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. 2021 Aug 30;20(10):3155–3164. doi: 10.1111/jocd.14398

TABLE 4.

Overview of the main panel recommendations and considerations about the treatment strategies for women. Each point identified in this table corresponds to those defined in the MD codes® 26

Indication Recommendation
Beautification

  • The therapeutic strategy of choice is the 7‐point pattern (See Figure 1: Strong consensus).

  • The MD Codes® T1, Ck1 and Jw1 may be considered as the pillar for beautification (Strong consensus).

  • The treatment of MD Codes® Ck2 and Ck3 is recommended, although this may depend on the patient's needs (Strong consensus).

  • The treatment of the MD Codes® Jw4 and Jw5 is crucial in beautification and facial contouring, improving prejowl appearance, inducing myomodulation, and acting on the superficial musculoaponeurotic system (SMAS) and the retaining ligaments (Strong consensus).

  • The MD Codes® C1 and C2 are essential to treat the chin and to provide support to the lip (Strong consensus).

  • Treating the MD Code® Ck4 is advisable for "top model look" contouring (Consensus).

  • The treatment of MD Code® C1 mostly depends on the patient's needs (Consensus).

  • In those cases, with no loss of structural support and in the absence of aging, in addition to the 7‐point pattern, it would be advisable to treat the lip (according to the patient's needs) and Ck2 (No consensus).
Microgeniaa

  • The treatment of microgenia requires an approach tailored to each patient (Strong consensus).

  • The MD Codes® of choice for treating microgenia are C1, C2, C4, Jw1, Jw4, and Jw5 (Strong consensus).

  • The MD Codes® where VYC‐25L treatment produces the greatest benefit are C2 and C4 (strong consensus).

  • The MD Code® C5 must be avoided (strong consensus).

  • In some selected patients, especially those with laxity and loss of volume in the mid‐face, treating the Ck MD Codes® may be a valuable strategy (Majority agreement).

  • Treatment of the MD Code® C1 might be associated with eversion of the inferior lip in some patients with sagittal microgenia (No consensus).
Rejuvenation

  • Rejuvenation requires full‐face assessment and a comprehensive approach to select the MD Codes® that best fit the patient's needs (Strong consensus).

  • For rejuvenation, the 7‐point pattern is the strategy of choice, although in some patients it would be worth adopting a customized approach according to patient's needs (consensus).

  • Treating MD Codes® Ck2 and Ck3 may be an option in some cases (Majority agreement).

  • Treating MD Code® T1 may be a valuable option when attempting to achieve beautification and rejuvenation (No consensus).
Submental fat

  • The Md Codes® of choice to treat submental convexity are Jw1, Jw3, Jw4, Jw5, C2, and C4 (Strong consensus).

  • Although HA fillers were not originally designed to treat submental convexity, this may be significantly improved by treating the mid‐ and lower‐face MD Codes® with these (myomodulation, action on the SMAS and on retaining ligaments: Consensus).

Abbreviations: C1, Labiomental angle; C2, Chin apex; C4, Anterior chin/soft tissue pogonion; C5, Lateral lower chin; Ck1, Zygomatic arch; Ck2, Zygomatic eminence; Ck3, Anteromedial cheek; Ck4, Lateral lower cheek/parotid area; Jw1, Mandible angle; Jw3, Mandible body; Jw4, Lower prejowl; Jw5, Lower anterior chin; T1, Anterior temple; HA, Hyaluronic acid; SMAS, Superficial musculoaponeurotic system.

aMicrogenia is usually associated with maxillary and mandibular atrophy in both men and women.