2 mins
The ageing neck
While surgical interventions remain the gold-standard treatments for neck ageing, there are a number of non-surgical interventions that may be more popular for patients due to downtime associated with busy schedules, operation anxiety and financial constraints
The neck can be a prominent indicator in ageing and is often neglected by patients, leading to changes such as skin laxity, dyspigmentation, rhytides, loss of mandibular contour and excessive skin laxity due to loss of collagen and elastin.
In aesthetic practice patients will present with a range of concerns relating to the neck which need to be explored fully before deciding on the best treatment options available.
An understanding of the anatomy of the neck is important so that structural changes can be discussed with the patient and in order to decide upon the best combination of treatment options available for the individual patient needs. Sykes (2001) described a loss of tone and elastin fibres in the face which causes sagging of the skin and soft tissues; this also includes loss of muscle tone in the anterior neck.
Analysis of patients should include looking at skin quality, bone structure and subcutaneous fat distribution as well as muscles in relation to overlying skin structures. The anatomical structure of the neck can be divided into several layers, these include skin, subcutaneous tissues, the superficial musclo-facial layer and deep subplatysmal structures.
AESTHETIC REJUVENATION
of the
NECK
can involve
MULTI-MODALITY
TREATMENTS
to enhance
PATIENT RESULTS.
Rejuvenation technologies
Aesthetic rejuvenation of the neck can involve multimodality treatments to enhance patient results. Common modalities include minimally-invasive interventions including laser, radiofrequency, high-intensity focused ultrasound (HIFU), energy-based therapy, injectable soft-tissue fillers, neuromodulators and prescriptive skincare as well as ablative and non-ablative technologies. Often, a number of treatment modalities will need to be combined in practice to optimise patient results, combining skincare, energy-based devices and injectable treatments.
Looking at the outer layer, the cutaneous layer consists of the epidermis and the dermal tissues. Patients can often present with ‘necklace lines’; this can be due to extrinsic ageing factors such as sun exposure which the neck itself is often exposed to. The neck can be neglected in patients’ skincare regimes and therefore show enhanced signs of photo-ageing compared with the face.
The photo-ageing can lead to increased epidermal thickening and breakdown of collagen and elastin as well as damage to melanin which will present as pigmentation. Patients can use a number of treatment modalities including prescription skincare regimes, radiofrequency (RF) and fractional radiofrequency microneedling.
Radiofrequency has been used as a thermal energy device which causes heating of the reticular dermis, triggering a healing cascade and leading to collagen formation.
In comparison, non-energy-based devices such as microneedling induce dermal collagen formation and resurface the skin through an inflammatory cascade. Local injury releases growth factors and stimulates collagen and elastin fibre production as well as angiogenesis.
HIFU technologies have also been used for skin rejuvenation – the ultrasound radiation generates a thermal coagulation point at a controlled depth and the healing process induces skin tightening through the generation of elastin, collagen and dermal tightening.
In practice, a combination approach using skincare, devices and injectable treatment modalities has been shown to be most effective for patient outcomes, however there is little literature on safety and efficacy of combining these procedures.
The above are excerpts from an article written by independent nurse prescriber Amanda Wilson for Aesthetic Medicine UK magazine.
Source: https://aestheticmed.co.uk/site/industrynewsdetails/the-best-treatments-for-the-neck