Constitutional Facial Acupuncture Renewal: Catching a Wrinkle in Time/ OM Summer 09
By Mary Elizabeth Wakefield, L. Ac., Dipl. Ac., M. S., M. M.
In the 1960's, my friend, and noted author, Madeleine L' Engle penned an award-winning novel for young adults entitled A Wrinkle in Time, which, in its wonderful invention, appealed to the inner child of a wide-ranging adult audience. In the course of the story, the young girl, Meg Cleary, "tesseracts" through space and time. In so doing, she transcends our quotidian 3-dimensional reality, and experiences a realm in which every instant of time co-exists in a perpetual present.
Those Baby Boomer children of the 1960's are similarly questing to re-invent themselves, to look and feel beautiful, healthy, creative, and whole. In their desire to remain vital and vibrant, their focus is on "catching a wrinkle in time" - seeking to minimize the visual evidence of aging, while likewise living each moment to its maximum in that state of eternal "now". While in our culture, physical beauty tends to be associated with superficiality and a corresponding lack of spiritual profundity, it seems that the ancient world recognized this desirable human attribute as more than skin deep -- a perspective that links a beguiling outer appearance to a manifest emergence of the deepest qualities of soul. This pre-modern notion of beauty as an aggregate of physical attractiveness and spiritual depth implies the existence of a deeper union between body and spirit, and reflects a multifaceted tapestry of possibilities for health, well being, and balance.
The treatment protocols that make up the program we call Constitutional Facial Acupuncture Renewali are based upon Chinese medicine, offering a comprehensive constitutional treatment that views the face as a mirror of the overall health and well being of the body. This approach seeks to achieve more than just a pretty face, transforming and renewing the essential and original quality and beauty of life. A synergy of methods is employed to first address the individual's constitutional make-up before the purely cosmetic considerations.
It is important to pre-screen the patient during an initial telephone interview, to ascertain that she or he is not contraindicated for facial acupuncture. The underlying constitutional issues must be addressed prior to any facial acupuncture; for example, acute migraine headaches, or any conditions of either Liver or Stomach Fire rising. 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
Prior to treatment, the patient is informed of realistic expectations for the treatment outcome, and the treatment's benefits are outlined, which may include the improvement of skin and muscle tone, receding of fine lines, and diminished deep wrinkles. The treatment increases local blood and lymph circulation, reduces bags, puffiness, sagging, and by its constitutional approach, can treat TMJ, Bell's palsy and neuropathies, help sinuses and headaches, gynecological and digestive problems, hypo- or hyper-thyroidism, and other health concerns.
Five Element Physiognomy
The next step is to examine the patient's physiognomy, which incorporates the ancient Chinese art of hand and face reading. This practice originated in the Han dynasty, in the 3rd century BCE, when shamans known as "fang shi" read faces, hands, and body types.1 Livia Kohn (1996)2 describes this: Physiognomic inspection does not consist of guessing-it is the recognition of what is natural, of what is there latently, invisible to the untrained, nonintuitive observer... The physiognomist may be a technician as well as a sage. The sage, as part of the underlying power of the Tao, spontaneously intuits people's standing in the world, while the fortune-teller or shaman is a trained technician who has learned his or her skill by memorizing signs and the character types associated with them...
By observing certain lines and physical attributes in the patient's face, we can discern which element or elements she or he embodies. It is important to remember that each individual is incorporated from all five elements, but tends to manifest one or two more distinctly than the others. Let us consider, for example, a patient who comes in for treatment with a wood/earth element combination: The wood face exhibits a prominent forehead as wide as (or wider than) the cheekbones, a slope between the cheekbone and jaw, and deep-set eyes, with a high superciliary arch.
The addition of the earth element would possibly show a double chin with sagging skin. Therefore, the upper portion of the face would manifest wood tendencies, and the lower jaw area would reveal the gravity of the earth element. Further investigation with the five elements will determine the constitutional treatment.
The Three Constitutional Levels
Acu-points are selected according to the three levels-the jing, the ying, and the wei-to support the patient's specific TCM patterns, and the classical five element meridian imbalances involved in the aging process.
The Jing Level
This level uses the eight extraordinary meridians as the repository for ancestral jing, due to the relationship each of these channels has with the Kidneys. These meridians carry our original pattern of qi and the ancient Taoists believed that these extraordinary channels could enhance and lengthen life.
Since we are treating patients constitutionally, and are observing their tendencies during the aging process, it is beneficial to treat at a deeper level to support the essence. Only the opening points of the eight extraordinary meridians are needled contralaterally to support the jing level, both in consideration of the physical aspects of these vessels, and also their emotional/energetic and psychospiritual levels.
