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

13 Neck Rejuvenation: Noninvasive Techniques

More Information

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
 
  • 1 American Society for Dermatologic Surgery. ASDS Survey on Dermatologic Procedures. Accessed February 5, 2020 at: https://www.asds.net/medical-professionals/practice-resources/asds-survey-on-dermatologic-procedures
  • 2 Ellenbogen R, Karlin JV. Visual criteria for success in restoring the youthful neck.. Plast Reconstr Surg 1980; 66 (6) 826-837 PubMed (PMID: 7443846)
    Google Scholar
  • 3 Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: a review.. Int J Cosmet Sci 2008; 30 (2) 87-95 PubMed (PMID: 18377617)
    Google Scholar
  • 4 Flament F, Bazin R, Laquieze S, Rubert V, Simonpietri E, Piot B. Effect of the sun on visible clinical signs of aging in Caucasian skin.. Clin Cosmet Investig Dermatol 2013; 6: 221-232 PubMed (PMID: 24101874)
    Google Scholar
  • 5 Ortonne JP. The effects of ultraviolet exposure on skin melanin pigmentation.. J Int Med Res 1990; 18 (Suppl. Suppl 3) 8C-17C PubMed (PMID: 2227089)
    Google Scholar
  • 6 Fisher GJ, Varani J, Voorhees JJ. Looking older: fibroblast collapse and therapeutic implications.. Arch Dermatol 2008; 144 (5) 666-672 PubMed (PMID: 18490597)
    Google Scholar
  • 7 Mashkevich G, Wang J, Rawnsley J, Keller GS. The utility of ultrasound in the evaluation of submental fullness in aging necks.. Arch Facial Plast Surg 2009; 11 (4) 240-245 PubMed (PMID: 19620529)
    Google Scholar
  • 8 Kenkel JM, Jones DH, Fagien S et al. Anatomy of the cervicomental region: insights from an anatomy laboratory and roundtable discussion.. Dermatol Surg 2016; 42 (Suppl. Suppl 1) S282-S287 PubMed (PMID: 27787268)
    Google Scholar
  • 9 Kligman A. The future of cosmeceuticals: an interview with Albert Kligman, MD, PhD. Interview by Zoe Diana Draelos.. Dermatol Surg 2005; 31 (7, Pt 2) 890-891 PubMed (PMID: 16029684)
    Google Scholar
  • 10 Brandt FS, Cazzaniga A, Hann M. Cosmeceuticals: current trends and market analysis.. Semin Cutan Med Surg 2011; 30 (3) 141-143 PubMed (PMID: 21925366)
    Google Scholar
  • 11 Boen M, Alhaddad M, Wu DC, Goldman MP. A prospective double-blind, placebo-controlled clinical trial evaluating the efficacy of a novel combination of hyaluronic acid serum and antioxidant cream for rejuvenation of the aging neck.. J Clin Aesthet Dermatol 2020; 13 (11) 13-18 PubMed (PMID: 33282096)
    Google Scholar
  • 12 Saxena SJ, Duque D, Schirripa MJ. Assessment of a comprehensive anti-aging neck cream.. J Drugs Dermatol 2015; 14 (9) 997-1002 PubMed (PMID: 26355619)
    Google Scholar
  • 13 Schlessinger J, Green B, Edison BL, Murphy L, Sabherwal Y. A firming neck cream containing N-acetyl glucosamine significantly improves signs of aging on the challenging neck and décolletage.. J Drugs Dermatol 2016; 15 (1) 47-52 PubMed (PMID: 26741381)
    Google Scholar
  • 14 Chajchir I, Modi P, Chajchir A. Novel topical BoNTA (CosmeTox, toxin type A) cream used to treat hyperfunctional wrinkles of the face, mouth, and neck.. Aesthetic Plast Surg 2008; 32 (5) 715-722, discussion 723 PubMed (PMID: 18491179)
    Google Scholar
  • 15 Cook KK, Cook Jr WR. Chemical peel of nonfacial skin using glycolic acid gel augmented with TCA and neutralized based on visual staging.. Dermatol Surg 2000; 26 (11) 994-999 PubMed (PMID: 11096382)
    Google Scholar
  • 16 Fulton JE, Rahimi AD, Helton P, Dahlberg K. Neck rejuvenation by combining Jessner/TCA peel, dermasanding, and CO2 laser resurfacing.. Dermatol Surg 1999; 25 (10) 745-750 PubMed (PMID: 10594574)
