Shellie Goldstein has been known for saying, "When you look good, you feel good, and when you feel good, you look good." As one of the first cosmetic facial acupuncturists in the U.S., for decades she has been striving to help her clients "not only look better, but feel better as well." Licensed in acupuncture as well as esthetics, Shellie developed the AcuFacial "to treat the inside to affect the outside" by integrating traditional acupuncture, facial gua sha, and face cupping with modern techniques including microcurrent, LED light, and ultrasound. The AcuFacial continues to be the most popular treatment at her busy practice, but these days Shellie is shifting her focus to dedicate more time and energy to teaching.
I met Shellie in 2016 when I was studying acupuncture at her alma mater, the Tri-State College of Acupuncture (TSCA) in New York, NY. She graduated in 1991 when acupuncture was not yet legal in the state of New York, and the school was located in Connecticut. Since then, Shellie has played an active role in the evolution of this medicine from a "fringe" phenomenon in this country to a modality that is increasingly mainstream.
She has also been a leader in establishing Cosmetic Facial Acupuncture (CFA) as one of the fastest growing specialties in the field. CFA may be relatively new to the Western world, but as I learned from Shellie, Chinese Medical Cosmetology, or Mei Rong, has a well-documented and venerated history dating back thousands of years to the Qin Dynasty (221-206 BC).
The modern application of ancient Mei Rong, referred to today as AcuFacial, Constitutional Facial Acupuncture, Cosmetic Acupuncture, Cosmetic Facial Acupuncture, or Facial Rejuvenation Acupuncture, has become a recognized and desired alternative or adjunct to well-established beauty-enhancing procedures such as Botox, fillers, and surgery. Widespread interest in CFA is reflected in the variety of students enrolling in Shellie's continuing education programs - new acupuncture graduates, seasoned acupuncturists with established practices, and even MDs.
AG: What inspired you to become an acupuncturist?
SG: I had a back injury, and I found an acupuncturist in Chinatown. He spoke no English, but his daughter did. She explained the principles of Chinese medicine, and I fell in love with the holistic concept. At the time I was working at the NYU Medical Center as a cell biologist, and I left the lab to study acupuncture at TSCA. I have always been interested in science, and my favorite subject in college was biology. I have a Masters in Biological Nutrition from the University of Bridgeport, CT.
AG: What led you to specialize in CFA?
SG: In 1990, Carolyn Bengston introduced me to acupuncture for appearance enhancement which was unheard of in the U.S. at that time. She gathered a small group of Tri-State students in her Manhattan studio apartment to share what she had learned on one of her many trips to Asia. Hard to believe that CFA was not universally embraced by the acupuncture community back then. Very few were practicing it, and certainly no one was teaching it. And yet less than three decades later, a 2014 NCCAOM "Acupuncture Facial Rejuvenation Certification Needs Assessment Survey" would reveal it had become the third most popular specialty. Based on acupuncturists' responses to that survey, 62 percent of their patients had inquired about acupuncture facial rejuvenation services for the purpose of appearance enhancement.
My passion for CFA grew during my trip to China after graduation from acupuncture school. I visited a hospital in Beijing where I apprenticed and treated patients in the facial paralysis unit. When I returned to New York, I observed a facial dissection class at Columbia University. In acupuncture school we learn a lot about Chinese medicine, but when practicing facial acupuncture, results are much better if you know facial anatomy and understand changes over time. Would you go to a surgeon who didn't know anatomy?
When I got my license and started practicing, immediately patients began to ask about acupuncture for appearance enhancement. Then one day I looked in the mirror and saw that I was getting older too. Oh dear!
AG: Can you explain your transition from practicing as a clinician to teaching?
SG: As CFA becomes more popular, I am drawn to sharing my knowledge and expertise to help acupuncturists achieve the best results possible. I want to help ensure the future of acupuncture in this country and the success of this specialty. Nearly three decades ago, as one of the first practitioners in the U.S. to specialize in CFA, the unpaved road was not easy. I spent years integrating my Eastern medicine experience with my knowledge of Western medical science before I was able to create my AcuFacial technique and confidently begin treating my patients for concerns about aging. From personal experience, I know the extent of practice and training required to get the kind of outcomes clients expect and demand.
