A Dual‐Phase Approach to Facial Rejuvenation Integrating Contouring and Ligamentous (CL Code) Anchoring With a Polycaprolactone‐Based Collagen Stimulator

BACKGROUND: Facial aging reflects concurrent skeletal remodeling, fat redistribution, and attenuation of retaining ligaments. Volume-oriented fillers may restore contours but often underaddress structural support. OBJECTIVE: To describe the CL Code, a dual-phase injectable protocol combining Contouring (C) and Ligamentous anchoring (L), using a polycaprolactone (PCL) collagen stimulator to integrate immediate volumization with delayed neocollagenesis. METHODS: The protocol aligned the biphasic kinetics of PCL with facial anatomy. The C-phase targeted seven contouring zones using small aliquots to restore volume, while the L-phase reinforced eight retaining ligament support points at the supraperiosteal or subsuperficial musculoaponeurotic plane using 27-gauge needles. A 49-year-old woman with pan-facial volume loss underwent treatment with a total volume of 2.9 mL (0.3 mL per C site and 0.1 mL per L point). Outcomes at 6 months included Global Aesthetic Improvement Scale (GAIS) ratings and patient-reported FACE-Q scores. FACE-Q was administered pretreatment and at 6 months using the Satisfaction with Facial Appearance module. GAIS was assessed by two independent dermatologists blinded to treatment details using standardized photographs. RESULTS: In this single patient, standardized photography demonstrated improved jawline definition, reduced jowling, and softening of nasolabial folds. GAIS was rated as "Very Much Improved," and FACE-Q scores increased from 58 to 86 (out of 100), indicating high patient satisfaction. CONCLUSIONS: Aligning the temporal behavior of PCL with anatomically targeted injection planes may couple immediate contour restoration with progressive ligamentous support. The CL Code achieved meaningful esthetic improvement using conservative volumes. Controlled comparative studies with longer follow-up are warranted.

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Publication Details

Journal
Journal of Cosmetic Dermatology
Published
2026-03-31
DOI
https://doi.org/10.1111/jocd.70796
Primary Topic
Facial Rejuvenation and Surgery Techniques
Type
article
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article

A Dual‐Phase Approach to Facial Rejuvenation Integrating Contouring and Ligamentous (CL Code) Anchoring With a Polycaprolactone‐Based Collagen Stimulator

Gi‐Woong Hong, Soo Yeon Park, Kyu‐Ho Yi, Jovian Wan et al.
Journal of Cosmetic Dermatology
Facial Rejuvenation and Surgery Techniques
article

A Dual‐Phase Approach to Facial Rejuvenation Integrating Contouring and Ligamentous (CL Code) Anchoring With a Polycaprolactone‐Based Collagen Stimulator

Gi‐Woong Hong, Soo Yeon Park, Kyu‐Ho Yi, Jovian Wan, Isaac Kai Jie Wong, Suyeon Lee
article en

Abstract

BACKGROUND: Facial aging reflects concurrent skeletal remodeling, fat redistribution, and attenuation of retaining ligaments. Volume-oriented fillers may restore contours but often underaddress structural support. OBJECTIVE: To describe the CL Code, a dual-phase injectable protocol combining Contouring (C) and Ligamentous anchoring (L), using a polycaprolactone (PCL) collagen stimulator to integrate immediate volumization with delayed neocollagenesis. METHODS: The protocol aligned the biphasic kinetics of PCL with facial anatomy. The C-phase targeted seven contouring zones using small aliquots to restore volume, while the L-phase reinforced eight retaining ligament support points at the supraperiosteal or subsuperficial musculoaponeurotic plane using 27-gauge needles. A 49-year-old woman with pan-facial volume loss underwent treatment with a total volume of 2.9 mL (0.3 mL per C site and 0.1 mL per L point). Outcomes at 6 months included Global Aesthetic Improvement Scale (GAIS) ratings and patient-reported FACE-Q scores. FACE-Q was administered pretreatment and at 6 months using the Satisfaction with Facial Appearance module. GAIS was assessed by two independent dermatologists blinded to treatment details using standardized photographs. RESULTS: In this single patient, standardized photography demonstrated improved jawline definition, reduced jowling, and softening of nasolabial folds. GAIS was rated as "Very Much Improved," and FACE-Q scores increased from 58 to 86 (out of 100), indicating high patient satisfaction. CONCLUSIONS: Aligning the temporal behavior of PCL with anatomically targeted injection planes may couple immediate contour restoration with progressive ligamentous support. The CL Code achieved meaningful esthetic improvement using conservative volumes. Controlled comparative studies with longer follow-up are warranted.

Journal of Cosmetic DermatologyVol. 25(4)
Yonsei University (KR), Paragon 28 (United States) (US), Plastic Surgery Hospital (CN), Dr Youth Clinic (KR), Yonsei University College of Dentistry
Openalex Percentile: Top 32%
Facial Rejuvenation and Surgery Techniques
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