    Google Scholar
  • 17 Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B. Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing.. J Clin Aesthet Dermatol 2010; 3 (7) 32-43 PubMed (PMID: 20725555)
    Google Scholar
  • 18 Rusciani A, Motta A, Fino P, Menichini G. Treatment of poikiloderma of Civatte using intense pulsed light source: 7 years of experience.. Dermatol Surg 2008; 34 (3) 314-319, discussion 319 PubMed (PMID: 18177401)
    Google Scholar
  • 19 Weiss RA, Goldman MP, Weiss MA. Treatment of poikiloderma of Civatte with an intense pulsed light source.. Dermatol Surg 2000; 26 (9) 823-827, discussion 828 PubMed (PMID: 10971554)
    Google Scholar
  • 20 Bernstein EF, Schomacker K, Paranjape A, Jones CJ. Treatment of poikiloderma of Civatte using a redesigned pulsed dye laser with a 15 mm diameter treatment spot.. Lasers Surg Med 2019; 51 (1) 54-58 PubMed (PMID: 30480322)
    Google Scholar
  • 21 Batta K, Hindson C, Cotterill JA, Foulds IS. Treatment of poikiloderma of Civatte with the potassium titanyl phosphate (KTP) laser.. Br J Dermatol 1999; 140 (6) 1191-1192 PubMed (PMID: 10354107)
    Google Scholar
  • 22 Behroozan DS, Goldberg LH, Glaich AS, Dai T, Friedman PM. Fractional photothermolysis for treatment of poikiloderma of civatte.. Dermatol Surg 2006; 32 (2) 298-301 PubMed (PMID: 16442059)
    Google Scholar
  • 23 Bencini PL, Tourlaki A, Galimberti M, Pellacani G. Non-ablative fractionated laser skin resurfacing for the treatment of aged neck skin.. J Dermatolog Treat 2015; 26 (3) 252-256 PubMed (PMID: 24953237)
    Google Scholar
  • 24 Luebberding S, Alexiades-Armenakas MR. Fractional, nonablative Q-switched 1,064-nm neodymium YAG laser to rejuvenate photoaged skin: a pilot case series.. J Drugs Dermatol 2012; 11 (11) 1300-1304 PubMed (PMID: 23135078)
    Google Scholar
  • 25 Jones D, Carruthers A, Hardas B et al. Development and validation of a photonumeric scale for evaluation of transverse neck lines.. Dermatol Surg 2016; 42 (Suppl. Suppl 1) S235-S242 PubMed (PMID: 27661746)
    Google Scholar
  • 26 Lee JH, Park YG, Park ES. A prospective observational study of the effectiveness and safety of botulinum toxin in the horizontal neck lines.. Aesthetic Plast Surg 2018; 42 (5) 1370-1378 PubMed (PMID: 29922842)
    Google Scholar
  • 27 Jeon H, Kim T, Kim H, Cho SB. Multimodal approach for treating horizontal neck wrinkles using intensity focused ultrasound, cohesive polydensified matrix hyaluronic acid, and incobotulinumtoxinA.. Dermatol Surg 2018; 44 (3) 421-431 PubMed (PMID: 28902030)
    Google Scholar
  • 28 Chao YY, Chiu HH, Howell DJ. A novel injection technique for horizontal neck lines correction using calcium hydroxylapatite.. Dermatol Surg 2011; 37 (10) 1542-1545 PubMed (PMID: 21707832)
    Google Scholar
  • 29 Casabona G, Nogueira Teixeira D. Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage.. J Cosmet Dermatol 2018; 17 (1) 66-72 PubMed (PMID: 29285863)
    Google Scholar
  • 30 Tseng F, Yu H. Treatment of horizontal neck wrinkles with hyaluronic acid filler: a retrospective case series.. Plast Reconstr Surg Glob Open 2019; 7 (8) e2366-e2366 PubMed (PMID: 31592383)
    Google Scholar
  • 31 Lee SK, Kim HS. Correction of horizontal neck lines: our preliminary experience with hyaluronic acid fillers.. J Cosmet Dermatol 2018; 17 (4) 590-595 PubMed (PMID: 28726351)
    Google Scholar
  • 32 Minokadeh A, Black JM, Jones DH. Effacement of transverse neck lines with VYC-15 L and cohesive polydensified matrix hyaluronic acid.. Dermatol Surg 2018; 44 (Suppl. Suppl 1) S53-S56 PubMed (PMID: 30358632)