As graduates of acupuncture school we proudly display our new diplomas on our office walls to assure patients of our academic education and professional proficiency. Although graduation from acupuncture school marks a milestone, it is only the beginning of our professional career. Acupuncturists are lifelong learners in the truest sense of the word. In addition to enhancing our skills, continuing education offers exposure to new treatment styles, approaches, techniques, and modalities. Post-graduate courses also provide the opportunity for advanced study and education in specialty fields such as CFA, as well as others including fertility and pediatrics.
With the help of the internet, today's patients are more educated and inquisitive. They ask more questions, expect informed answers, and demand a higher level of quality care. Knowing their healthcare professional is trained, proficient, and competent to treat their specific problems gives them confidence and a sense of personal safety and security.
AG: How do you reconcile the principles of Chinese medicine with your biomedical approach to CFA?
SG: In keeping with the philosophy of Mei Rong, modern practitioners of CFA view a disharmony in the Zang-Fu Organs, meridians, qi, blood, and fluids as the core of cosmetic-related complaints. An imbalance of any or all of these can be reflected on the face in the form of wrinkles, loss of muscle tone, decreased skin elasticity, skin problems (e.g., acne, rosacea), a withered, pale, dry appearance, and more. The etiology of these conditions is imbedded in the pattern recognition, diagnosis, and treatment of qi, blood, and fluids as they influence and are influenced by the elements, Organs, and meridians. As practitioners of Chinese medicine, we know that patients' primary complaints are generally one of myriad disharmonies. As cosmetic facial acupuncturists we find that those presenting with allergies often have abdominal disturbances, loose stools, as well as loss of muscle tone in the cheeks and along the jaw, all of which can be related to Spleen Qi Deficiency with Dampness. Treating the Spleen can resolve allergies and address abdominal disorders such as loose stools, while at the same time restoring facial muscle tone. Patients presenting with menstrual problems related to Liver Blood Deficiency and Qi Stagnation commonly experience headaches, and difficulty sleeping, along with dry skin with forehead wrinkles. Treating the Liver, often the root of menstrual disorders, can relieve headaches, alleviate insomnia, hydrate skin, and soften forehead wrinkles. Patients with chronic low back pain related to Kidney Yang and Essence Deficiency may feel tired and chilled, and they may be prone to aging prematurely. Treating the Kidney can resolve low back pain, reduce fatigue, increase internal warmth, as well as enhance overall facial appearance.
However, identifying disharmonies from a Chinese medicine point of view is only the first step. Equally important is knowing how to address these imbalances from a biomedical perspective. CFA training entails learning to recognize visual subtleties in facial structure and shape while considering morphological changes that occur over time.
Aging alters the balance, proportions, and symmetry of the face. Skeletal resorption of the head and face causes eye sockets to enlarge, the angle of the brow to drop, and the mandible to lengthen. Facial fat loss and redistribution leads to cheek flattening, thickening of the nasolabial folds, and a deflated frontal appearance. Changes in facial structure can cause muscles to hyper- and/or hypo- extend. For example, the platysma muscle of the neck tightens and weakens creating rigid neck banding with a concurrent flaccidity producing loss of definition along the jawline and chin. Collagen and elastin depletion in the superficial tissue causes skin laxity, and epidermal wrinkling. Dermal collagen breakdown leads to skin pitting, crow's feet, laugh lines, and dimpling particularly in the lower cheek and perioral area.
AG: How does the content of your continuing education programs relate to the curriculum most acupuncturists already studied in acupuncture school?
