The MD Codes (Distinction) Conference in London

Dr Sabba

2nd March 2018

This two day conference took place in London on the 27th and 28th February 2018 and I was invited by Allergan (the company that make Juvederm and BOTOX®). It is one of the highlights of the year as it gives aesthetic practitioners in the UK an opportunity to see world-renowned plastic surgeon  Mauricio de Maio who created the MD Codes™ (more on that later).


Day 1

The auditorium was packed-out with delegates queuing to get inside well before the 10am start! I managed to get a seat in the second row but there were also two large screens on the stage which were relaying images further back.

In the first part of the day Dr de Maio discussed what motivates people to have aesthetic treatments. What is so interesting is he takes a very detailed look at what motivates people from an emotional level. How do they feel when they look in the mirror? Do they feel they look tired? Sad? Angry? Saggy? It is only once we know how patients feel about their appearance we can incorporate this into their treatment plan. Looking at aesthetics this way rather than focusing solely on lines and wrinkles can achieve far superior results.


Foundation, Contour and Refinement (The FCR Approach)

Dr de Maio likened this concept to that of a house.  You would not start decorating the interiors of a house before ensuring the foundation and the actual build/shape were addressed first.  When patients ask for refinement such as nasolabial fold or tear trough rejuvenation it must be ensured that the foundation is correct in order to achieve the best and also most natural-looking results.  Foundation often means addressing the mid-face i.e. the cheeks as it is due to volume changes here which can lead to the development of nasolabial folds and tear troughs.  The mid-face also has an impact on how the lower face ages and contributes to jowl formation.

Slide from conference demonstrating the concept of Foundation Contour and Refinement

What are MD codes?

As mentioned earlier Mauricio de Maio created MD Codes where every part of the face that can be treated with dermal filler is given a code. The codes are grouped by area.  For example the cheek area has 5 codes (CK1, CK2, CK3, CK4, CK5) and the tear trough has 3 codes (TT1, TT2, TT3).  Each code correlates to a specific area and is targeted for a specific reason.

Once we know what the patient wants to achieve including how they want to feel we can select the codes that need treating in one or multiple parts of the face (see picture below) and produce a formula and this is in essence a treatment plan.

Picture demonstrating the different codes on the face

Afternoon Session- the Injecting

I witnessed two models being treated by Mauricio in the afternoon and it was an awe-inspiring experience. The first was a 45-year old female of Indian descent who wanted to look less tired and sad and the second was a 52-year old Caucasian female who had a lot of volume loss who wished to look less tired, sad and saggy.

Prior to each treatment session there was an interactive treatment planning stage where we found out what bothered the model and how she wanted to feel. We selected the codes and formulated a treatment plan. We then got to witness Dr Maurcio de Maio inject the models and as he did so he discussed the amount of filler he was injecting and the technique. During the injecting Mauricio talked about there being a point during a treatment when a patient begins to ‘blossom’ and blossom they did! It was incredible seeing them transform. I only wish I could show you the before/afters but clinical photography is not allowed without patient consent.


Day 2

This followed a similar pattern to Day 1. Again there were two models and after finding out what their concerns were and how they wanted to feel, we selected the codes and formulated a treatment plan.  It was clear to see that all the models were blown-away by their results with one becoming quite emotional.

I found the conference so inspiring. What can be achieved now is incredible and this is all without any surgery. The models had their treatments in one session but in real -life they would have their treatment over a period of usually 3 appointments with an average of 4mls of product injected in each treatment session.

The picture below demonstrates differing amounts of filler.  You can see that 1ml is a very small amount indeed.  For full facial rejuvenation it is not uncommon to require 8, 10 or even 12mls of filler.  This is where starting sooner pays off as less ageing will have taken place which then means less dermal filler is required for the desired result.


Tablespoon demonstrating the amount of dermal filler (in this case Voluma) in mls.

Which fillers did Maurico de Maio use?

He used products from the Juvederm Vycross range (Voluma, Volift and Volbella). These are a premium range of fillers which last 12-18 months but often longer. This range is also my favourite and one that I recommend to my own patients.

I have now been attending the MD Codes Masterclass for the past 4 years. It is so exciting to see how facial aesthetics is continually evolving and I love being a part of this.  Ultimately as an aesthetic doctor my aim is to improve the lives of the patients I see and this conference again confirmed to me why I do what I do.


For further information or to book a consultation please call 020 36334908, email or DM @drsabba

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