No Fear of the Needle
by Charles Yarborough, L.  Ac.
from Les Nouvelles Esthetiques, August 2005

Facial acupuncture is a unique and exhilarating experience, one that combines ancient techniques with modern technology.  However, before adding it to your spa menu, there are logistical and legal issues you should consider.  While facial acupuncture draws on centuries of Chinese medical theory, it has to be administered and marketed correctly to maximize its effectiveness and minimize your liability.  Let’s first define this modality.  Who developed it, what does it entail and how well does it work?

Cosmetic acupuncture is also known as acupuncture facial rejuvenation and acupuncture facial renewal.  Common to all facial acupuncture techniques is the concept that a person’s face reflects the health of their internal organs.  For this reason, a practitioner will first diagnose the organic strengths and weaknesses of the client within the context of traditional Chinese medicine and give him or her the appropriate whole-body treatment.  From there, techniques may vary.  Generally, they entail the painless insertion of super-thin needles into the face—along wrinkles, on facial acu-points and at specific locations on facial muscles.  Depending on their training and technique, practitioners may use as few as a dozen or as many as 60 needles on the face and body.  Herbal poultices and creams may be administered and diet is likely to be discussed as well.  Facial acupressure and essential oils may also be included, along with pulsed light and microcurrent stimulation.  Despite claims of ancient pedigree, facial acupuncture has been refined into a distinct discipline only within the past 10 years.  Various teachers have since developed their own techniques, which practitioners may modify in service.  Nevertheless, there exist ancient records of acupuncture in the service of enhanced beauty.

Does it really work?

Can clients look better and more youthful with facial acupuncture? Absolutely! Fine lines can be lessened or eliminated (after a half-dozen treatments), deeper lines can be reduced, baggy eyes and sagging jowls firmed up.  Also important is the probability that the client will feel better and enjoy increased energy.  While the practitioner may also address health issues during the course of treatment, clients should understand that specific health issues must be addressed during a separate appointment, at a different rate of service.  A series of 10, twice-weekly facial treatments is usually recommended (smokers and others with destructive lifestyle habits may require more), along with periodic tune-ups.  The marketer of this program—or your receptionist—may encounter skepticism from potential clients who seek a quick, permanent fix.  These clients will be poor prospects for facial acupuncture and should probably be steered toward more familiar services.  There are, however, many people willing to make a sustained commitment to generating vitality and radiance from the inside out.

Integration into the menu

Integrating facial acupuncture into the menu of spa services needn’t be an ordeal.  Your acupuncturist should help you by supplying the receptionist with printed answers to questions they’ll inevitably face.  Experience has taught me that these will include:

1.           How does it work?  A maximum three-sentence explanation, including the word “collagen.” Skip the Eastern philosophy; leave it to the acupuncturist.

2.           Does it hurt?  The answer should be “not generally.” Avoiding absolutes will reduce liability.  It is essential that the acupuncturist give sample treatments to all staff members who interface with the public.

3.           How much is a treatment?  This is a high-end purchase.  Treatments should be sold as a package only, if possible.  In some states it’s illegal to sell blocks of treatments.  A way of staying within the law may be to offer pro rata refunds for unused sessions.  Check with your state’s acupuncture licensing board.

4.           How long does a treatment last?  At least an hour, depending on modalities included.

5.           Does the acupuncturist offer weight management and other services? Price these out in advance, as the question will inevitably arise.  Call it weight management, not loss.

6.           Is this a facial?  No; nor is it an alternative to a facial.

7.           Are needles sterile?  Needles should always be disposable.

8.           Is the practitioner trained?  He or she should be a member of the American Cosmetic Acupuncture Association: www.AmericanCosmeticAcupuncture.com.  This assures you the practitioner is certified.

