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Reading the face with MD ASA™ The Multi-Dimensional Aesthetic Scan Assessment (MD ASA™) is a tool to organise assessment of the face at rest and on animation. The face speaks and we must be able to read it. What our patients see in the mirror often differs from how they see themselves in photos and how they are perceived by others. MD ASA™ will help them to bridge this gap. The aesthetic hierarchy forms the basis of MD ASA™ and defines the systematic process of facial evaluation, all the way from full facial assessment (hierarchy 1 or H1) to identification of individual distractions on the face (H5). The ideal outcome should focus on H1, where the unfavourable messages are reduced when the patient looks in the mirror, at themselves in photos and when they are observed by others. However, patients often come to us with a request that falls lower down the hierarchy and focuses on tiny distractions. MD ASA™ is a useful assessment tool to integrate all of the facial hierarchies and deliver the most favourable outcome. We have to teach the patient to differentiate what is important from what is just annoying to them. It is very common for them to say, ‘I hate this line’; however, the treatment of this tiny, annoying distraction is unlikely to impact their overall message. So it can be considered unimportant.
At rest
Smiling H1: Full face: Analysis Patient feels: Emotional attributes
H2: Facial thirds and neck: Analysis Patient presents: Symmetry and proportion
H3: Periorbital and perioral: Analysis Patient expresses: Animation H4: Facial units: Analysis Patient needs: Key facial units or areas H5: Facial subunits: Analysis Patient wants: Distractions