    Google Scholar
  • 33 Oram Y, Akkaya AD. Neck rejuvenation with fractional CO2 laser: long-term results.. J Clin Aesthet Dermatol 2014; 7 (8) 23-29 PubMed (PMID: 25161757)
    Google Scholar
  • 34 Vanaman M, Fabi SG, Cox SE. Neck rejuvenation using a combination approach: our experience and a review of the literature.. Dermatol Surg 2016; 42 (Suppl. Suppl 2) S94-S100 PubMed (PMID: 27128251)
    Google Scholar
  • 35 Geister TL, Bleßmann-Gurk B, Rzany B, Harrington L, Görtelmeyer R, Pooth R. Validated assessment scale for platysmal bands.. Dermatol Surg 2013; 39 (8) 1217-1225 PubMed (PMID: 23650974)
    Google Scholar
  • 36 Brandt FS, Bellman B. Cosmetic use of botulinum A exotoxin for the aging neck.. Dermatol Surg 1998; 24 (11) 1232-1234 PubMed (PMID: 9834744)
    Google Scholar
  • 37 Matarasso A, Matarasso SL, Brandt FS, Bellman B. Botulinum A exotoxin for the management of platysma bands.. Plast Reconstr Surg 1999; 103 (2) 645-652, discussion 653–655 PubMed (PMID: 9950556)
    Google Scholar
  • 38 Ascher B, Talarico S, Cassuto D et al. International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood unit)—part II: wrinkles on the middle and lower face, neck and chest.. J Eur Acad Dermatol Venereol 2010; 24 (11) 1285-1295 PubMed (PMID: 20569284)
    Google Scholar
  • 39 Chen DL, Cohen JL. Botulinum toxin: a chemical denervation for platysmal bands: maximal dosing considerations.. J Drugs Dermatol 2015; 14 (9) 931 PubMed (PMID: 26355609)
    Google Scholar
  • 40 Sugrue CM, Kelly JL, McInerney N. Botulinum toxin treatment for mild to moderate platysma bands: a systematic review of efficacy, safety, and injection technique.. Aesthet Surg J 2019; 39 (2) 201-206 PubMed (PMID: 30052764)
    Google Scholar
  • 41 Levy PM. The “Nefertiti lift”: a new technique for specific re-contouring of the jawline.. J Cosmet Laser Ther 2007; 9 (4) 249-252 PubMed (PMID: 18236245)
    Google Scholar
  • 42 de Almeida ART, Romiti A, Carruthers JDA. The facial platysma and its underappreciated role in lower face dynamics and contour.. Dermatol Surg 2017; 43 (8) 1042-1049 PubMed (PMID: 28394862)
    Google Scholar
  • 43 Awaida CJ, Jabbour SF, Rayess YA, El Khoury JS, Kechichian EG, Nasr MW. Evaluation of the microbotox technique: an algorithmic approach for lower face and neck rejuvenation and a crossover clinical trial.. Plast Reconstr Surg 2018; 142 (3) 640-649 PubMed (PMID: 29879010)
    Google Scholar
  • 45 Alhaddad M, Wu DC, Bolton J et al. A randomized, split-face, evaluator-blind clinical trial comparing monopolar radiofrequency versus microfocused ultrasound with visualization for lifting and tightening of the face and upper neck.. Dermatol Surg 2019; 45 (1) 131-139 PubMed (PMID: 30531187)
    Google Scholar
  • 46 Yutskovskaya YA, Kogan EA. Improved neocollagenesis and skin mechanical properties after injection of diluted calcium hydroxylapatite in the neck and décolletage: a pilot study.. J Drugs Dermatol 2017; 16 (1) 68-74 PubMed (PMID: 28095536)
    Google Scholar
  • 47 de Almeida AT, Figueredo V, da Cunha ALG et al. Consensus recommendations for the use of hyperdiluted calcium hydroxyapatite (Radiesse) as a face and body biostimulatory agent.. Plast Reconstr Surg Glob Open 2019; 7 (3) e2160-e2160 PubMed (PMID: 31044123)
    Google Scholar
  • 48 Mazzuco R, Hexsel D. Poly-L-lactic acid for neck and chest rejuvenation.. Dermatol Surg 2009; 35 (8) 1228-1237 PubMed (PMID: 19438668)
    Google Scholar
