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Lin, Samuel J. et al.: 2024 Neck Rejuvenation DOI: 10.1055/b-0044-201793

13 Neck Rejuvenation: Noninvasive Techniques

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Book

Editors: Lin, Samuel J.; Slavin, Sumner A.; Tandon, Vickram J.

Authors: Angelini, Matteo A.; Cunha Araujo, Marcelo; Barrios, Esther; Bellamy, Justin; Boustany, Ashley N.; Chia, Christopher T.; Citarella, Enzo R.; Condé-Green, Alexandra; Couto, Rafael A.; Dayan, Erez; Dover, Jeffrey S.; Ebersole, Trina G.; Foppiani, Jose A.; Gould, Daniel J.; Grover, Ritwik; Grow, Jacob N.; Janne Hasbun, Samir; Hogan, Sara R.; Hurwitz, Dennis J.; Kaminer, Michael S.; Kaminer, Michael S.; Kochuba, Andrew L.; Maia, Munique; Matarasso, Alan; Nassar, Amer H.; Nicholas, Mathew N.; Piña, Jeremie O.; Pelle-Ceravolo, Mario; Rodriguez-Unda, Nelson A.; Rohrich, Rod J.; Sinder, Ramil; Sterodimas, Aris; Talei, Benjamin; Ziai, Hedyeh; Zins, James E.

Title: Neck Rejuvenation

Subtitle: Surgical and Nonsurgical Techniques

Print ISBN: 9781626239630; Online ISBN: 9781684202850; Book DOI: 10.1055/b000000386

1. Edition © 2024. Thieme. All rights reserved.
Thieme Medical Publishers, Inc., New York

Subjects: Plastic, Reconstructive and Cosmetic Surgery

Thieme Clinical Collections (English Language)



 
Mathew N. Nicholas, Sara R. Hogan, Michael S. Kaminer, and Jeffrey S. Dover

Abstract

Noninvasive neck rejuvenation treatments can make significant differences for patients and have less recovery time and less risk of adverse effects when compared to surgical approaches. The choice of which noninvasive treatment to use requires identifying individual patient concerns. Patient concerns can be divided into five distinct categories: (1) dyschromia, (2) horizontal necklines, (3) platysmal banding, (4) skin laxity, and (5) submental fullness. Dyschromia is largely caused by ultraviolet radiation exposure. It can be targeted with cosmeceuticals, chemical peels, intense pulsed light, and various nonablative lasers. Horizontal necklines are caused by a combination of skin laxity, underlying fascial attachments, and downward pull of the platysma. Neuromodulators, fillers, and laser and energy-based devices can work in combination to target these causes. Platysmal banding results from the chronic contraction of the platysma muscle in the setting of increasing skin laxity. Neuromodulators are the primary noninvasive treatment; however, multiple different techniques in using them have been described. Skin laxity can be mild, resulting in rhytids and wrinkling, or severe, creating jowls and submental sagging. Fillers and energy-based devices, including microfocused ultrasound with visualization, monopolar capacitive-coupled radiofrequency, and radiofrequency microneedling target more severe laxity, while chemical peels, dermarolling or microneedling without radiofrequency, and platelet-rich plasma can target more mild laxity. Submental fullness is a common patient concern and more resistant to improvement through exercise and diet. Deoxycholic acid injections, cryolipolysis, energy-based devices, and laser lipolysis all work by decreasing subcutaneous fat with different mechanisms of action. In this age of numerous noninvasive techniques, a combination of techniques is used to target different patient concerns and optimize outcomes. In this chapter, we describe currently available noninvasive techniques and illustrate our approach to tailored treatments for an individual patient.

Key words

neuromodulators - lasers - energy-based devices - fillers - deoxycholic acid - cryolipolysis
 
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