Facial Distractions

Correction Versus Beautification

Many women and men have a negative image of Aesthetics / Cosmetics and the medical application of Dermal Fillers and facial aesthetics in general. This is totally understandable given the imagery that has been portrayed by the rich and famous. This alarming trend of facial distortion, oversized lips and cheeks, I think this came about from a small percentage of patients wanting to ‘flaunt’ the fact that they had had ‘work’ done. They welcomed the attention somewhat.

This type of injecting has in my view damaged the industry. These unnatural results quite rightly put people off having a treatment, that in the right hands can be life changing.

As a Physician, my desire is to see Medical aesthetics practiced ethical, with a view to educating patients. Education is a pivotal part of the consultation process and allows Physician and Patient to establish what emotional influences are at play, establish what that patient feels they perceive and how they are perceived.

Many Physicians & practitioners inject as a small part of their overall practice. Some of taken a small training course (typically two days) and become skilled through trial and error.

But what of the understanding of the facial muscles and how they change through the subtleties of expression and emotion? What of those patients who need correction because of genetics or ageing? Our expressions help to make us who we are, and how we are perceived by others.

Without looking in depth at these attributes, injectors are simply treating the symptom.

By symptom, I mean treating the fine lines and wrinkles that most patients want treated. These are the things that motivate many patients to initially seek treatment.

Facial Distractions
MD Codes Planning

Enter the MD Codes™️

In 2016/2017 I was invited to join a preceptorship program with Allergan (the creators of Botox & Juvéderm). This preceptorship focused on working with Physicians such as myself, who wanted more from injecting, and who wanted a protocol for achieving NLO – Natural Looking Outcomes. I have been extremely fortunate, and have studied directly under some of the leading Physicians, all of whom are dedicated to Education and NLO.

MD Codes™️ is an innovative methodology of facial aesthetic injection techniques using neuromodulators (Botox) and dermal fillers (Juvederm). Dr De Maio’s more natural approach to ‘facial augmentation’ is based on the concept of the “emotional attributes”.

Dr Mauricio De Maio & Dr Sarah Kennea

Dr. Mauricio De Maio is world renowned Plastic Surgeon and innovator in facial aesthetic medicine is the founder and creator of MD Codes™️.
Dr Mauricio de Maio and Dr Sarah Kennea

Our bodies produce Hyaluronic Acid in a bid to maintain moisture levels in the skin. But, ageing and environmental aggressors (to name just two) cause levels of Hyaluronic Acid to decrease. Dermal Fillers are made of Hyaluronic Acid, which our own body produces naturally. As we get older the production of collagen and Hyaluronic Acid can drop. Dermal Fillers simply replace that lost volume.

Emotional Attributes

Female at rest angry

As you can see in this photograph, sometimes we can portray an emotion that is not consistent with how we feel. As we lose volume our ability to control how we look at rest can be challenged. The emotional attributes are portrayed as sadness, tired, angry and saggy. This methodology, and the techniques that were developed out of this approach, replaced the practice of just “chasing” the lines and folds that typically concern patients.

These are the lines around the eyes, nasolabial folds, smile lines, marionettes and so on. You KNOW which one’s right!

Dr De Maio spent many years of research and design, and he refers to these areas as facial distractions.

This is a great description!! It completely changed how I look at my patients faces.

Patients are often distracted” by the symptom – the line or wrinkle that initiated the consultation. This distracts both patient and Physician from looking beyond the symptom at the “MESSAGE” on the face.

A good example of this would be nasolabial folds (the deep folds that appear at the side of the nose to the corners of the mouth). Many patients who complain about this symptom, ask for this one area to be “filled”, and so historically Physicians have filled it. The problem however is that by addressing only this area, the Physicians were not realizing or treating the ‘actual cause’ which is the loss of support in the cheek. This in turn causes sagging into the medial face.

To treat the cause and not the symptom, we must recognize the need for an entirely different approach. Physicians (and their consultants) need to work together, to re-educate patients on the need to treat the origin first as this is what produces natural, age appropriate outcomes.

Correction as Opposed to Beautification

Yes, there is beauty in the equation, but it is also how about we feel as individuals about ourselves. How we feel others perceive us. How we want to feel, as opposed to solely, how do we want to look.

To achieve this, we need to build relationships and trust with our patients.

In many cases we’ve seen a minor physical change cause a metamorphosis in a patient.

One patient spent her life troubled by her chin shape. She was nicknamed for it … She dressed to hide it … And it damaged her confidence. Using the MD Codes to create contours, increase and restore volume, I was able to gently shape a more natural looking profile.

On a follow up visit, she was a different person. New posture. New presence. An inner empowerment from a minor change.

Everyone noticed. Nobody knew. The compliments were real.

Another patient came to see me because she felt that she looked angry all the time. It was quickly apparent that she was the most beautiful, kind woman.

Ageing had caused some sagging causing an angry/sad look. This wonderful patient had completely internalized these feelings, and it had two results. Firstly, others perceived her to be angry or sad and reacted. She recognized this, and among other things had a loss of confidence which affected her work and personal life.

She had a truly beautiful outcome that not only made her look younger but corrected the sagging and allowing her face to appear softer and calmer. This softening was also internalized. She felt softer, more feminine and her body language changed.

If you look in the mirror, and what you see does not reflect who you are or how you feel, then there are options. I love Kathy’s story. It epitomizes the voice of so many.

Love who you are people.
Love who you can be.
Love the skin you're in.


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