For example: for the wood/earth combination person, we might use these opening points:
Waiguan SJ-5 (Right)
Gongsun SP-4 (Right)
Neiguan P-6 (Left)
Zulingqi GB-41 (Left)
This is Kiiko Matsumoto's Infinity treatment that opens the belt meridian, drains the channel, and regulates any gynecological or digestive problems.
The Ying Level
Ying and blood are crucial for the nourishment of the cells of the facial tissue, and the textural quality of the skin in general, thus, we must assess the general state of the nutritive-ying as well as attend to local obstruction that may be preventing nourishment from reaching the tissues involved. This is where a practitioner will use her or his own diagnostic tools to address the patient's constitutional signs and symptoms.
The Wei Level
This level releases the surface, and involves tight, tender ashi points that, when palpated, are registered as pain or discomfort by the patient. Ashi points can refer sensation to other muscles and, when needled, cause a jump in the muscle as it releases.
Needling the Face
There are many approaches to needling the face: one effective 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. A motor point is a specific location where the nerves enter the muscles (a neuromuscular junction). When these sites are needled, the muscle fires and grabs the needle, which can elicit a local twitch response. This information is reported by the muscle spindle to the central nervous system (CNS), which gives instructions to either relax tight, contracted muscles, or to strengthen flaccid, weak muscles.
On our wood/earth person's face, we may 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 crepe-like skin on the neck.
For the Liver frown 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 levels. Similarly, you can treat the motor point of the corrugator supercilii muscle by needling Zhanzhu BL-2 toward Yuyao (M-HN-6), 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 1/2" red (40mm) Seirin needles or with intradermal needles. The painless Japanese needling technique is certainly appreciated by most facial acupuncture patients.
For the drooping nasolabial fold (the "smile line"), 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 can encourage collagen production. When treating a double chin, we needle the digastricus muscle, which opens the mouth by depressing the jaw and elevates the hyoid bone.
Needle Tianrong SI-17 towards Yifeng SJ-17 under the platysma muscle. Once again, the practitioner is seeking to elicit that sensation of having the needle grasped by the muscle. For the crepe-like skin of the neck, the platysma muscle must be strengthened. The platysma muscle is a large, thin sheath muscle that is one of the first muscles to droop, creating a wrinkled appearance. Motor points can help tighten up this neck area. Bilaterally needle Daying ST-5, 1 cun back toward the ear. Needle a second ST-5 on the bone, and then wrap the needle under the bone to elicit another motor point response; needling an extra point on the neck 1 cun lateral from Renying ST-9 can help tighten up this area as well.
Also needle Qihu ST-13 bilaterally. These are suggested protocols only. Constitutional Facial Acupuncture Renewal is very much a "less is more" approach to the facial terrain; we do not overload the face with needles.
The treatment protocols embodied in Constitutional Facial Acupuncture Renewal are designed to reveal the natural goodness and beauty in each patient's appearance, of whatever age. We aim not for the mere appearance of youth, nor do we adopt a cosmetic approach that creates what we might term a facial tabula rasa -- a visage seemingly unmarked by the passage of time, reflecting in its unblemished smoothness a "brow completely unfurrowed by thought" or personal experience. This is an organic, gradual process, but, after 12 to 15 treatments, most patients will appear to have shed between five to ten years of age. Often, too, this facial renaissance becomes the outward physical manifestation of an inner transformation that can be literally life-changing. An increased sense of worth and self-esteem blossoms for these patients, and they radiate a new confidence and joy.
Note: Portions of this article appeared in an article by Mary Elizabeth Wakefield in The Lantern (Australia), vol. 6 no. 1,
i. The term "Constitutional Facial Acupuncture Renewal" is trademarked as a proprietary name for this treatment protocol.
1. "The first systematic exposition or manual of the rules and principles of applied physiognomy in China, as extant today, is found among the Dunhuang manuscripts. Ascribed to Xu Fu of the Han dynasty, the Xiangshu, (‘Physiognomy') has survived in three different manuscript versions ..." Livia Kohn (1988). "Mirror of Auras": Chen Tuan on Physiognomy. Asian Folklore Studies, Vol. 47, No. 2 (1988), pp. 215-256.
2. Livia Kohn (1996). "The Looks of Laozi." Asian Folklore Studies, Vol. 55, No. 2
(1996), pp. 193-236.
3. "Content of Chapter Five of Chen Tuan's ‘Mirror of Auras': Physical appearance according to the five phases (wuxing). Here correspondences are given between ‘metal'
and angular appearance, ‘wood' and slimness, ‘water' and obesity, ‘fire' and sharply-cut
features, ‘earth' and coarse, solid looks. In addition certain psychological dispositions are
associated with the five types. They are in the above order: deep resolution, wealth, literary talent, courage, and caution."