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

TABLE 5.

Overview of the panel's main recommendations and considerations regarding the treatment strategies for men. Each point identified in this table correspond to those defined in the MD codes® 26

Indication Recommendation
Masculinization
  • The preferred therapeutic strategy of choice for men is the 9‐point pattern, including the MD Codes® T1, Ck1, Ck4, Jw1, Jw2, Jw4, Jw5, C1, C2, and C5 (See Figure 2: Strong consensus).

  • The most important points are the MD Codes® Ck1, Jw1, and Jw2 (Strong consensus).

  • The MD Code® Ck4 deserves special attention because it makes the profile more slender and it gives the man a softer look. Depending on the patient's characteristics this point could also be avoided (Strong Consensus).

  • In addition, MD Codes® C2 and C5 are very important for masculinization to achieve a firmer and squarer chin (Strong consensus).

  • VYC‐25L is well suited to treat the Prejowl as it induces a myomodulation (Consensus).

  • In some cases, treating MD Codes® (E1 and E2)* of the eyebrow may be recommended to create structure in the superciliary arch (No consensus).

Microgeniaa
  • Treatment of microgenia requires an approach tailored to each patient (Strong consensus).

  • The most important MD Codes® to treat microgenia are C1, C2, C4, C5, Jw1, Jw3, Jw4, and Jw5 (Strong consensus).

  • In those patients with no aging, treating MD Codes® Ck1 and Ck4 may be omitted (Consensus).

  • Treatment of MD Code® C3 may be useful to improve the pogonion projection and provide bone and subcutaneous structure (No consensus).

Rejuvenation
  • The basic therapeutic strategy would be based on a 9‐point pattern (See Figure 2). Nevertheless, a comprehensive approach that addresses the specific needs of each patient is the best treatment (Strong consensus).

  • Treatment of MD Code® Ck4 may be considered depending on the aging and skin thickness (thicker skin: Consensus).

  • Treatment of MD Code® Ck2 may cause feminization and as such, it should be approached very cautiously (No consensus).

Submental fat
  • Treating MD Codes® Jw1, Jw2, Jw4, Jw5, C2 C4, and C5 were indicated (strong consensus).

  • Although HA fillers were not originally contemplated to treat submental convexity, this may be significantly improved by using them to treat the mid‐ and lower‐face MD Codes®, thereby achieving myomodulation, acting on the SMAS and on the retaining ligaments (Consensus).

Abbreviations: C1, Labiomental angle; C2, Chin apex; C3, Anterior chin; C4, Anterior chin/soft tissue pogonion; C5, Lateral lower chin; Ck1, Zygomatic arch; Ck2, Zygomatic eminence; 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 to maxillary and mandibular atrophy in both women and men.

*There was no consensus on this issue. The panel's opinions ranged from those who do not treat these points to those who treat them with other HA fillers like VYC‐17.5L, as well as those who treat them with VYC‐25L.