Times have gone, when hyaluronic acid (HA) fillers were used only in specific areas of the face, such as the nasolabial folds, the marionette’s lines and the eye trough. Today, a three-dimensional approach prevails over previous techniques. These new-generation techniques do not focus on the localised problem, but rather, treat the face holistically trying to restore youthful features and balance up proportions, without changing the natural look.
MD Codes is the universal, international language for aestheticians.
Unquestionable pioneer and inventor of this technique, Brazilian practitioner Dr de Maio; was also part of the team defining MD Codes. MD Codes describe very clearly points, type of filler, injection technique and depth, to achieve satisfying results. MD Codes also describe areas of potential risk and where extra care should be applied.
This injection lifts the face by subtly increasing the structural support for facial tissues
The initial method called 8-point lift includes following points:
1. Over lateral zygoma (upper/outer cheekbone) – this provides the lift and defines the ogee curve
2 .Over junction of maxilla and zygoma (cheekbone) – supports and lift the midface and improves the cheek prominence
3. Malar fat pad (within the cheek/mid face) – supports the tear trough and may provide gentle lift of nasolabial folds
4. Nasolabial folds
5. Marionette lines/mouth corners
6. Pre-jowl sulcus - supports and defines the jawline and chin
7. Angle of the mandible (jawline)
8. Sub-zygomatic hollow (lower cheek hollows) plumps up cheeks and improves their volume
As the 8 point method became very effective other practitioners worked upon its modification and successfully developed and described 12 point face rejuvenation and full face lift, which includes additional points peripherally, but reduces the amount of filler injected in mid-face.
Profhilo® is a product available that has been on the market since 2015 and is based on stable, hybrid, and cooperative complexes produced by Hybrid Technology, which is an innovative thermal process that rules out the use of any chemical reagents.
Injection areas of Profhilo are almost identical to 8 points lift MD Codes. The main difference is the technique, aim and amount of the product.
Profhilo is a HA filler with high biocompatibility and low viscosity that favors optimal diffusion at the tissue level to obtain the target bioremodeling of the facial contour.
Due to these properties, Profhilo can also be used successfully for neck rejunevantion.
As the 8 and 12 point lift focus on correction of face features, liquid lift is designed to rejuvenate the skin by administration of diluted filler in place of subdermal fat. The method is recommended specially for the skin with visible fat and volume loss, with loss of elasticity and collagen support, saggy and ,,fluffy’’. This method can be used on any area on the face and body. Usually the whole treatment requires injection of 8 mL of HA filler, mixed with 6 mL of saline and 2 mL of anaesthetic agent injected in a feathered The procedure requires only two injection points each side of the face and is barely painless.
In the youthful face, the peri-ocular area consists of well-toned, elastic skin absent sun damage, a full, well-defined brow without descent, a crisp and visible upper eyelid crease with minimal dermatochalasis (a term used to describe the presence of loose and redundant eyelid skin), and a taut, well-positioned lower eyelid with minimal laxity or excess skin.
With aging, patients may experience loss of volume, with deflation and hollowing of the upper eyelid, thereby exposing the superior orbital rim. This can result in an appearance of a sunken, hollowed eye, with a deep superior sulcus. There may also be drooping of the brow and dermatochalasis, obscuring the pretarsal platform and the eyelid crease.
Traditional approaches to rejuvenation of the eyelids have typically involved sub-tractive surgical procedures that remove tissue and fat (and volume) from the eyelids, leading to a hollowed appearance. These invasive procedures can include skin- and muscle-excision blepharoplasty, fat excision and contouring, and eyelid shortening and tightening.
With the high expansion of non-invasive aesthetic procedures, our understanding of the components of the aging face has evolved and rejuvenation strategies have also developed and evolved to address the needs of volume restoration.
The recognition of volume depletion in the peri-orbital area is important, because removing fat and tissue can cause more hollowness and result in the loss of eyelid support, particularly in the area of the inferior orbital rim. Traditional surgical approaches that seek to lift and excise can further bare a deep superior sulcus, accentuating the superior orbital rim. A customized approach seeking to deliver filler with precision to focal hollows in selected patients can be performed to soften surface depressions and mask exposed deeper structures such as the orbital rim
There have been high patient satisfaction and low morbidity with hyaluronic acid gel in the treatment of the lower eyelid peri-orbital hollows as well as for upper eyelid contouring.