  • 49 Carruthers J, Fabi S, Weiss R. Monopolar radiofrequency for skin tightening: our experience and a review of the literature.. Dermatol Surg 2014; 40 (Suppl. Suppl 12) S168-S173 PubMed (PMID: 25417570)
    Google Scholar
  • 50 Alster TS, Tanzi E. Improvement of neck and cheek laxity with a nonablative radiofrequency device: a lifting experience.. Dermatol Surg 2004; 30 (4, Pt 1) 503-507, discussion 507 PubMed (PMID: 15056138)
    Google Scholar
  • 51 Fritz M, Counters JT, Zelickson BD. Radiofrequency treatment for middle and lower face laxity.. Arch Facial Plast Surg 2004; 6 (6) 370-373 PubMed (PMID: 15545529)
    Google Scholar
  • 52 Kerscher M, Nurrisyanti AT, Eiben-Nielson C, Hartmann S, Lambert-Baumann J. Skin physiology and safety of microfocused ultrasound with visualization for improving skin laxity.. Clin Cosmet Investig Dermatol 2019; 12: 71-79 PubMed (PMID: 30666145)
    Google Scholar
  • 53 Kerscher M, Nurrisyanti AT, Eiben-Nielson C, Hartmann S, Lambert-Baumann J. Clinical and biophysical outcomes of combining microfocused ultrasound with visualization and calcium hydroxylapatite filler for facial treatment.. Dermatol Ther (Heidelb) 2019; 9 (1) 135-142 PubMed (PMID: 30536203)
    Google Scholar
  • 54 Narins RS, Carruthers J, Flynn TC et al. Validated assessment scales for the lower face.. Dermatol Surg 2012; 38 (2, Spec no.) 333-342 PubMed (PMID: 22316189)
    Google Scholar
  • 55 Werschler WP, Werschler PS. Long-term efficacy of micro-focused ultrasound with visualization for lifting and tightening lax facial and neck skin using a customized vectoring treatment method.. J Clin Aesthet Dermatol 2016; 9 (2) 27-33 PubMed (PMID: 27047630)
    Google Scholar
  • 56 Oni G, Hoxworth R, Teotia S, Brown S, Kenkel JM. Evaluation of a microfocused ultrasound system for improving skin laxity and tightening in the lower face.. Aesthet Surg J 2014; 34 (7) 1099-1110 PubMed (PMID: 24990884)
    Google Scholar
  • 57 Fabi SG, Joseph J, Sevi J, Green JB, Peterson JD. Optimizing patient outcomes by customizing treatment with microfocused ultrasound with visualization: gold standard consensus guidelines from an expert panel.. J Drugs Dermatol 2019; 18 (5) 426-432 PubMed (PMID: 31141851)
    Google Scholar
  • 58 Consensus recommendations for 4th generation non-microneedling monopolar radiofrequency for skin tightening: a Delphi Consensus Panel.. J Drugs Dermatol 2020; 19 (1) 20-26 PubMed (PMID: 31985194)
    Google Scholar
  • 59 Alessa D, Bloom JD. Microneedling options for skin rejuvenation, including non-temperature-controlled fractional microneedle radiofrequency treatments.. Facial Plast Surg Clin North Am 2020; 28 (1) 1-7 PubMed (PMID: 31779933)
    Google Scholar
  • 60 Tan MG, Jo CE, Chapas A, Khetarpal S, Dover JS. Radiofrequency microneedling: a comprehensive and critical review.. Dermatol Surg 2021; 47 (6) 755-761 PubMed (PMID: 33577211)
    Google Scholar
  • 61 Serdar ZA, Tatlıparmak A. Comparison of efficacy and safety of fractional radiofrequency and fractional Er:YAG laser in facial and neck wrinkles: six-year experience with 333 patients.. Dermatol Ther 2019; 32 (5) e13054 PubMed (PMID: 31381220)
    Google Scholar
  • 62 Alexiades M, Berube D. Randomized, blinded, 3-arm clinical trial assessing optimal temperature and duration for treatment with minimally invasive fractional radiofrequency.. Dermatol Surg 2015; 41 (5) 623-632 PubMed (PMID: 25915628)
    Google Scholar
  • 63 Redaelli A, Romano D, Marcianó A. Face and neck revitalization with platelet-rich plasma (PRP): clinical outcome in a series of 23 consecutively treated patients.. J Drugs Dermatol 2010; 9 (5) 466-472 PubMed (PMID: 20480789)
