, upward toward the nose. This seems to enhance protein development under the line and encourages collagen production.

Also recommended are tonification/sedation techniques for the levator labii superioris muscle.  This raises the angle of the mouth, as in a smile.

Sedate (15 minutes): St 4
Tonify (2 minutes): Ren 24, LI 19

This affects the protagonist and antagonist aspect of the muscles, and the amount of time the needles are retained constitutes the sedation/tonification protocol.

Or, the motor point of this muscle can be treated by needling bitong, angling it toward St 2, to get a grabbing reaction, and retracting the needle to angle it slightly downward toward St 3 for another reaction. Both of these techniques work well for lifting out the smile line with the sedation/tonification technique being more gentle and cumulative.

Double Chin

For the double chin, it is important to bring the patient’s attention to how they customarily hold their jaw and neck; often they are exacerbating this problem with their body language and old habits. Suggested isometric facial “qi gong” exercises as homework are terrific!

Needle the digastricus muscle, which opens the mouth by depressing the jaw, and elevates the hyoid bone. Thread SI 17 toward TH 17 under the platysmus muscle. Once again, the practitioner is seeking to duplicate that sensation of having the needle grasped by the muscle.

Crepey Neck

The platysma muscle is a large, thin sheath of muscle that is one of the first muscles to wrinkle and droop. This is one of the best facial “qi gong” exercises to address the cords below the neck, belovedly named “turkey wattles.”

1. Move your head back and your chin upward, so that the entire throat feels taut;

2. move the lower teeth over the upper teeth and lip;

3. smile with the mouth corners backward and upward;

4. hold this position for 10 seconds, feeling the muscle all the way up from the chest and around and under the chin;

5. bring the jaw gently down and repeat 5 times.

In about a week, visible results can be seen. Also, motor points can help tighten up this neck area.  Needle:

St 5, 1 cun back toward the ear, bilaterally;
Needle a second St 5 on the bone, and then wrap the needle under the bone to elicit another motor point response (bilaterally); needling an extra point on the neck 1 cun from St 9 out toward the SCM muscle can help tighten up this area, as well.

Also recommended is the needling of St 13 bilaterally for the neck and chin. Releasing the motor point of the upper trapezius muscle by obliquely needling SJ 15 toward GB 21 can actually give a person with “no neck” some length in their neck. After this, intradermals can be used on the deeper neck lines to bring qi and blood into the area.  This works wonderfully! Retain the needles in the face for about 15-20 minutes, and leave the intradermals until the redness has subsided.

“Qi-Lifting” Mask

After the facial needling and before the “modular” microcurrent, a mask frothed with egg whites, herbs and essential oils is used to penetrate facial tissue, nourish and stimulate the generation of new cells, and to promote healthy, moist, supple skin.

Needle-less “Modular” Microcurrent

Here, instead of needling the face, especially if the patient is needle-phobic or has an event to attend that evening and fears bruising, a “modular” microcurrent treatment is recommended. A simple microcurrent machine is employed, with probes dipped in collagen serum to wake up the face. This takes about 30 minutes and traverses the neck, chin jaw, smile line, droopy eyebrow, sinus, forehead, chin and jowls, as well as Du 20 to raise yang for the purpose of counteracting sagging skin and prolapse.

The microcurrent is 1/1000 of a milliamp, and the low frequencies mirror the body’s natural electrical pulses. According to Dr. Robert A Becker in The Body Electric, it is possible to repair tissue at the cellular level by means of these treatments.

Moisturizing: “A Facial Feast”

The final stage in the treatment can be the use of a moisturizer that combines Chinese herbs, vitamins, natural oils, and soothing botanicals to improve the texture of your skin, reduce dryness, and help to make the skin feel soft and elastic.

Then place heated basalt rocks on the heart charka, and in both the patient’s hands in order to calm the shen, and nurture the patient while “photo”-massaging the moisturizing cream into the face with a LED or “light emitting diode” machine. It is an infrared pulsed light source that stimulates the DNA within the cell, causing increased protein and calcium production. According to Stephen Guy-Clarke, an English acupuncturist, “the light beam can be applied directly to the skin, where it penetrates into the soft tissue, or it may also be used on acupuncture points, where it travels through the meridians like fiber optics to reach the internal areas within the body.”

The Grand Finale

A nice way to end the treatment employs jade rollers, which are cooling and draw forth yin to the face. The ancient empresses of China used jade as a precious stone to be worn, not only around their necks, but also to attract the yin and nourishment into the skin. The stone served a double purpose of promoting beauty and for magical protection.

Finally, spritz and hydrate the face with the scent of rose or lavender essential oil water, depending upon whether the patient tends to manifest heat in the face or has dryness and wrinkles.

This is an organic process, but, after 10-12 treatments, most patients will have shed at least 5-10 years. However, this facial renewal is only the outward physical manifestation of their inner pilgrimage; in the course of their journey with us, lives may have changed, old relationships been released, new relationships and careers embarked upon. Invariably, an increased sense of worth and self-esteem blossoms, and they radiate a new confidence and joy.

Conclusion

Because the Taoists say that the face reflects the “3 Treasures,” we observe and then constitutionally protect the client’s inherited Jing, supporting the level of qi, a deficiency of which can manifest in sagging skin, prolapses, wrinkled skin, and nurture the shen, which shines through the color, radiance and expression of the spirit. 

Yes, we are indeed poised on that “paradigmal precipice,” gazing upon a changed “face” of aging. There is a large group of people who are interested in “healthy vanity,” and in living longer with an increased quality of life. The possibilities are vast, presenting a myriad of opportunities for us, as acupuncturists, to be facilitators of this ongoing shift of consciousness.

About the Authors:

Mary Elizabeth Wakefield, L. Ac., M.S., and Sunanda Harrell-Stokes, L. Ac., both specialize in exploring “healthy aging.” They can be reached at (866) 841-9139, x 2449, or at marisanda@onebox.com.