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Non-surgical neck/décolletage rejuvenation

Quick facts

• The neck is an important area to rejuvenate as one's age is often judged by the appearance of the neck
• Surgery is often indicated to reduce skin laxity and remove fat, but there are many non-surgical methods of rejuvenating the neck
• Sun damage and pigmentation can be treated with laser and photodynamic therapy
• Redness/brown discolouration of the neck, or Poikiloderma of Civatte, can be treated effectively with the Pulsed dye laser or  Gemini laser
  
• Neck fat can be treated with liposuction or non-surgically with Lipodissolve
• Skin tags can be treated with the Gemini laser or radiowave surgery.
  
• Horizontal neck bands can be treated with dermal filler and anti-wrinkle injections.
  

What is non-surgical neck rejuvenation?

The neck is an aesthetically important area of the face, and may be as important as the face in revealing one's age. The neck is subject to many degenerative changes such as loss of collagen and elastin, accumulation of fat, and from external factors such as ultraviolet radiation. The neck and the decolletage area are particularly prone to premature ageing because these are areas of increased sun exposure.

Traditionally, neck rejuvenation has been performed surgically to help to reposition lax skin, reduce wrinkles, and to reduce redundant fatty tissues. Non-surgical neck rejuvenation has an adjunctive role to surgery and is also an alternative to surgery. Non-surgical procedures can also address the skin texture of the neck and decolletage whereas surgical procedures are unable to address this issue.

With an increasing need for minimally invasive procedures with little or no downtime, there has been a trend towards non-surgical neck rejuvenation.

What methods can be used to rejuvenate the neck non-surgically?

Various methods can be used to rejuvenate the skin and underlying tissues in the neck.  The first step is to prevent further damage by daily use of sunscreen on the neck, colletage, and hands and not just the face.

Skin texture can then be addressed. The neck and decolletage are areas of the skin that may be highly exposed to UV radiation, and this causes progressive degenerative changes in the skin. These include;

Sun damage

Pigmentation, appearing as brown patches, can appear as a result of sun exposure. Also, solar (actinic) keratosis are red and scaly patches that are pre-cancerous lesions that may appear over time with cumulative sun exposure - especially on fairer skin types. The treatment of solar keratosis is not only cosmetic, but also preventative as these are pre-malignant lesions. 

The tissues of the neck are usually thinner and more sensitive than that of the face, and need to be treated more cautiously. Chemical peels may be used to help exfoliate dead skin cells and reduce pigmentation and solar damage. Skin care containing retinoic acid or hydroquinone can also help, but can be very irritating in this area in comparison to their effect on the face.

Laser is another means of helping to reduce brown pigmentation. The Gemini laser emits a green wavelength of light that is attracted to the brown pigmentation on the neck and helps to break down this pigmentation. Lasers such as the Medlite laser and ruby laser can also be used for brown spots on the neck and chest area. For solar keratosis, photodynamic therapy can be implemented. Photodynamic therapy is particularly targeted to solar keratosis.

Fractional carbon dioxide laser treatments can be used for resurfacing the neck and to help with skin texture, wrinkles and to tighten neck skin. Carbon dioxide lasers are lasers that ablate the top layers of the skin and cause it to regenerate with fewer wrinkles and improved tightness. With fractional carbon dioxide lasers, small columns of laser are fired into the skin and parts of the skin in between these columns are left untreated. This helps to reduce the risk of treatment, and allows for much safer treatment of off-face areas than traditional (non-fractional) carbon dioxide lasers.

Plasma skin regeneration is another method of resurfacing the neck. It uses plasma energy to reduce pigmentation, and also has the added advantage of reducing wrinkles and tightening skin. Only the lower energy settings can be used on the neck with plasma however, and therefore a few treatments may be required to achieve the optimal results.

 

Poikiloderma of Civatte

Poikiloderma of Civatte is a condition that causes a red-brown discolouration on the side of the neck. The redness represents superficial capillaries and the brown discolouration is overlying pigmentation. The area that is shaded by the chin is usually spared. Poikiloderma is exacerbated by UV exposure, but the underlying cause is not known. Perfumes and various cosmetics have been implicated, as well as hormonal causes like low oestrogen levels. People with a family history of poikiloderma as well as fair-skinned individuals are more likely to develop this condition.

Avoidance of potential causes of poikiloderma such as perfumes, UV radiation, and various cosmetics is the first step in treating poikiloderma.