SG: In my continuing education programs, I build on that education to increase the breadth and depth of training. Seasoned acupuncturists, and those trained in a specialized field of acupuncture, routinely draw upon a wide array of treatment modalities mastered from years of training and experience. Specialists in CFA are trained to recognize the subtleties of the face and facial patterning, and integrate them with Eastern root/branch diagnosis and biomedically-oriented treatment strategies. Therapeutic treatment requires understanding the anatomical layers of the face along with knowledge of vessel and nerve locations. Skilled needling technique involves awareness of appropriate angles and depths of insertion. Skin, superficial fascia, and adipose disharmonies are resolved when needling at a shallow angle into the integumentary tissue layer. Needling into the muscle at a medium angle restores superficial/deeper muscle and deep fascia integrity. To delay the signs of aging, needling through the deep fascia to the level of the periosteum is most effective.
Cosmetic facial acupuncturists must also learn to recognize and address patients' emotional and psychodynamic aging concerns. In our youth-driven culture, when faced with the realization that one is getting older and will eventually die, it is common to experience emotional instability and psychological upheaval. During this time, many turn to acupuncture to erase the visible signs of aging. The healing, however, lies in their deep-seated yearning for self-realization, personal acceptance, and spiritual renewal.
AG: Can you say more about the root/branch relationship and treatment strategy in the context of CFA?
SG: In acupuncture school, students learn that treatment works best when the underlying root problem is correctly identified and addressed in accordance with each patient's symptoms. Different patients may present with similar cosmetic complaints. However, although the branch complaints may be comparable, the underlying root patterns of disharmony may be very different. In order to effect lasting changes, a proficient cosmetic facial acupuncturist will develop a treatment strategy to address the root cause of the branch complaints, as well as the uniqueness and individuality of each patient. Understanding facial anatomy and how faces change over time enables us to integrate eastern medicine with western physiology. When applied properly, face gua sha/cupping improves lymph drainage and increases circulation. In addition, biomedical interventions can enhance the efficacy of acupuncture-based treatment: microcurrent exercises the face muscles while LED and ultrasound improve healthy cell production and fibroblast activity to enhance collagen and elastin production. Also important is educating your patients about lifestyle choices and homecare for long term skin health benefits. I like to empower my patients to play a role in the process. In fact, I developed a kit with a DIY acupressure device and protocol for just that reason, the TOUCH+GLOW: Do-It-Yourself Acupressure Face Lift. I also wrote a book for non-acupuncturists interested in learning more about the Chinese medicine approach to beauty and health, "Your Best Face Now."
AG: If you could offer any advice to your colleagues, new graduates from acupuncture school, and acupuncture students, what would you tell them?
SG: As the field of acupuncture gains a more respected and integrated role in today's modern healthcare system, our need to be responsible practitioners has never been more crucial. As acupuncturists, it is our responsibility to present ourselves in the manner that we want to be acknowledged. This includes how we represent ourselves, as well as how we educate ourselves. Although intention is of utmost importance, we know that acupuncture cannot be learned by reading about it, and advanced skills cannot be mastered by simply taking an abbreviated course. This is particularly true when considering yourself a specialist in any given field. The key to a rewarding and financially successful practice is rooted in a proficiency in clinical skills yielding positive results. Such achievement relies on comprehensive post-graduate study entailing competency-based training in a diversity of specialty modalities with the intention of mastering an area of expertise.
As a specialist in CFA for over 26 years, mastery of my craft comes with a lifetime of study, hard work, and perseverance. It never stops, as to this day I am still learning. My research, patients, and students are my teachers. Pursuing my passion has been and continues to be a long and extraordinary journey.
Case Studies for Cosmetic Facial Acupuncture: More than Skin Deep
| Physiological Changes Associated with Aging Changes in Facial Architecture:
Changes in Skin:
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| Benefits of Cosmetic Facial Acupuncture Enhanced Appearance:
Improved Health:
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Chinese Medicine and Biomedical Cosmetic Facial Acupuncture Treatment
In acupuncture school, students learn that treatment works best when the underlying root problem is correctly identified and treated in accordance with each patient's symptoms. Different patients presenting with similar branch "signs and symptoms" often require entirely unique approaches. Seasoned acupuncturists, and those trained in a specialized field of acupuncture, routinely draw upon a wide array of treatment modalities mastered from years of training and experience. Specialists in cosmetic facial acupuncture are trained to recognize the subtleties of the face and facial patterning, and integrate them with Eastern root/ branch treatment and biomedical-oriented treatment strategies.