    Google Scholar
  • 64 Fabbrocini G, De Vita V, Di Costanzo L et al. Skin needling in the treatment of the aging neck.. Skinmed 2011; 9 (6) 347-351 PubMed (PMID: 22256622)
    Google Scholar
  • 65 American Society for Dermatologic Surgery. ASDS Consumer Survey on Cosmetic Dermatologic Procedures. 2019. Accessed April 16, 2020 at: https://www.asds.net/Medical-Professionals/Practice-Resources/ASDS-Consumer-Survey-on-Cosmetic-Dermatologic-Procedures
  • 66 Jones DH, Kenkel JM, Fagien S et al. Proper technique for administration of ATX-101 (deoxycholic acid injection): insights from an injection practicum and roundtable discussion.. Dermatol Surg 2016; 42 (Suppl. Suppl 1) S275-S281 PubMed (PMID: 27787267)
    Google Scholar
  • 67 Ascher B, Fellmann J, Monheit G. ATX-101 (deoxycholic acid injection) for reduction of submental fat.. Expert Rev Clin Pharmacol 2016; 9 (9) 1131-1143 PubMed (PMID: 27457304)
    Google Scholar
  • 68 Hogan S, Kandula P, Callagan DJ, Dover JS. Submental fat contouring: a comparison of deoxycholic acid, cryolipolysis, and liposuction. In: Branham GH, Dover JS, Furnas HJ, Tenenbaum MMJ, Wulc AE, eds. Advances in Cosmetic Surgery. Vol. 2. Philadelphia, PA: Elsevier Health Sciences; 2019:75–87 (PMID: NOT_FOUND;INVALID_JOURNAL)
  • 69 Rzany B, Griffiths T, Walker P, Lippert S, McDiarmid J, Havlickova B. Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study.. Br J Dermatol 2014; 170 (2) 445-453 PubMed (PMID: 24147933)
    Google Scholar
  • 70 Humphrey S, Sykes J, Kantor J et al. ATX-101 for reduction of submental fat: a phase III randomized controlled trial.. J Am Acad Dermatol 2016; 75 (4) 788-797.e7 PubMed (PMID: 27430612)
    Google Scholar
  • 71 Jones DH, Carruthers J, Joseph JH et al. REFINE-1, a multicenter, randomized, double-blind, placebo-controlled, phase 3 trial with ATX-101, an injectable drug for submental fat reduction.. Dermatol Surg 2016; 42 (1) 38-49 PubMed (PMID: 26673433)
    Google Scholar
  • 72 Dayan SH, Schlessinger J, Beer K et al. Efficacy and safety of ATX-101 by treatment session: pooled analysis of data from the phase 3 REFINE trials.. Aesthet Surg J 2018; 38 (9) 998-1010 PubMed (PMID: 29401213)
    Google Scholar
  • 73 Behr K, Kavali CM, Munavalli G et al. ATX-101 (deoxycholic acid injection) leads to clinically meaningful improvement in submental fat: final data from CONTOUR.. Dermatol Surg 2020; 46 (5) 639-645 PubMed (PMID: 31517654)
    Google Scholar
  • 74 Shridharani SM. Real-world experience with 100 consecutive patients undergoing neck contouring with ATX-101 (deoxycholic acid): an updated report with a 2-year analysis.. Dermatol Surg 2019; 45 (10) 1285-1293 PubMed (PMID: 30789506)
    Google Scholar
  • 75 Shridharani SM. Early experience in 100 consecutive patients with injection adipocytolysis for neck contouring with ATX-101 (deoxycholic acid).. Dermatol Surg 2017; 43 (7) 950-958 PubMed (PMID: 28448317)
    Google Scholar
  • 76 Beer K, Weinkle SH, Cox SE, Rubin MG, Shamban A, Somogyif C. ATX-101 (deoxycholic acid injection) for reduction of submental fat: results from a 12-month open-label study.. J Drugs Dermatol 2019; 18 (9) 870-877 PubMed (PMID: 31524342)
    Google Scholar
  • 77 Glogau RG, Glaser DA, Callender VD et al. A double-blind, placebo-controlled, phase 3b study of ATX-101 for reduction of mild or extreme submental fat.. Dermatol Surg 2019; 45 (12) 1531-1541 PubMed (PMID: 30998531)
    Google Scholar
  • 78 Shome D, Khare S, Kapoor R. The use of deoxycholic acid for the clinical reduction of excess submental fat in Indian patients.. J Drugs Dermatol 2019; 18 (3) 266-272 PubMed (PMID: 30909331)