Poikiloderma is then best treated with the Gemini Laser or Pulsed dye laser. This helps to reduce the pigmentation and close off any superficial capillaries causing the redness. The wavelengths from these lasers are specifically attracted to the capillaries and pigmentation, and hence normal skin is relatively unaffected.

Neck fat

Excess neck fat has traditionally been treated with liposuction. This is the most effective means of removing the fat from under the chin and around the neck. It can be done under local anaesthetic with or without sedation, and usually takes about 2 hours to perform. There is usually some retraction of neck skin after liposuction is performed in conjunction with the removal of fat.

Lipodissolve is a relatively new method of treating neck fat by injection. Lipodissolve helps breakdown the fat in the neck area. There is some associated swelling post-treatment. The key advantages of Lipodissolve are that it helps tighten the skin, and is uniform in its results.

The neck/chin is one of the best areas for treatment with Lipodissolve as the amount of fat here is usually less than other areas of the body, and the results are more dramatic as a result.

Case study 

This female patient presented to The Victorian Cosmetic Institute with concerns about the fat in her neck as well as the skin laxity. She underwent liposuction to her neck and jowls, under local anaesthetic and light sedation. The the 'after' photo was taken 3 months later. As can be seen, there is a significant degree of both skin retraction and fat reduction achieved in those areas.

Skin Laxity

Skin laxity of the neck is best treated with plastic surgery.

Non-surgical methods have attempted to emulate the results of surgery, but have so far been unsuccessful. Skin tightening methods such as using machines like the Thermage, Accent fat blaster, Titan, and Refirme ST, usually use radio-frequency to help heat the skin and stimulate collagen. The effects are usually variable and subtle.

Suture lifting (Contour threads, Silhouette threads, Aptos threads), is a method of lifting the skin by placing a suture under the skin to pull the skin tight. The effect of these methods has not been found to be very long lasting in the clinical studies performed, and also there is the problem of skin bunching around the ears (where it is pulled to).

Skin tags

Skin tags, or acrochordons, are generally benign growths of skin that commonly occur on the neck, armpits, and groin. They are usually from 1 to 5 mm in size, and appear as a small outgrowth of skin, connected by a small narrow stalk.

Smaller skin tags can be removed by the Gemini laser on its 532nm wavelength. Often 1 to 2 treatments are required and this is an excellent treatment for those who have multiple small skin tags, as it causes minimal disruption to the normal skin.

For larger skin tags, radiowave surgery is preferred. This involves the use of high radio-frequency technology to cut off the skin tag. No sutures are required using this method.

Case study 2

This female patient in her forties presented to The Victorian Cosmetic Institute with concerns about her neck and decolletage. She had multiple skin tags on the neck, and some redness (poikiloderma) from sun damage on the neck and chest. The Gemini laser was used to remove the skin tags and also to help to shut down the superficial vessels in the neck and chest to reduce the redness there. The before and after show the result after one session only.

 

Vertical neck bands

Vertical neck bands are caused by changes in the platysma muscle which is the band of muscles from the collar bone to the jawline and can normally be seen when the teeth are clenched hard. This muscle, with time, can separate into bands and this can be aesthetically undesirable.

Anti-wrinkle injections can be injected into these bands to help flatten them. Anti-wrinkle injections can also be injected into the areas where bands are not present to help reduce the downward pull of the platysma muscle on the face. A resulting lift in the face can often result. In addition to stopping the platysmal bands from forming, some injections can be placed along the jawline to help stop the pull of these muscles on the face and therefore help to lift the face.

Horizontal neck bands

Horizontal neck bands are creases in the skin of the neck caused by movement of the neck which creases the skin over time.

These bands can be treated with anti-wrinkle injections, although the success of this procedure is low. A more effective treatment for these lines is with fillers. Depending on the size of the line, an appropriate dermal filler can be injected into the lines to help fill them out.

Why should I choose the Victorian Cosmetic Institute as my provider of neck rejuvenation?

Otherwise, you can phone us directly on (03) 8850 0655 (Templestowe) or (03) 9707 0888 (Berwick).

 

• Quick facts

• What is non-surgical neck rejuvenation?

• What methods can be used to rejuvenate the neck non-surgically?

• Sun damage

• Poikiloderma of Civatte

• Neck fat

• Case study 

• Skin Laxity

• Skin tags

• Case study 2

• Vertical neck bands

• Horizontal neck bands

• Why should I choose the Victorian Cosmetic Institute as my provider of neck rejuvenation?