Tuesday, April 9, 2013

Cosmetic Acupuncture

I was blown away reading Audrey’s December article on her experience of receiving Botox injections for the first time. Hers is the first article I’d seen giving the not-so-good side of what happens when Botox (Botulism Type A) works too well at paralyzing the nerves that activate muscles. The part about drooling really frightened me… Elective drooling. Elective nerve paralysis. But then again, I’m afraid of big needles.

There is great irony to this as I’m an acupuncturist.

But first, back about 6 years ago…

At age 39, I looked in the bathroom mirror one day, and audibly gasped. I leaned in closer to the mirror. What HAPPENED?! It is summertime, I have a little color on my face, so why am I so…dull? I see nothing but a grayish pallor staring back at me. Why is the area under my eyes so dark? Why am I so…blotchy?! There was no uniformity to my skin color. It was as if various areas of my face had given up on trying to look ruddy.

Then I moved to another room, flooded in natural light, and looked at a different mirror. I still looked gray, blotchy, but had a slight tan on top of it. I refuse to wear foundation. It’s just not me. Besides, I’d have to wash it off sometime, right? Conclusion: Maybe I’m getting old. That is such a cop out answer, by the way. I’m sorry, at age 39 at that moment, I was NOT old. I eat well, I have healthy fats in my diet which should nourish the skin. I work out. I get acupuncture because I’m an acupuncturist. I take Chinese herbs, because I have access to the best and most established medicine on the planet.

I even asked my dermatologist for suggestions but was not sold on any of the choices. Every procedure involved either injecting something foreign into my skin, or chemical removal of part of the skin. And the area under the eyes would involve something more. This would take time and lots of money to reshape the condition my face was in. My gut churned enough to say this was never going to happen. And each procedure carried risks. Some of them were rather serious, like an allergic reaction to dermal fillers which would leave skin bumps for 6 months. And you’d still have that dull skin, but plumper. That seemed like a band-aid, and not a solution to the problem.

So why does a healthy 39-year-young woman look like she’s just emerged from 6 months underground?
Answer: At age 28, the epidermal skin layer sloughs off about every 28 days. At age 40, it slows to every 40 days. But it doesn’t stop sloughing, it just slows down. And new skin builds slower. This is why bluish veins start to show through, why the gray / blue color takes over. A new question: How to make this happen faster?

A few years later at dinner with my acupuncture colleagues we discussed that we’d all been tinkering with what now has the name Cosmetic Acupuncture and is also known in some circles as Facial Rejuvenation. This was applying the proven techniques of Traditional Chinese Medicine to a new application: getting rid of wrinkles. Some of us had seen better results than others: we needed a consistent protocol. We concluded through a few people’s research that most preferred the protocol taught and created by Dr. Martha Lucas of Colorado called Mei Zen. It means “Beautiful Person” in Chinese. Dr. Lucas employed her own proprietary protocol, favoring many acupuncture points, and only superficial placement of the needles, rather than deep into the skin.

I booked the next seminar that she had. I went to Day One of her seminar on about 2 hours of sleep thanks to my neighbors having a party the preceding evening. I looked rough and felt worse. After discussing the specifics of her proprietary protocol, and the logic behind it, how to tailor it to each patient (one needs to diagnose each patient for his or her specific health presentation, based on assessing the patient’s pulse, and looking at his or her tongue, which is how acupuncture diagnosis has been practiced for over 5,000 years), Dr. Lucas had us practice the Mei Zen protocol on one-another. I found the facial points sensitive, similar to the “zing” one gets after having wasabi with sushi, but once the needles were out, I sat up, looked in the mirror and gasped. But this time, I gasped because my face felt tight, tingly, and I had a GLOW all over it, a healthy shine, and I swear my eyes looked less dark underneath and the tiny crinkles in the corners of my eyes were less prevalent. I was hooked. The clock started turning back on that day.

I tell my patients that getting acupuncture once is like working out once. The benefits build exponentially over time. And this is why in cosmetic acupuncture it is done for 5 weeks or more to start the body producing more collagen and elastin on its own. One or two treatment will look nice, but for more lasting effects, ten sessions are recommended within 5 weeks. If a patient is needle-sensitive or schedule-challenged, then we extend cosmetic acupuncture to once a week for 10 weeks. Two maintenance sessions are recommended quarterly or semiannually to continue positive effects of the treatment. In a healthy person, results should last 3 to 5 years. This is one comprehensive procedure, not the cost of multiple procedures (Botox, Juvederm, Restalyne) which also require new injections every 3 to 6 months. In the end, the cost works out to be less than the chemical alternatives due to its comprehensive nature and the fact that it’s not repeated in full as often. Ten cosmetic acupuncture treatments cost about $1200, or $120 each.

Results-wise, cosmetic acupuncture offers a few great features: there is no down-time after having this procedure. Aside from some minor temporary redness, no one can tell any type of treatment was performed.. I have met women who could not go out in public for ten days after having a dermal filler due to severe bruising. Cosmetic acupuncture will occasionally bruise a small spot that concealer will cover nicely. This is because acupuncture needles are significantly thinner that a typical needle. Twenty hair-thin acupuncture needles can fit on the head of one Botox syringe.

