A youthful neck only lasts so long. It is an area of the body we commonly receive consultations on. Did anyone read Nora Ephron’s brutally honest and sarcastically funny book, “I Feel Bad About My Neck And Other Thoughts On Being A Woman”?! She had a thing or two to say about her neck!
But seriously, we tend to take good care of our faces but neglect our necks. There are many options for our necks. From topicals creams, injectables, skin firming treatments, and finally, surgery. This will be a quick and easy breakdown of modalities to address a variety of issues that can effect the neck.
As we age the skin on our neck becomes thinner, the platysmal bands show, looking like cords in our neck.
Our sub mental fat pads can become more apparent and we loose the definition along our jawline, altering our profile.
Sub mental fullness
The tissues can become looser, frequently due to repeated pulling of the platysma muscle along with the loss of collagen and elastin.
Loose skin/loss of collagen/elastin
Skin can become discolored. A condition called Poikiloderma is common in both men and women. The skin is marked with a combination of hyperpigmentation and redness (from vascular injuries from sun exposure). Poikiloderma frequently involves the chest in addition to the neck. Most often the medial neck is not affected.
I think we can agree the first photograph in this blog looks better than all the others! So, how to get closer to that….
Platysmal bands can be easily corrected with Botox®. Botox® is injected along the platysmal band and within two weeks the band will relax and not show. Additionally, doses of Botox® can also be injected along the mandible (jaw bone) to improve the jawline contour. This is sometime referred to as a Nefertiti Lift. This is a quick, non-invasive procedure.
Sub mental fullness can be addressed with Kybella® injections. The injection of this acid breaks down the fat which is then eliminated by the body. A series is generally recommended. Other than 48 hours of socially awkward swelling (think bullfrog), this is a low down time procedure. The procedure is ideally repeated at 4-6 week intervals. We are noticing patients experience some skin retraction with this procedure as well. (likely as a result of the inflammatory process in which collagen is stimulated)
The loss of skin turgor can be treated with a skin tightening treatment, such as Ultherapy®. During this treatment heat is delivered deep in the tissues, using ultrasound, creating tightening and lifting. This is also a low to no down time procedure as most people can receive an Ultherapy® and return to their activities without anyone knowing. The improvement is gradual over the next 4-6 months as the collagen that was stimulated grows in.
Discoloration, such as Poikiloderman, can be treated with a series of IPL treatments. Again, other than redness the day of treatment, this is a minimally invasive/no downtime procedure. We recommend a series of 3-5 treatments.
I do not want to underestimate the importance of good skin care. Sunscreen is a no brainer. There are also products specifically formulated to treat the skin of the neck and décolleté. My current favorite is Neocutis® Microfirm™. This topical product, utilitzing peptides and glycolic acid, increases elasticity and improves skins crepey appearance. It can also help to fade hyperpigmentation.
Finally, there comes a time when the tools and products we have in a medical spa are not enough. There is a time when the neck is best addressed with a skilled surgeon. A neck lift involves redraping the skin. Additionally the platysma muscle is reattached and tightened. You and your skin care provider ideally have honest conversations along the way allowing to make this call when it is appropriate.
Anyway, don’t forget your neck! Hope this gives you some helpful tips:-)