When it comes to dermal fillers treatments for facial contouring and skin rejuvenation, everyone desires natural looking results. Even though the perception is that natural looking filler results depend on your doctor’s experience level, sense of aesthetics, and type of filler used, do you know that there is a scientific approach that aesthetic doctors can apply to achieve a result that does not look over-filled, puffy, or unnatural?
If the fear of unnatural looking dermal filler result and the cost of correcting it are stopping you from booking a dermal filler contouring or facial rejuvenation appointment, why not ask your aesthetic doctor about MD Codes?
Defined as a methodological approach for injecting hyaluronic acid (HA) fillers, the MD Codes a dermal filler injection system that was developed by Dr. Mauricio de Maio, a Brazilian plastic surgeon, in 2015. It has since been recognised by the medical aesthetics community as a structured, codified approach to dermal filler injections regardless of dermal filler brands.
An introduction to MD Codes
Credit: https://pmc.ncbi.nlm.nih.gov/articles/PMC8012343/figure/Fig1/
The objective of MD Codes or medical codes is to guide aesthetic doctors globally and in Singapore to achieve safe, consistent, effective, and natural results.Therefore, instead of just filling in lines, folds, and sunken areas, the MD Codes dermal fillers injection technique focuses on restoring the emotional expressions of the face to help patients look more youthful, refreshed, and natural without changing or losing their unique features. MD Codes focus on placing fillers based on the foundational cause of the problem instead of basing the treatment protocol on isolated problem areas. An example of this symptomatic approach is when the doctor injects the filler directly into the nasolabial folds (smile lines) to fill them in.
MD Codes essentially provide a universal language for aesthetic doctors to reduce inconsistency in results, optimise treatment and outcomes, and improve patient satisfaction. Therefore, for those considering dermal fillers in Singapore, understanding MD Codes, and opting for a doctor who uses the MD Codes injection technique can be the key to minimising uncertainties, and unlocking a more confident and natural-looking you.
Traditional dermal filler treatments vs. MD Codes injection technique
Before the development of MD Codes, some aesthetic doctors treated individual facial areas in isolation by “chasing the line” or “chasing the fold” rather than having a treatment plan that focuses on overall facial harmony. This can lead to unnatural-looking results without addressing the underlying issues.
Some common issues for traditional dermal fillers treatments, or filler treatments with a less experienced doctor are:
- Over- or under-treatment: Injecting too little filler may result in subtle changes that are not noticeable, leaving patients dissatisfied. Conversely, injecting too much filler can lead to an unnatural, stiff appearance, sometimes referred to as a “pillow face.”
- Focus on individual problem areas: When doctors focus treatment on individual areas without considering overall facial harmony and proportions, it can result in unnatural-looking outcomes and also affect natural facial movements.
- Lack of standardised protocols: Different doctors use different injection techniques and filler volumes, leading to variations in results and decreased patient satisfaction.
These challenges often leave patients feeling anxious about their treatment.
What are MD Codes
The MD Codes injection method is a guide, or a “blueprint” for injecting HA dermal fillers with consistency. It specifies the exact injection points on the face for different concerns, and each point is assigned a code based on location and treatment purpose. (You can see the full list of codes here)
The MD Codes include:
- Exact injection depth
- Recommended volume (called “active numbers”)
- Injection technique (cannula vs needle)
- Sequence of treatment steps: foundation, contour, refinement
The MD Codes framework helps doctors customise filler treatment based on the patient’s unique facial anatomy, emotional expression, and patients’ concerns, focusing on improving overall facial harmony rather than just filling individual areas.
Algorithm for deciding which MD Codes to use to provide midface foundation by (a) treating saggy cheeks, to contour the upper face by (b) treating sunken temples, and to provide periorbital refinement by treating (c) the tear troughs and (d) the eye bags. Ck1, zygomatic arch; Ck2, zygomatic eminence; Ck3, anteromedial cheek–midcheek; Ck4, lateral lower cheek/parotid area; Ck5, submalar area; T1, anterior temple; T2, posterior temple; Tt1, central infraorbital; Tt2, lateral infraorbital; Tt3, medial infraorbital
Credit: https://pmc.ncbi.nlm.nih.gov/articles/PMC8012343/figure/Fig2/
How MD Codes work: foundation, contour, refinement
The MD Codes system can be broken up into three essential stages.
- Foundation
This step restores lost volume in key structural areas of the mid-face and upper face, such as the cheeks (Ck1, Ck4) and temples (T1, T2). These points are the underlying structures that support the entire face and rebuilding them helps create a natural lift.
- Contour
Next, the doctor will restore youthful proportions by sculpting and enhancing the jawline, chin, and other defining features at codes Jw1, C1, C2, for example.
- Refinement
Lastly, the doctor will refine and give the treatment a final “touch up” by focusing on subtle details like tear troughs (Tt1, Tt2, Tt3), nasolabial folds (NL1, NL2), and lips (Lp1, Lp6) for a polished, natural finish.
This way, MD codes can ensure that that the patient gets a comprehensive treatment that is structured with no rushed “spot fixing,” and one that is customised to their facial anatomy.
