Multi‐Dimensional Aesthetic Scan Assessment (MD ASA™): Initial experience with a novel consultation, facial assessment, and treatment planning tool

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.

The 7-point Shape and The 9-point Shape: An Innovative Nonsurgical Approach to Improve the Facial Shape

“…10 11 12 The aging process may produce a sad look when the patient is not feeling sad which means that unfavorable facial signs may lead to discrepancy between feelings and physical appearance. 8…”

“…The suggested equations for the treatment of the negative Emotional Attributes were already published in another paper. 8 On the other hand, there are four positive or favorable facial messages that patients usually desire to convey and are considered to be the “dreams.” Here are included patients' requests such as to achieve a more attractive, younger, more contoured or a more feminine/masculine look. The 7-point Shape and The 9-point Shape are technical options to directly improve the saggy appearance and indirectly the tired look, sad look and angry look (negative attributes).…”

“…[10][11][12] The aging process may produce a sad look when the patient is not feeling sad which means that unfavorable facial signs may lead to discrepancy between feelings and physical appearance. 8 The eight Emotional Attributes are divided into two categories: negative and positive attributes. There are four negative or unfavorable facial messages (tired look, sad look, angry look, and saggy appearance).…”

“…The single treatment of visible distractions usually is the tip of the iceberg and failure to fully comprehend the facial structure, contour, and anatomy may be a critical reason for patient dissatisfaction. 8 Therefore, it is necessary to have a comprehensive approach to ensure that both the symptoms (signs) and the causes are tackled to achieve the desired outcomes.…”

The Importance of Patient Mindset: Cosmetic Injectable Patient Experience Exploratory Study—Part 1

“…Other studies have found that aging patients are commonly concerned with one area, such as nasolabial folds, without being aware of underlying or causative aging changes such as volume loss elsewhere, even when using a mirror. 6 Many patients have limited knowledge of either contributory aging factors or negative nonverbal messages communicated by the face. Should they attribute their negative feelings to one specific feature, discussion prior to treatment is needed to set realistic expectations around their presenting concern.…”