Facial ageing: causes and solutions
Facial ageing is a complex, gradual and multifactorial process. Contrary to a still widespread belief, it is not simply skin laxity. From the thirties, and sometimes earlier, the face undergoes a series of deep anatomical changes.
The first change is volume loss. It involves bone resorption, atrophy of deep and superficial fat compartments and impaired skin quality. As these supporting volumes disappear, soft tissues lose their anchor points and tend to descend under gravity.
This explains the gradual appearance of nasolabial folds, marionette lines, loss of definition of the facial oval and jowls. The face may then look tired, sad or severe, regardless of the patient's actual emotional state.
Effectively treating facial ageing therefore requires understanding its main cause: loss of structure.
Facial rejuvenation techniques in aesthetic medicine
For many years, a surgical facelift was the only response to facial laxity. This approach remains an essential reference for certain indications, but it is neither routine nor suitable for all patients.
Intermediate techniques subsequently emerged, such as thread lifts or energy-based devices (focused ultrasound, radiofrequency). Although these methods may temporarily improve skin firmness, their effectiveness is often limited when significant volume loss is present. In fact, they do not treat the structural cause of ageing.
The advent of new hyaluronic acid injection techniques has profoundly changed the medical approach to facial laxity. More cohesive, more stable and specifically designed for deep injection, these products now restore strong, lasting support points.
This development opened the way to a true alternative to a surgical facelift for patients with mild to moderate laxity: a non-surgical facelift with hyaluronic acid injections, performed according to a precise, established methodology.
MD Codes: rejuvenating the face with injections
MD Codes are a standardised medical language for precisely planning and reproducing facial injection treatment. This methodology was developed by Dr Mauricio de Maio to improve safety, consistency and reproducibility of results.
The principle relies on detailed facial mapping divided into 84 injection points. Each point corresponds to a specific action: support, projection, filling, lifting or muscle modulation. The whole system rigorously respects bone anatomy, vascular pathways, nerve structures and fat compartments.
Speaking the language of MD Codes is like reading a musical score. Each combination of codes conveys a precise therapeutic intention, whether correcting a tired appearance, redefining the facial oval or restoring overall facial balance.
Non-surgical facelift
Unlike an isolated injection or one targeting a wrinkle, a facelift with MD Codes relies on a comprehensive, three-dimensional view. The aim is not to fill a wrinkle, but to rebuild the face's ‘foundations’.
Treatment first targets lateral support areas, often responsible for overall sagging. Restoring these anatomical pillars achieves a natural lifting effect without artificial traction.
During a standard non-surgical facelift, certain key points are systematically assessed, particularly in the cheekbones, jawline and chin. This approach, often called “7/9 Points Shape”, restores structure, projection and definition to the facial oval.
For men, specific adjustments respect masculine facial characteristics and avoid unintended feminisation.
Which facial areas can be treated with MD Codes?
MD Codes mapping covers the whole face, allowing extremely precise, personalised care.
The main areas include the cheekbones, true pillars of the middle third of the face; the temples, where volume loss accentuates eye-area ageing; the forehead and eyebrows; and the tear troughs, often responsible for a tired appearance.
Nasolabial folds and marionette lines are treated indirectly by restoring supporting volume rather than filling them directly. The jawline and chin play a central role in defining the facial oval and balancing the profile.
This comprehensive approach provides harmonious results without making features heavier or freezing expressions.
Non-surgical and surgical facelifts: two complementary approaches
A non-surgical facelift with hyaluronic acid injections effectively corrects mild to moderate laxity. It mainly restores volume and improves the face overall. The products used are absorbable, a major safety advantage.
The risk of complications is low when treatment is performed by a trained doctor, and the absence of social downtime allows an immediate return to activities. The non-permanent nature of treatment is sometimes seen as a constraint, but is actually an advantage because results can be adjusted as the face changes.
A surgical facelift is indicated for significant laxity, particularly when the neck is also involved. Ideally, it follows prior volume restoration with injections.
These two approaches do not conflict: they form part of a comprehensive, evolving facial rejuvenation strategy.
Which patients is a non-surgical facelift suitable for?
A non-surgical facelift with MD Codes is particularly suitable for patients aged 30 to 60 with the first signs of laxity. It corrects early sagging, improves a tired appearance and prevents ageing from worsening.
For younger patients, it may also be indicated preventively or to restore constitutional structural imbalances. After 50, it is often excellent preparation for or a complement to surgery, or is indicated for patients who do not wish to undergo surgery.
The key to success is a precise assessment of the patient's expectations and the actual anatomical causes of their request.
Fully personalised care
MD Codes treatment is never standardised. Each face is unique and ages differently. During the consultation, a thorough assessment examines bone structure, muscle dynamics, skin quality and blood supply.
A tailored treatment plan is then developed, considering the patient's goals: rejuvenation, correction of laxity, improvement in expression, facial feminisation or masculinisation.
This methodology requires specific training and thorough mastery of facial anatomy.
Results of a non-surgical facelift with MD Codes
Results are immediately visible and improve in the weeks following treatment. The face regains balanced volume, a redefined facial oval and a more rested expression.
The aim is never to transform, but to restore a fresher, more harmonious version of the face. Features remain natural, expressions preserved and corrections subtle.
When performed with restraint and precision, a non-surgical facelift with MD Codes provides natural, lasting rejuvenation fully integrated with the patient's identity.