Why are MD Codes a preferred dermal filler treatment technique in Singapore
Predictable, personalised results
MD Codes use a standardised system of injection points and the clear guidelines on injection technique and volume reduce variability between different doctors, ensuring consistent, natural-looking results.
Reduced variability, increased safety
With a standardised protocol, there are lower risks of common complications like lumps, unevenness, or swelling. Doctors using the MD Codes system have a deep understanding of facial anatomy and injection safety, especially in sensitive areas where caution and experience are essential.
Holistic approach that goes beyond wrinkles
MD Codes are well-suited for patients in Singapore because most seek natural, subtle enhancements rather than overly dramatic or artificial-looking results. This aligns with the MD Codes technique which goes beyond treating isolated lines or folds. It targets the emotional messages your face conveys such as tiredness, sagging, or sadness, and transforms them into a refreshed and sculpted appearance.
Patient education and transparency
In Dr. de Maio experience, using “building a house” analogy for MD Codes allows doctors to clearly explain why foundation and contour are prioritised before refinement during the treatment to help patients understand the treatment journey and set realistic expectations.
The numbers system also helps patients visualise the treatment and better estimate the cost.
MD Codes in action: real case examples
To better understand the power of MD Codes, consider these typical case studies in this study “MD Codes: A Methodological Approach to Facial Aesthetic Treatment with Injectable Hyaluronic Acid Fillers” by Dr. Mauricio de Maio.
- Case 1: A 44-year-old woman with saggy cheeks and marionette lines received injections over several steps, focusing first on mid-face foundation and upper face contour, then lower face sculpting, followed by delicate periorbital and perioral refinements. Her smile became more attractive and natural, and her facial shape more youthful and balanced.
- Case 2: A 42-year-old man with a narrow face and double chin was treated with MD Codes targeting mid-face foundation, chin projection, and jawline contouring. Repeat sessions reinforced the zygomatic arch and jawline, resulting in a confident, square jaw shape with less sagging and a reduced double chin.
These examples showed us how MD Codes guide doctors through a layered treatment plan that is customised for the patient’s unique facial architecture and aesthetic goals.
What patients in Singapore should look for when choosing MD Code dermal filler treatments
If you’re considering dermal fillers in Singapore and want to benefit from the MD Codes approach, keep these tips in mind:
- Look for experienced, MD Code-trained doctors
The MD Codes system requires doctors with a thorough understanding of facial anatomy and injection technique. Consider choosing clinics with certified doctors who have filler injection training and experience using MD Codes and can explain the treatment plan clearly.
- Personalised consultations
A good doctor will assess your face holistically, discuss your aesthetic goals, and develop a customised treatment plan rather than offering generic “off-the-shelf” filler treatment.
- Ask about volume planning and cost transparency
Doctors using MD Codes injection method should be able to estimate the total volume of filler needed based on your face and treatment goals, helping you plan financially with confidence.
- Understand the treatment timeline
Some patients may prefer completing their treatment in one session, while others may benefit from staged sessions to achieve gradual and natural results. With this knowledge in mind, you can discuss your preferences and expectations openly.
- Enquire about safety protocols
Safety is paramount. Ask your doctor on his approach to minimising side effects, such as sterile technique, post-treatment care, and pre- and post-treatment medications, if any.
Ready to experience the MD Codes difference?
Whether you’re a first-time filler patient or someone who’s tried injections before but wasn’t satisfied, MD Codes offer a level of confidence and clarity.
If you’re considering dermal filler treatments in Singapore, ask our doctors about the MD Codes system to achieve a natural and youthful look.
FAQs about MD Codes and dermal fillers in Singapore
- What exactly are MD Codes in dermal filler treatments?
MD Codes are a systematic set of injection points developed by a Brazillian plastic surgeon, Dr. Mauricio de Maio, and is widely recognised as a guide for doctors on where, how deep, and how much dermal filler to inject. This method ensures consistent and natural-looking results by treating the face in a structured way, starting with foundation, then contour, and finally refinement. - How do MD Codes improve the safety of dermal filler treatments?
MD Codes follow specific anatomical landmarks and standardised injection techniques to reduce the risk of complications like lumps, asymmetry, or vascular injury. Trained doctors use MD Codes to avoid sensitive areas and administer dermal fillers safely and effectively. - Are MD Code treatments suitable for everyone?
MD Codes can be customised for every individual’s unique facial structure and aesthetic goals, making the system adaptable for a wide range of patients. A thorough consultation with a trained doctor is a must for safety and treatment effectiveness. - How many dermal filler syringes are typically needed when using MD Codes?
The number of syringes of dermal fillers varies depending on your facial anatomy and desired outcomes. The MD Codes system helps doctors estimate the volume needed which can be administered in one or multiple sessions, depending on your preference. Consult a doctor to find out more. - Where can I find clinics offering MD Code treatments in Singapore?
Doctors at Halley Medical Aesthetics haveexperience in doing dermal filler treatments using the MD Codes dermal filler treatments. Check with our front desk to find out more.