The following case studies illustrate examples in which 2 different patients present with cosmetic complaints. Upon examination, it is clear that the changes both wish to address are objectively similar:
However, although the branch complaints are the same for both patients, the underlying root patterns of disharmony are very different. In order to effect lasting changes for these patients, a proficient cosmetic facial acupuncturist will develop a treatment strategy to address the root cause of the branch complaints, and then tailor an approach uniquely suited to each case. In addition, biomedical interventions will be used to enhance the efficacy of acupuncture based treatment.
| PATIENT 1: Female age 42 Busy professional with high stress corporate job ------ SUBJECTIVE ------ Chief Complaint: "I hate these lines on my forehead-- especially between my eyebrows-- and these deep creases around my nose and mouth, and also I am noticing jowls. Sitting in front of the computer all day gives me a headache." ------ SUBJECTIVE ------ Physical Exam:
Tongue: slightly pale with sticky, yellow coat Additional observations: ------ ASSESSMENT ------ Patterns of Disharmony:
------ PLAN ------ TREATMENT: Body acupuncture Auricular acupressure Gua Sha Facial acupuncture Shallow and medium insertion into the SMAS region of the platysma muscle surrounding the neck. Additional points to relax sternocleidomastoid muscle and improve posture. Medium and deeper insertion into the deep fascia region of the midface. Homecare Recommendations: Touch+Glow wand applied to base of neck and orbicularis oculi area and gentle massage to relax upper face region. |
Outcome
After 3 weekly treatments, this patient's forehead appeared more relaxed, wrinkles significantly diminished, softening of nasolabial fold and improved jawline definition. She no longer had headaches.
| PATIENT 2: Female age 54 Wife and mother of 3 children ------ SUBJECTIVE ------ Chief Complaint: "Every time I look in the mirror, all I see are wrinkles across my forehead. My face sags. I have creases between my nose and mouth. My once sculpted jawline is gone. I'm getting hot flashes at night and can't sleep. I feel anxious, afraid, old, and miserable." ------ SUBJECTIVE ------ Physical Exam:
Tongue: thin and dry with red tip Additional observations: ------ ASSESSMENT ------ Patterns of Disharmony:
------ PLAN ------ TREATMENT: Body acupuncture Auricular acupressure Face cupping Facial acupuncture Medium depth needling of mid and lower face and neck. Deep needling around temple, forehead, and jawline to delay orbital, malar, and mandibular bone resorption. Western Ancillary Methods Light Emitting Diode (LED) to enhance production of healthy collagen and elastin. Homecare Recommendations: Dermarolling (0.25mm) to improve skin integrity and enhance production of collagen and elastin. |
Outcome
After 6 sessions, this patient's appearance had significantly improved. Frontalis muscles appeared more relaxed, wrinkle creasing across the forehead diminished, cheek muscles appeared lifted, and jawline more sculpted. Patient stated she looked and felt 10 years younger. Her anxiety about aging was greatly reduced. She also noted that not only had appearance changed her overall attitude about the aging process was changing as well.
Structured water (H3O2) can be considered a fourth state of water between liquid and solid. It has the hexagonal structure of ice; however, missing a critical bond, it behaves more like a gel than a solid, but retains some of its crystalline structure.
In the past five years of my clinical practice, I have seen an astonishing upsurge in the chronic use of proton-pump inhibitor (PPI) medications for the gastrointestinal issue diagnosed by allopathic medicine as GERD. It is not uncommon to encounter patients taking these prescriptions for five-plus years.
Working with chronically ill patients entails acknowledging the reality that not all patients will survive their diagnosis. Chinese medicine and acupuncture play a crucial role in palliative and end-of-life care, addressing medication and disease side effects, alleviating pain associated with death, reducing anxiety and stress, and helping patients find peace during the dying process.
