Anti-Aging Neck Solutions

Multiple issues can cause the skin of the neck to look older:

• Laxity (sagging) – caused by loss of collagen and elastin due to aging and sun damage. The skin
thins and it has less support.

• Neck Bands (verticle) – caused by the muscle of the neck pulling apart from the middle so we are seeing the borders of the muscle sticking up

• Excess Fat – fat can collect under the chin due to age or for genetic reasons.

• Brown and Red Discoloration (poikiloderma) – on the neck from the sun.

• Horizontal Lines – etched in lines caused from the neck flexing at the same place every time.

Let’s look at some of the treatments that can help with these issues starting with laxity. Since almost everyone has laxity neck aging, so this is the biggest category.

Neck laxity can be addressed by either performing tissue tightening (Thermage®, Ultherapy®, or Pellevé®) or with RF microneedling (Genius™). Each of these is slightly different and we choose with you based on the neck thickness and other factors. One other thing we can do is inject diluted fillers, such as Radiesse or Sculptra. These fillers stimulate new collagen formation and also make the skin slightly thicker, giving it more structure and firmness that thus sags less.

Neck bands are treated with a muscle relaxer like BOTOX®, Dysport®, or Xeomin®. This typically lasts 3-4 months. Excess fat is addressed with either CoolSculpting® or Kybella™ (injection of fat-dissolving chemical). Fortunately, both treatments are permanent, although each of them may need more than one treatment.

Brown and red discoloration can be successfully diminished with a laser treatment called thulium. We have 3 different brands of thulium: Fraxel®, Clear + Brilliant®, Perméa®, and LaseMD® Ultra, but they are very similar. Depending on which is chosen, usually, 1-3 treatments are needed, unless we use the Perméa
which has almost no downtime but does accomplish less in each individual treatment, so more treatments are necessary.

Horizontal lines can be lessened with skin tightening or fillers, such as injecting a very thin filler directly into the lines to lessen their appearance.

I wish it were simpler! People often ask me, what is the best sunscreen? What is the best skincare product? Which is the best laser? What is the best treatment for the neck? The answer is…it depends. It depends on your anatomy, your ability to tolerate downtime, the condition of the skin involved, your financial limitations… etc! This is why we do consultations and why they are so long, as it does take time to figure out what are your unique features, your highest priorities, and also take into account your lifestyle preferences.

Ideally, for many things, a combination of treatments is the optimal solution. The reason is that most of us don’t just have one feature of aging, so we do have to combine these treatments to make the optimal treatment.

Let’s take a common example (see photo below) . The neck has laxity and has soft wrinkles around the base of the neck. There are neck bands vertically, the neck bands horizontally aren’t too noticeable, there is a little bit of fat under the neck and there isn’t much discoloration. The skin is relatively thin. The following solutions would be an option:
Ultherapy® of the neck plus BOTOX® and/or Radiesse®
– Radiesse® plus BOTOX®
Genius™ plus BOTOX® and/or Radiesse®

It’s confusing to have so many options, I know. If you don’t want to make the decision we can. We are lucky to have so many choices now, other than surgery, but surgery is always an option. Surgery will help with laxity, it can help with fat if liposuction is done at the same time as is commonly done, and the bands can be treated by sewing them together. You will still need laser treatment(s) if you have brown/red discoloration.