Rather than using Botox or Dysport for the forehead, a dermal filler (Juvederm or Restalyne) for the laugh lines, and a chemical peel for the skin to slough off a thick layer, cosmetic acupuncture is a one-step solution encompassing the entire face. One important concept in Traditional Chinese Medicine is that building overall functionality of the body prevents or delays the break-down of health later. When applying this concept to Cosmetic Acupuncture, this means firming up the jaw line before it starts to fall into jowls. This is tightening wrinkles before they form, or unwinding them after they have formed. Because this procedure also addresses functionality of the body, patients report sleeping better, digesting better, having less stress, and resolving mild depression or anxiety. All of these factors result in the production of healthier skin. Better health equates to better skin.

This is a cosmetic procedure for women and men who want to show their skin and not cover it up in foundation. Cosmetic acupuncture also can help with side effects induced by other procedures. If someone has residual issues following a facelift, acupuncture helps regain sensation and movement, while reducing pain. Cosmetic acupuncture reduces wrinkles and fine lines; they may even disappear. Deeper wrinkles may not go away, but they can look softer and less severe. It reduces puffiness and darkness around the eyes. Skin becomes more vibrant, radiant, brighter, and softer. Age spots have faded, and the beginnings of jowls can be minimized. It helps for rosacea, getting rid of excess redness.

Most people receiving this are women in their early to mid-50s, but also women in their 30s to their 60s. This is a popular procedure for upcoming “life events” like being a bride, or being the mother of the bride. It is not recommended for those with severe headaches, chronically unwell, nor pregnant women. Results vary from patient to patient and I consult with each potential patient before beginning the procedure. Ironically, when looking for the newest and latest way to look younger, it is cosmetic acupuncture and 5,000 years of Traditional Chinese Medicine that answered my question on how to make a now 45-year-old face look and stay younger.

Post by  Dana Hoffman, Licensed Acupuncturist, Masters of Science in Oriental Medicine

Thursday, April 4, 2013

Massage Q & A

What are some of the benefits of Massage Therapy?

"There are many benefits to Massage Therapy, relaxation is really the biggest result. However, it can also relieve muscle pain, increase circulation, headache and migraine relief, lowers blood pressure, improves flexibility and range of motion and can help with depression and anxiety. These are just some of the many benefits of massage. Talk to your therapist about what goals you are trying to reach so that we can give you a more focused massage."  -Melissa

"The main benefits of massage therapy are mental and physical stress reduction, the release of tension in muscles, tendons, fascia and scar tissue, pain reduction, increased musculoskeletal flexibility, faster healing time after injuries, surgeries and illnesses, and improved blood and lymphatic circulation. Regular massage is considered to also stimulate the immune system, help reduce depression and anxiety, improve the appearance of skin, help prepare the body for athletic performance, improve postural imbalances, promote better sleep and help diminish scar tissue." -Corinne

Why is it important to stretch and drink plenty of water after a massage?

"Massage increases circulation in your muscle tissues. Blood is responsible for both nourishing your tissues as well as carrying the metabolic waste away. The blocked area is usually from muscle tightness, which comes from stress, physical activity, poor posture or injury. We need water after muscle manipulation occurs to hydrate our bodies so it can better flush out the waste. I look at stretching like brushing my teeth. I go to the dentist periodically when I have a problem or need a deep cleaning. Between visits, I brush and floss. Stretching is self care.
I recommend people stretch for a couple reasons. 1) Sometimes depending on how tight a person is and/or how long a session is there may be some areas that need more work. The person who received the massage can stretch specific muscles to enhance the work we did in the room. 2) I recommend stretches so they can increase mobility and stay more relaxed between massage sessions." -Robin

"Gentle stretching will help facilitate further muscle release and blood circulation after a massage. After a deep tissue massage in particular, it is important to stretch slowly and gently or even wait 24 hours after the massage to stretch, because some deep tissue techniques cause micro-tears in muscle fibers in order to release tension, which requires some time for muscles to recuperate. Drinking plenty of water, especially after a massage, will help continue to flush out any toxins and lymphatic waste that was freed up during a massage. Keeping the body extra hydrated after a deep tissue massage especially will help reduce soreness and inflammation associated with certain deep tissue techniques." -Corinne

"Stretching in general is very important. Most people have chronically tight and restricted muscles. By stretching regularly this will aid in movement and improved range of motion. When we work your muscles, it releases built up toxins that need to be flushed out, so drinking extra water after a massage will help do this. However, working on tissue that is dehydrated is more difficult and takes more time to get a result so it's also very important to drink extra water the 24 hours before your massage as well. In general, most people are dehydrated so drinking more water everyday is a great idea!" -Melissa

What should I expect during my first massage?

