How We Work

The 23MD Method.

A four-part methodology — diagnostic, structural, sequential and systemic — that governs every consultation, plan and treatment at 23MD.

Meet 23MD Digital

The 4D Approach

Skin · Structure · Movement · Personality

The 4D Approach is the diagnostic framework that underpins every aesthetic consultation at 23MD. Rather than treating a single feature in isolation, we read the face across four dimensions, and only then propose a plan.

Skin. Quality, tone, texture, hydration, pigmentation.
Structure. Bone, fat compartments and ligaments.
Movement. Expression, muscle dynamics and resting tone.
Personality. Who you are, and what looks like you.

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Abstract layered white forms illustrating facial structure and contouring concepts at 23MD

Dermal Architecture

Structure · Contouring · Volumising

Dermal Architecture is our injectable methodology. We treat the face as a layered structure — bone, deep fat, superficial fat, skin — and intervene at the level the concern actually lives in.

Structure. Reinstating the underlying scaffolding where bone resorption or laxity has shifted proportion.
Contouring. Shaping the perimeter — jawline, chin, temples, brow. Subtractive thinking.
Volumising. Replacing what time has taken, only where loss is genuinely the cause.

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Stacked pale layers illustrating the sequencing of combined aesthetic treatments at 23MD

Combining Treatments

System · Structure · Surface

When more than one treatment is needed, the order matters. We work from the inside out — internal foundations first, structural support second, surface finishing last — so each stage supports the next.

System. Internal foundations first — hormones, metabolism, sleep, inflammation.
Structure. Then the architecture — bone-level support, deep volume, ligament-aware contouring.
Surface. Finally the surface — regenerative facials, boosters, polynucleotides, devices.

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Abstract concentric white forms illustrating a whole-person longevity approach at 23MD

360 Longevity

Hormonal · Metabolic · Regenerative · Lifestyle

360 Longevity is the wellness arm of the 23MD method. It maps healthspan across four interlocking systems, and treats them as one continuous physiology — not four separate appointments.

Hormonal. Comprehensive panels and bioidentical, physician-led replacement where indicated.
Metabolic. Glucose, insulin, lipids, body composition.
Regenerative. IV nutrients, sleep architecture, cellular repair.
Lifestyle. Movement, nutrition and stress load, written into the plan.

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Begin with a doctor-led consultation.

Every 23MD patient starts with The Foundation Reset — bloods, 4D facial assessment, 360 Longevity consultation, and a written treatment plan within 24 hours.

From the Journal