9.           Free consultations?  Yes.  A 15-minute consultation will allow the practitioner to reassure and educate the client.  This is an opportunity for the acupuncturist to inform the client of other services he or she offers, whether or not facial acupuncture is purchased.  In these consultations, as with any treatment, practitioners should be wary of inserting needles and offering diagnoses without first having the client sign an “informed consent” form and (if their insurance company requires it) a standard arbitration form. 

Insurance imperatives

At a recent acupuncture conference, I met several seasoned practitioners who were, to my amazement, conducting business without liability insurance.  Their close connection with their patients, they argued, was their protection from legal problems.  As a spa owner or manager, you know that regardless of close connections, enthusiastic clients can become disgruntled litigants very quickly—and without apparent cause.  In the facial acupuncture field, it’s important not only to be insured, but to know whether one is performing within one’s scope of practice. 

The American Acupuncture Council, a California-based insurer with nearly 10 thousand U.S.  members, including plastic surgeons, has received almost 500 applications mentioning facial acupuncture.  To date, there have been no claims regarding this specialty, says the company’s vice president and general counsel Michael J.  Schroeder.

“State laws vary regarding scope of practice.  The question that keeps coming up is: Are you practicing acupuncture or Western medicine? The answer lies in how you frame your treatment and what you call it.  We have declined applications from those who perform what they call ‘acupuncture facelifts.’ That’s clearly Western medicine.  The term ‘facelift’ creates disappointment for the patient who expects sudden dramatic—or even structural—changes.” And this, Schroeder notes, is pivotal when it comes to legal exposure. 

“Unrealistic expectations are going to generate insurance claims,” says Schroeder.  “A client may go for a treatment, expecting his or her life to change, expecting to walk out magically transformed.  When that doesn’t happen, when they find they’re still the same person, they may be disappointed and angry.  It is essential to manage the patient’s expectations.  They should know what to reasonably expect.  This ought to be spelled out in your ‘informed consent’ form.”


Putting it to work

The term “facelift” may not be appropriate, but there are many others to choose from.  One of them is “Constitutional Facial Renewal,” a patented protocol.  It is a treatment modality used at several Canyon Ranch Spas, at New York’s Aveda Spas, and is the creation of Mary Elizabeth Wakefield, L. Ac., Dipl. Ac.  Wakefield has published extensively on facial acupuncture and has trained a thousand practitioners worldwide.  Her patented, ultra-luxuriant Diamond Acupuncture Facial has been featured in such venues as People Magazine.  Wakefield’s seminars draw from her extensive clinical studies as well as from traditions of Chinese facial diagnosis, pulse reading (six pulses are used) and Eastern philosophy.

“This is very exacting work,” Wakefield says.  “It’s almost like being a Swiss watch maker.  You’re working not only with acupuncture channels and acu-points but with some very delicate tissue and multiple groups of facial muscles, with many of them having varied functions.  Thorough training and a knowledge of Western-based anatomy are essential.”  As part of the whole-person treatment, she says, “we may use traditional psycho-spiritual points on the body.  We guide the body so that it can reabsorb the signs of aging.  Our field is unique in that we treat the body, mind and spirit while enhancing longevity.”

Besides her rigorous teaching schedule, Wakefield conducts a yearly spa training for facial acupuncturists—the only program of its kind.  Decorum and presentation, as well as familiarity with spa modalities, are all part of the curriculum.

“Working within a spa setting is very different from private practice,” she says.  “You have to be able to discuss all the spa features intelligently with your clients and understand the value of cross-referrals.  It’s not enough to be proficient in this work; you must become part of a well-integrated team.”

A qualified facial acupuncturist on a well-integrated team will be a terrific asset to your spa.  With facial acupuncture, you’ll widen your client base and give yourself a competitive edge, bringing an added dimension of health and beauty to your service menu.

Charles Yarborough, L. Ac., practices at Blue Spa in Sherman Oaks, CA, and is director of the American Cosmetic Acupuncture Association (www.AmericanCosmeticAcupuncture.com). 

Mary Elizabeth Wakefield, L. Ac., practices in New York.  For more information, please visit www.ChiAkra.com.