摘要

Objectives: To evaluate the efficacy of a three-session full-face rejuvenation strategy using variable hyaluronic acid (HA) concentrations (25, 20, 15, 12 mg/ml) to restore structural support and refine the periorbital region. Introduction: Aging in the Asian face involves complex volume loss and tissue descent requiring more than superficial correction. This case demonstrates a systematic, multi-layered rejuvenation in a filler-naive patient using the MD Codes framework. Materials / method: A 65-year-old filler-naive Asian female was treated in 3 sessions. S1: 2ml HA 20mg/ml via supraperiosteal layer at Ck1 and Ck3. S2: 2ml HA 20mg/ml at Ck1 and subcutaneous Ck4. S3: Lower face addressed with 3 ml HA 20mg/ml (Chin) and 3 ml HA 25mg/ml for jawline (1 ml supraperiosteal Jw1; 2ml subcutaneous Jw4/Jw5). Periorbital rejuvenation utilized 1ml HA 15mg/ml(Tt1-3). Final refinement with intradermal HA 12mg/ml at the lid-cheek junction. Clinical outcomes were assessed via standardized photography at 2-month follow-up. No adverse events were reported. Results: At 2-month follow-up, standardized photography confirmed significant mid-face restoration and a lifting effect on the lower face. The tiered MD Codes approach achieved approximately 70% correction of periorbital hollowing and a defined mandibular angle and jawline contour. Intradermal refinement at the lid-cheek junction successfully optimized the light reflex and surface texture. No adverse events, including delayed inflammatory nodules or Tyndal effect, were reported. The patient expressed high satisfaction with the natural, balanced outcome. Conclusion: Superior aesthetic outcomes in older, filler-naive Asian patients are achieved by matching specific HA concentrations to anatomical layers within the MD Codes framework. Prioritizing structural mid-face and lower-face support (HA 20-25 mg/ml) before periorbital refinement (HA 12-15 mg/ml) is essential to restore youthful proportions. This systematic, tiered approach minimizes the risk of an overfilled appearance while maximizing facial harmony, providing a reproducible roadmap for complex full-face rejuvenation.