    Google Scholar
  • 79 Shridharani SM. Improvement in jowl fat following ATX-101 treatment: results from a single-site study.. Plast Reconstr Surg 2020; 145 (4) 929-935 PubMed (PMID: 32221205)
    Google Scholar
  • 80 Bernstein EF, Bloom JD. Safety and efficacy of bilateral submental cryolipolysis with quantified 3-dimensional imaging of fat reduction and skin tightening.. JAMA Facial Plast Surg 2017; 19 (5) 350-357 PubMed (PMID: 28426847)
    Google Scholar
  • 81 Jain M, Savage NE, Spiteri K, Snell BJ. A 3-dimensional quantitative analysis of volume loss following submental cryolipolysis.. Aesthet Surg J 2020; 40 (2) 123-132 PubMed (PMID: 31099382)
    Google Scholar
  • 82 de Gusmão PR, Canella C, de Gusmão BR, Filippo AA, Filippo GR. Cryolipolysis for local fat reduction in adults from Brazil: a single-arm intervention study.. J Cosmet Dermatol 2020; 19 (11) 2898-2905 PubMed (PMID: 32281283)
    Google Scholar
  • 83 Suh DH, Park JH, Jung HK, Lee SJ, Kim HJ, Ryu HJ. Cryolipolysis for submental fat reduction in Asians.. J Cosmet Laser Ther 2018; 20 (1) 24-27 PubMed (PMID: 28850270)
    Google Scholar
  • 84 Leal Silva H, Carmona Hernandez E, Grijalva Vazquez M, Leal Delgado S, Perez Blanco A. Noninvasive submental fat reduction using colder cryolipolysis.. J Cosmet Dermatol 2017; 16 (4) 460-465 PubMed (PMID: 28901051)
    Google Scholar
  • 85 Kilmer SL, Burns AJ, Zelickson BD. Safety and efficacy of cryolipolysis for non-invasive reduction of submental fat.. Lasers Surg Med 2016; 48 (1) 3-13 PubMed (PMID: 26607045)
    Google Scholar
  • 86 Gregory A, Humphrey S, Varas G, Zachary C, Carruthers J. Atypical pain developing subsequent to cryolipolysis for noninvasive reduction of submental fat.. Dermatol Surg 2019; 45 (3) 487-489 PubMed (PMID: 30640270)
    Google Scholar
  • 87 Shah GM, Greenberg JN, Tanzi EL, Monheit GD. Noninvasive approach to treatment of submental fullness.. Semin Cutan Med Surg 2017; 36 (4) 164-169 PubMed (PMID: 29224033)
    Google Scholar
  • 88 Leclère FM, Vogt PM, Moreno-Moraga J et al. Laser-assisted lipolysis for neck and submental remodeling in Rohrich type IV patients: fact or fiction?. J Cosmet Laser Ther 2015; 17 (1) 31-36 PubMed (PMID: 25286033)
    Google Scholar
  • 89 Leclère FM, Moreno-Moraga J, Alcolea JM et al. Laser assisted lipolysis for neck and submental remodeling in Rohrich type I to III aging neck: a prospective study in 30 patients.. J Cosmet Laser Ther 2014; 16 (6) 284-289 PubMed (PMID: 25065416)
    Google Scholar
  • 90 Sarnoff DS. Evaluation of the safety and efficacy of a novel 1440 nm Nd:YAG laser for neck contouring and skin tightening without liposuction.. J Drugs Dermatol 2013; 12 (12) 1382-1388 PubMed (PMID: 24301239)
    Google Scholar
  • 91 Valizadeh N, Jalaly NY, Zarghampour M, Barikbin B, Haghighatkhah HR. Evaluation of safety and efficacy of 980-nm diode laser-assisted lipolysis versus traditional liposuction for submental rejuvenation: a randomized clinical trial.. J Cosmet Laser Ther 2016; 18 (1) 41-45 PubMed (PMID: 25968162)
    Google Scholar
  • 92 Department of Health and Human Services: Food and Drug Administration. Sculpsure Approval. 2017. Accessed April 29, 2020 at: https://www.accessdata.fda.gov/cdrh_docs/pdf17/K171992.pdf
  • 93 Park J-H, Kim JI, Park HJ, Kim WS. Evaluation of safety and efficacy of noninvasive radiofrequency technology for submental rejuvenation.. Lasers Med Sci 2016; 31 (8) 1599-1605 PubMed (PMID: 27402002)
    Google Scholar