Non surgical facial reshaping using MD Codes

Abstract

BackgroundBoth age‐related and congenital volume deficiencies may be addressed through the injection of hyaluronic acid (HA) fillers. Deep injection provides structural support, more superficial fat‐tissue injection mediates contouring, and superficial intradermal use of HA filler and/or onabotulinumtoxinA may be used for refinement.AimsTo evaluate the clinical efficacy, patient satisfaction, and safety of the MD Codes approach as a proposed standardized methodology for full‐face rejuvenation.MethodsThis was a retrospective, single‐center study of 250 consecutive adult patients undergoing full‐face rejuvenation with HA fillers (Vycross) and onabotulinumtoxinA based on the MD Codes approach.ResultsThe mean age was 39.4 ± 11.6 years, and 80.4% were female. All patients were treated with HA filler in the midface; 89.6% were also treated in the upper face, and 63.2% in the lower face. The mean number of syringes used was 14 ± 4 (range 4‐25), with more syringes typically required in older versus younger patients. All patients received onabotulinumtoxinA treatment. Mean FACE‐Q Appearance‐Related Psychosocial Distress score decreased from 54.3 ± 9.3 pretreatment to 36.1 ± 8.9 at 3 months post‐treatment (P < .05). The most common complications were bruising (35.2%), transient soft‐tissue edema (14.0%), and prolonged periorbital edema (3.6%).ConclusionsFull‐face rejuvenation based on the MD Codes approach provides significant esthetic improvements, with no major safety issues observed.

Treating Aging Changes of Facial Anatomical Layers with Hyaluronic Acid Fillers

“…For those familiar with MD Codes filler injection technique, the deep fat compartments relate to CK3 (SOOF) and CK1* (Sub-SMAS along the zygoma), both of which are accessed with a cannula; while NL1 (Piriform space) and T1 (temple) are accessed with a needle. 67 HA is postulated to have regenerative capacity when injected into the tissues, 40 so it will be interesting to see if future studies show an improvement in DMCFC elasticity after repeated injections of volumizing HA fillers.

Figure 5 Treatment description: Lateral Cheekbones: Juvederm Voluma, 0.1mL in 3 points each side, on periosteum with a needle; Pre-auricular area: Juvederm Voluma, 0.7mL each side, in the subcutaneous layer using a cannula; Malar area- Juvederm Voluma, 0.5mL each side, in the deep malar fat pad, using a cannula; Malar area: Juvederm Volift 0.5mL each side, in SOOF layer, using a cannula; Temporal fossa- Juvederm Voluma, 0.5mL each side, on periosteum using a needle; Labiomental crease- Juvederm Voluma, 0.7mL each side, in the subcutaneous layer using a cannula; Chin apex/pogonion: Juvederm Volux, 0.3mL each side, subcutaneous/intramuscular (mentalis muscle) using a needle; Medial to marionette lines- Juvederm Voluma, 0.5mL each side, in the subcutaneous layer using a cannula; Jawline- Juvederm Voluma, 1mL each side, in the subcutaneous layer of the pre-jowl sulcus and medial jawline using a cannula; Nasolabial folds- Juvederm Volift, 0.5mL each side, in the subcutaneous layer using a cannula.

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Minimally invasive aesthetic treatment of male patients: The importance of consultation and the lower third of the face

“…Injection points were based on those described in the standardized MD Codes™ approach, 10 , 11 and the acronyms used are from this method: Jw1, mandibular angle; Jw2, pre‐auricular area; Jw3, mandibular body; Jw4, lower pre‐jowl; Jw5, lower anterior chin; C1, labiomental angle; C2, chin apex; C3, anterior chin; C4, anterior chin / Pogonion; C5, lateral lower chin; and C6, lateral chin. A 25G 38‐mm cannula was used for all points except C2‐3–4–5 and Jw1, for which a 27G 13 mm needle was preferred.…”

Erratum

“…In the article by Bertossi, et al (2020), 1 the Figure 4C is incorrect. The correct Figure 4 should be:…”