When (it comes to) comparing the differences between cosmetic oriental medicine and new advances within western medicine, it is like comparing apples and oranges. In this article we will explore the benefits, facts, and truths about Facial Rejuvenation Acupuncture (FRA) and Botox®.
What are the Origins of these procedures?
FRA stems from Traditional Chinese Medicine, where focusing on treating the root of a symptom or illness allows for balance within the body, mind and spirit. This in turn will create optimal health where prevention is the key.
Botulinum Toxin is a protein produced by the bacterium Clostridium botulinum which is considered the most powerful neurotoxin ever discovered and the most acutely toxic natural substance known.
It was Kerner, a physician, who first conceived a possible therapeutic use of botulinum toxin, and also coined the name Botulism. There are three forms of Botulism, and all forms lead to paralysis that typically starts with the muscles of the face and then spreads towards the limbs. In severe forms, it leads to paralysis of the breathing muscles and causes respiratory failure. In small doses though, Botulinum Toxin can be very effective temporarily as it decreases muscle activity.
FRA is believed to have originated during the Sang Dynasty (960-1279 AD), where it was used on emperors’ concubines as an anti-aging technique.
Botox® was first used in 1980 therapeutically for people who were cross eyed or who had uncontrolled blinking. Spasm of the lower esophageal sphincter and sweating were also showed to benefit from Botox® (the side-effects mild and it needs to be administered 3-4/year as it wears off). The drug was also used to treat muscle spasms and hyper tonicity, excessive sweating, cervical dystonia, and chronic migraines.
Cosmetically, Botox® was approved by the FDA in 2002, and is the trade name for Botulin Toxin Type A.
How do they work?
In ancient theories of Chinese Medicine, the face is thought of as a reflection of what is happening internally with the body. Therefore, with FRA, it’s as important to know what symptoms a patient may have with their digestive system (or other systems), as it is that they have jowls or bags under their eyes. Once the patient has been diagnosed with a Root syndrome and acupuncture body points have been chosen according to the pattern, we then look to the facial concerns.
The basic concept is that by inserting needles locally on the face, circulation is increased, flooding the area with red and white blood cells and allowing collagen and elastin to form. Depending on the individual constitution, acupuncture points are chosen either to relax or strengthen muscles along energy meridians, or at the meeting point of a muscle and nerve. The focus is normally on two to three areas of concern at a time keeping the energy contained and focused.
Botox® injection treatments work to relax the muscle at motor nerve endings to block the release of acetylcholine (the chemical that causes muscles to contract). It is used for the temporary improvement in the appearance of frown lines, crow’s feet, etc. A very small dose is injected to ‘paralyze’ the muscles in the surrounding area so they cannot move for a period of time (preventing the muscles from contracting). This basically prevents the brain from sending electrical messages to the muscles so they won’t contract or move. This allows the muscles to rest and relax.
Who can administer the treatments?
FRA must be done by a Registered Acupuncturist (R.Ac) in Canada, or a Licensed Acupuncturist (L.Ac) in the US. It is best to look for a practitioner who has also specialized in FRA in addition to their required certification.
Botox® can be administered by dermatologists, plastic surgeons, aesthetic spa physicians, dentists, nurse practitioners, nurses and physician assistants.
The benefits of FRA are both internal and external. If a patient has symptoms such as headaches, insomnia, constipation and anxiety, this will be addressed, treating the patient holistically. Some of the external benefits include improving muscle tone, eliminating fine lines, as well as reducing bags and sagging jowls. FRA is also very esthetically effective in tightening the neck, lifting drooping eyelids, tightening the pores and improving facial color. Significant findings are that it can reduce symptoms of Bell’s palsy, TMJ, neuropathies, and helps stroke patients.
Botox® simply diminishes wrinkles, creating a more smoothed appearance. Patients usually notice a clinical effect 1-3 days following injection, and the effect is maximal by 1-2 weeks.
What happens during a treatment?
FRA treatments start with an initial consultation, where an overall health assessment is made. This is additionally followed by an individualized treatment including facial and body acupuncture including an herbal poultice, oils and moisturizers to rehydrate the face. Sometimes tuning forks are used to increase overall relaxation and increased balancing and grounding of the patient.
With Botox® an initial consultation is made followed by injections administered with a small sterile needle.
How long does the treatment take?
FRA initial treatments can take between 90–120 minutes, and subsequent visits can be anywhere from 60-90 minutes depending on the practitioner and what they include within the treatment.
Botox® takes only ten minutes after the initial consultation.
How long does a treatment last?
FRA should be done with a course of treatment to have a noticeable result. A recommended course of treatment will be discussed by the practitioner within the initial session. Ideally this ranges between 10-15 sessions depending on the age, health, habits of a patient. After the first course of acupuncture sessions, maintenance treatments are required. Of course the aging process cannot be stopped, but it can be slowed down. If a patient starts treatment within their twenties or thirties, likely there will be a significant decrease in health issues, as well as a more radiant face.
Botox® can last anywhere from 3-8 months, with the average being 4 months. At which point the patient would return for the next treatment.
FRA side effects may include bruising and puffiness. The possibility of infection, nerve injury, or allergic reaction to the topical applications is very rare.
