Case Report Describes Dual-Phase CL Code for Facial Rejuvenation

A case report in the April 2026 issue of Journal of Cosmetic Dermatology described a dual-phase injectable approach to facial rejuvenation that combined contour restoration with ligamentous support using a polycaprolactone-based collagen stimulator. The authors termed the method the “CL Code,” with C representing contouring and L representing ligamentous anchoring.

The protocol was designed to reflect both the anatomy of facial aging and the biphasic behavior of polycaprolactone (PCL), which the authors said may provide immediate volumization followed by delayed neocollagenesis. In the contouring phase, investigators treated 7 facial zones with small aliquots intended to restore volume. In the ligamentous phase, they injected 8 retaining-ligament support points in the supraperiosteal or subsuperficial musculoaponeurotic plane using 27-gauge needles.

The report described outcomes in a 49-year-old woman with pan-facial volume loss who received a total of 2.9 mL of product, including 0.3 mL per contouring site and 0.1 mL per ligamentous anchoring point. At 6 months, standardized photographs showed improved jawline definition, reduced jowling, and softening of the nasolabial folds. Two independent dermatologists blinded to treatment details rated the outcome as “Very Much Improved” on the Global Aesthetic Improvement Scale. The patient’s FACE-Q Satisfaction with Facial Appearance score increased from 58 pretreatment to 86 at follow-up.

“Aligning the temporal behavior of PCL with anatomically targeted injection planes may couple immediate contour restoration with progressive ligamentous support,” the authors wrote. “Controlled comparative studies with longer follow-up are warranted.”