Abstract
BackgroundPatients often seek aesthetic correction of facial deficiencies (e.g., lines and folds) that are rarely the underlying cause of dissatisfaction with their appearance. Use of a more holistic approach focused on improving the emotional messages of the face (e.g., looking less sad) may improve patient satisfaction with treatment outcomes. The MD Codes™ system was developed to increase clinician success rates by reducing variability in the technical aspects of hyaluronic acid (HA) filler treatment and focusing on addressing unfavorable emotional attributes of the face.MethodsThe MD Codes, or medical codes, represent specific anatomical subunits for injection of HA fillers. Each MD Code includes information regarding the target depth of injection, the proper delivery tool (needle or cannula) and delivery technique (e.g., aliquot, bolus, fanning), and the minimum product volume recommended to achieve visible, reproducible results (active number). During treatment planning, the appropriate MD Codes are selected using algorithms focused on lessening unfavorable facial attributes (a saggy, tired, sad, or angry look) and enhancing positive attributes (an attractive, younger, more contoured, or feminine [soft] or masculine look).ResultsThree case studies are presented to illustrate how the MD Codes and their algorithms were used to address sagginess, tiredness, and sadness in two women and one man.ConclusionsMD Codes provide a universal symbolic language for reducing variability in injection technique. The platform provides user-friendly algorithms to help clinicians increase patient satisfaction by going beyond treatment of lines and folds and to focus on reducing unfavorable facial attributes.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Highlights
Patients who undergo facial aesthetic procedures may be dissatisfied with treatment outcomes [1,2,3]
A single bolus of 0.3 mL in only one site is not advised here as it may bulge and look unnatural dAspiration is highly recommended when injecting with a needle at the level of the bone eAlthough the active number for C1 is 0.5 mL, when treatment of C1 is combined with C2, the active number for C1 becomes 0.7 mL so that the total volume for C1 ? C2 = 1.0 mL (1 syringe)
The same happens when Ck1 is combined with T1 or Ck4 fMainly used in male patients gThis approach is for restoring forehead volume loss, forehead advancement, and forehead reshape hTreatment of the forehead, eyebrow, glabella, and nose areas is very advanced and should only be delivered by highly trained experts with extensive injection experience and knowledge on the management of severe complications iTear trough and orbital codes are reserved for specialists trained in this technique and those who have a sound knowledge of the anatomy and physiology for this particular area jThis treatment approach is designed to correct bone structural deficiencies kThe use of cannulas in the nasolabial fold is advisable to correct dynamic nasolabial folds
Summary
Patients who undergo facial aesthetic procedures may be dissatisfied with treatment outcomes [1,2,3]. The same happens when Ck1 is combined with T1 or Ck4 fMainly used in male patients gThis approach is for restoring forehead volume loss, forehead advancement, and forehead reshape hTreatment of the forehead, eyebrow, glabella, and nose areas is very advanced and should only be delivered by highly trained experts with extensive injection experience and knowledge on the management of severe complications iTear trough and orbital codes are reserved for specialists trained in this technique and those who have a sound knowledge of the anatomy and physiology for this particular area jThis treatment approach is designed to correct bone structural deficiencies kThe use of cannulas in the nasolabial fold is advisable to correct dynamic nasolabial folds.
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