Affiliations 

  • 1 MD Codes Institute, São Paulo, Brazil
  • 2 Vanila Dermologie, New Delhi, India
  • 3 Dr Sarah Hart, Auckland, New Zealand
  • 4 Anna Hoo Clinic, Petaling Jaya, Malaysia
  • 5 Marchac Chirurgie Plastique, Paris, France
  • 6 Well Aging Clinic, Athens, Greece
  • 7 Shang-Ho Aesthetic Medical Clinic, Kaohsiung City, Taiwan ROC
J Cosmet Dermatol, 2021 Jul;20(7):2069-2082.
PMID: 33977669 DOI: 10.1111/jocd.14216

Abstract

BACKGROUND: Comprehensive patient assessment and planning are central to esthetic treatment with injectables. MD ASA™ (Multi-Dimensional Aesthetic Scan Assessment) is a novel tool developed for this purpose.

AIMS: To describe the MD ASA technique and present its preliminary application.

METHODS: MD ASA breaks down the face into five hierarchies (H1-H5). H1 shifts patients' focus from "distractions" (individual lines and folds) toward the overall messages their face portrays, based on eight Emotional Attributes: four negative (tired, sad, angry, and saggy); four positive (youthful, attractive, contoured, and feminine/masculine). Three priority Emotional Attributes are selected for each patient. This is followed by a process of narrowing down through facial thirds (H2), periorbital and perioral dynamics (H3), facial units (H4), and subunits (H5), to arrive at a final assessment. Based on the key facial signs identified, this can be translated into MD Codes equations and thus a treatment formula. A retrospective analysis was performed based on 12 female patients injected by expert clinicians at an educational event. All patients were selected for, and treated using, a single MD Codes formula derived from a common MD ASA work-up.

RESULTS: There were substantial differences between patients and clinicians in their views of which anatomical areas needed treatment-but good alignment on priority Emotional Attributes. Patients were treated only for three negative Emotional Attributes, but improvements were observed across all eight attributes.

CONCLUSIONS: MD ASA provides a practical method for translating facial messages into actionable injectable treatment plans and facilitates greater patient-clinician alignment. Prospective studies are warranted.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.