Most side effects from cosmetic application of Botox® are mild and temporary. These include paralysis of the wrong muscle group, allergic reaction, headaches, trouble swallowing, flu-like symptoms, blurred vision, dry mouth, fatigue, and swelling/redness at injection site. Due to how the drug is administered there can be bruising, drooping eyelid, double vision, uneven smile, or loss of the ability to close eyes, which should wear off within six weeks.
In April 2009, the FDA updated its mandatory boxed warning cautioning that the effects of the botulinum toxin may spread from the area of injection to other areas of the body, causing symptoms similar to those of botulism.
Botox® formal clinical evaluations of long term treatment have not yet been conducted as it is only been around for twelve years for cosmetic use, therefore it is not possible to determine if there are long term effects.
FRA cannot be performed on patients who bleed or bruise easily, and caution must be taken on those taking blood-thinning medications. Severe migraines must be treated prior to having facial treatments, and the individual needs to be migraine-free for three months. Patients who have had Botox must wait 6 month after their treatment to work on the same muscle group. FRA can still be performed, but only on other facial concerns. If an individual has had laser resurfacing they must wait 3 weeks for an FRA treatment. A patient receiving chemical peels or microdermabrasion should wait 2 weeks as the skin will be healing within that time. If there are any other severe health concerns, they must be addressed prior to FRA specific treatments.
Botox® is contraindicated in patients who are hypersensitive to any botulinum toxin preparation or to any of the components in the formulation. Also, if there is the presence of infection at the proposed injection site(s)
FRA cost ranges from the initial session being $175-350 depending on the experience level of the practitioner and the quality of product they are using, along with the duration of the session. Subsequent visits range from $125-200. Ask your practitioner if there is a package price for purchasing a course of treatment.
Botox® injections will be between $250-500 for each area injected.
Living in this fast-paced society, many people expect results yesterday. FRA is a more organic process. It is important that patients realize aging is something that happens the moment after you are born, and is impossible to counteract this within one to five sessions. If your Practitioner is promising fast results, be weary. An improvement should be noticeable in overall health (including the face), but FRA does not claim to be a cure for aging.
Even though FRA is an ancient practice, there are few studies published. There haven’t been as many before or after photos done to those receiving Botox®, so the trust into the Practitioner. However, there are many testimonials on its benefits.
Allergan, Inc. Botox® is made within a multibillion dollar industry that is still growing and the studies are in the hundreds. For the future of Botox®, there are no signs of the drug running short on supplies. Cost is kept down as the main goal is to have repeat customers globally.
As the society is becoming continuously more obsessed into freezing beauty, movie starts and other famous people in the public eye look amazing for their age, but is this thanks to such treatments as Botox®, among more severe cosmetic procedures?
There is so much pressure from society, that an important question should be when is it too much? How young is too young to start? Should there be an age regulation on when this procedure cosmetically can be allowed?
In Hollywood, directors are complaining that some actors no longer perform a full range of facial expressions. Some Licensed Acupuncturists are having requests to “de-Botox” young actors.
A trend that is quite popular, like a modern day Mary Kay or Tupperware party. This can ease individuals nerves, knowing that everyone around them is receiving the treatment. Could it also create peer pressure within social groups?
It is not as safe as being within a controlled sterile environment, especially as there may be drinking involved at the party, increasing the tendency for bruising. 
Emotions and the face
There is a direct correlation between the emotions and the face. If there is an imbalance with these emotions, it is guaranteed to show up on the face. For example, if a parent has lost their child, you can easily see worry on their face as they are looking around the supermarket for their little one.
With Acupuncture, by working with an individuals emotional timeline of their life, it is possible to free some of the cellular memory that would show over the years on the face. As well, self-esteem is almost always benefited from FRA treatments.
Published in Forbes and originally published in the journal Social Psychology and Personality Science, Botox® takes away or dampens the emotional feelings in a particular situation. That may be due to less interaction between facial muscle movement and brain. According to David Neal, a psychology professor at the University of Southern California, “if muscular signals from the face to the brain are dampened, you’re less able to read emotions.”
With any Cosmetic procedure (i.e. breast implants, tummy tuck), self-esteem is boosted. If the patient undergoes a more severe transformation, the person may still see their old self in the mirror. In the TV series “The Swan”, where women were judged to be ‘ugly’ were given “extreme makeovers” that included several forms of plastic surgery.
The Swan has been widely criticized for promoting plastic surgery and a beauty standard packaged and marketed by the fashion industry, as well as for demonstrating a lack of ethics by preying on vulnerable women.
Of course Botox® is one of the safest cosmetic treatments out there, but could it be a ‘gateway drug’ to others?
Bottom line, it is important as a consumer to be educated prior to any treatment before receiving it, so that your expectations will be fully met.
So in the end, the question between FRA and Botox® comes down to either impressive result fast? Or slower result but with long term health benefits?
Advanced Constitutional Facial Rejuvenation™ © 2009 Chi-Akra Center
 BOTOX (R) Injections in Plastic Surgery Author: Robert A Hauser, MD, MBA; Chief Editor: Jorge I de la Torre, MD, FACS