"Before the massage begins, a good therapist should spend time discussing what you are hoping to accomplish during the session, regarding specific areas of pain or tension, or simple relaxation, for example. They should find out if you are interested in receiving a full body massage, or if you would like to spend as much time as needed on one or more particular areas. Keep in mind that in a 60 minute session, while it is possible to get everything in, there will be more of a limit to how much time can be spent in each area. So if you have a particular area of discomfort that you're hoping to relieve as much as possible, it might be best to agree to spend as much time as needed on it, possibly forgoing the rest of the body for that session. 
Your therapist should also go over your basic medical history including any injuries, surgeries or illnesses, particularly those that currently affect you. It is important to be thorough in giving medical history, particularly with injuries, to help your therapist avoid causing any further harm. Licensed massage therapists are under the same oath of confidentiality as medical professionals and legally cannot share this information. Your therapist should explain basically what will happen during the session and what all the various options are. It should be explained that you have the option of removing only as much clothing as you are comfortable with and that you will be draped appropriately as needed. Keep in mind that while you can keep on as much clothing as you like, and massage can still be effective over the clothes, it is most effective to work directly on the skin. Some people will remove everything and many will leave just their underwear on, but you will be draped appropriately at all times depending on your level of undress. 
During the massage, it is very helpful to let your therapist know if you would like more or less pressure, and a good therapist should ask you if you'd like more or less pressure fairly early in the session, or throughout the session in different areas. However, even with deep tissue massage, most therapists will begin each area with somewhat lighter strokes in order to warm the area in preparation for deeper techniques. 
It is good to know that this is your session, and you can feel free to have things the way you like it. Let the therapist know if you are not warm enough or too warm, if the music is too loud or quiet, if you need the face rest adjusted, if you are uncomfortable laying on your stomach or back, if you would like more or less oil used, if you need a tissue or water, if you would like to spend more time in certain areas, or if you are uncomfortable with the experience altogether and would like to stop the session. A good therapist will gladly accommodate these requests." -Corinne

"Welcome to Massage! Your Massage Therapist will be asking some questions about you. rest assured your privacy is always protected. We need to know what you like and what is happening with you physically so we can give you the best massage. When we leave the room you should only undress to your comfort level, the most important thing is that you're comfortable on the table. As we are working on you, always let us know if something is uncomfortable or you would like changed. This is your time and we are here to make it the best experience we can for you. Don't be shy! We want to know how we can make this experience the best it can be for you." -Melissa

What is the difference between a Swedish and Deep tissue massage? How will I know which one to get?

"Swedish massage is mostly focused on relaxation. It is lighter touch but still can be therapeutic. 
Deep Tissue massage is also relaxing, however it goes to the deeper layers of tissue, so the touch is more firm.  When in doubt, if this is your first time, Swedish is a good place to start, but if you know that you like a nice firm deep touch then Deep Tissue is the way to go. We will adjust our depth with your needs." -Melissa

"A purely Swedish style massage consists of strokes ranging from light to medium-firm pressure, depending on the client's preference. Strokes will mainly be long, flowing and 'mushy'. There can be some kneading, squeezing, compression and even stretching, but truly Swedish techniques should not go beyond a medium-firm pressure. Swedish style massage is beneficial mostly for mental and physical stress reduction, tension reduction in the more superficial layers of soft tissue, pain reduction, improved blood and lymphatic circulation, and other benefits listed above, including stimulation of the immune system, increased flexibility, and reduced inflammation. Requesting a Swedish style massage is ideal if you are mostly interested in the above benefits (particularly relaxation), and not concerned about addressing deeper tension in soft tissue, which is where deep tissue techniques come in.
Deep tissue massage is ideal for those with more stubborn tension found in muscles, tendons, fascia and scar tissue, due to such things as repetitive stress, an injury, or postural imbalances. There are many deep tissue techniques that can be used, all with the goal of releasing the more stubborn tension that will not fully release from Swedish techniques alone. It is important to understand that the actual amount of pressure needed is relatively different for every client, depending on their own pain tolerance and the particular qualities of tension in the tissues. It's also good to understand the difference between 'Good Pain' and 'Bad Pain' in deep tissue massage. Many particularly deep tissue techniques will create some sensation of pain, but Good Pain should simultaneously feel relieving, such as a good deep stretch of a tight muscle-it "hurts so good". There is a 'sweet spot' with deeper pressure when even a tiny bit more would be Bad Pain. It is a fine line. Bad Pain is pain but without the concurrent relief. If you feel pain during a massage that is unbearable, without relief, or feeling as though it might cause more harm than good, particularly due to something your therapist is doing, it is very important to let your therapist know immediately. Many people worry that they might offend their therapist for asking them to change what they are doing, and will stay silent instead. We promise we won't be offended, we need to know what we can do to improve your experience. It is better to politely speak up instead of bearing discomfort and potentially causing injury. This is your session and you have control over what happens.
It is also good to be aware that after some deep tissue massages, it is normal and common to feel some soreness in the areas worked for the next 24 hours. Drinking plenty of water, gently stretching, applying hot or cold packs, and resting the area can all help to pass this soreness more quickly.
All this said, it is important to know that a good therapist will be able to customize your massage. Many people like a mixture of deep tissue and Swedish techniques, and it is okay to ask for this. Remember this is your time on the table to do not be afraid to discuss with your therapists any concerns and requests you might have." -Corinne

All questions were answered by Licensed Massage Therapists at Spa Soak: Corinne Sanders, Melissa Terrell and Robin Stephens.