By Dr Alexandre Marchac: An innovative protocol to beautify and rejuvenate the facial contours

Can you explain the 7-Point Reshape to us?

It is a protocol for injecting hyaluronic acid into 7 strategic points (lateral part of the cheek, angle of the jaw and chin), which enables us to restore or beautify the oval of the face. It was designed in 2019 by Mauricio de Maio, the inventor of the MD Codes, for the new generation of hyaluronic acids – Juvederm, Voluma and especially Volux, which gives three times as much projection.

What makes these new hyaluronic acids so special?

These hyaluronic acids are much more useful than those from the 2010s, which held on to water and fi lled grooves and wrinkles. These new acids can project the tissues without holding on to water (they are only weakly hydrophilic), which means we can create angles and provide support without making the face look “infl ated”. We inject them right up against to the bone and they are slowly resorbed over 18 to 24 months.

How have these new hyaluronic acids changed the way you work?

Previously, in order to get the facial features to project, I had to operate and use bone grafts or implants. Some of my colleagues used non-resorbable products, but the risk of complications was high. With these new hyaluronic acids, we can achieve equivalent results but with an excellent safety profile. We’re always talking about hyaluronic acid, but the products are all quite different. The other thing that has changed my way of working is the MD Codes.

The MD Codes is the language of injections invented by De Maio, the same man who designed the 7-Point Reshape.

Yes, exactly. Before the MD Codes, it was diffi cult to accurately describe our injection protocols, and Mauricio had the genius idea of giving us a language, a kind of solfège, to describe the face. We can now accurately transcribe our treatment technique: for example, a treatment to make you look less tired (cheekbones, temples and under-eye hollows) would be written: CK1 + T1 + CK2 + CK3 + Tt1 + Tt2 + Tt3. This might seem incomprehensible to you, but for a colleague who has learnt the MD Codes it immediately makes sense, just like a sheet of music does to a musician. They will know which points have been injected, to what depth and what quantity of product was used. This is fundamental because we are now entering the era of preventing facial aging and we will be treating patients over several decades.

What happens during the 7-Point Reshape treatment? Does it hurt? Is it very obvious afterwards?

The 7-Point Reshape involves injecting into 7 key points: the lateral part of the cheek (CK1 + CK4), the angle of the jaw (Jw1) and the chin (C1 + C2 + Jw4 +Jw5). By creating projection in these precise points, I can tighten the tissues, a bit like in a lift. I carry out the injections in my medical surgery: I have two special treatment rooms. The Juvederm hyaluronic acid contains a local anaesthetic and so it does not hurt. The results are visible immediately and patients can get straight back to their daily life. There may be some mild swelling for 48 hours, but it is very discreet and patients all say that their friends and family did not notice a thing.

If you use the same technique for all patients, isn’t there a risk they will all end up looking the same?

No, because each patient’s facial architecture is different and my role is to advise and to adapt my treatments according to each patient’s face. I am a bit like an interior designer: this sofa may be lovely, but it is too big for this living room. In certain cases, we must not inject the CK4, in others, you might add the Lp1 + Lp6 for the lips. You need to know how to adapt the 7-Point Reshape protocol: that is how you achieve attractive and natural- looking results.

And is the 9-Point Reshape the protocol for men?

Yes, that’s right. In the 9-Point Reshape, we add 2 key points in the jawline to give a squarer jaw. I really like treating men because the 9-Point Reshape not only allows us to fi ght the first signs of sagging but also makes the patient look much more handsome. And these treatments are well suited to an active man’s (or woman’s) lifestyle: immediate results, straight back to work, little risk and not obvious.

What advice would you give to anyone wanting to give it a try but who is too scared?

If it is your fi rst time, my advice is to ask a lot of questions. Find out as much as you can: ask about your doctor’s qualifications, ask if they have already treated patients like you, ask to see some before and after shots (beware of trick lighting!), ask for a written treatment plan and make sure they specify which products they will use. After the session, keep a note of the products, because there are a great many hyaluronic acids on the market and some are not particularly good. Finally, hyaluronic acid is just a tool: the most important thing is the hand that injects it.

Dr Marchac has been a plastic surgeon in Paris for the last 10 years and specialises in facial repair and aesthetics. He is passionate about methods that fight facial aging, such as the “deep plane” lift, blepharoplasty and the MD Codes injection protocol. For the last 4 years, he has collaborated closely with Mauricio De Maio to teach the MD Codes in France and abroad.

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