Deep horizontal neck lines: what is the best treatment option with long lasting results? (photos)

Question

I am a 40 year old female who has had deep horizontal neck lines. I am looking to have this corrected. It does not appear to be tech neck as I've had them since I was a young child. It maybe genetic as my Mom has them as well. I am looking at PRP, mini neck lifts. I'm not sure what is the best option with longer lasting results.

Thomas Wright, MD · Answer

Sammie Thank you for sharing your photos.  You don't need a full open surgical neck lift.   From your photos it appears that you have quite prominent necklace lines, horizontal line on your neck.  These can be difficult to treat completely, but with a combination of treatments they can be significantly improved. Microneedling with PRP may help a bit. Skin Tightening with Renuvion/  J Plasma or FaceTite can make a pretty big difference. Non Surgical neck lift with MyEllevate can lift the neck and help smooth out the lines.  I would actually recommend you do a MyEllevate non surgical neck lift with a Renuvion / Jplasma and Microneedling to the surface possibly with RF energy such Fractora or Morpheus.  Wishing you the best of health.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Ever since the mid 1990s, when I first began to inject it, microdroplet Botox has been used to treat what has come to be called the horizontal "necklace" lines that ring the neck. Not long after, low viscosity, cohesive HA fillers were added to enhance the benefit of treatment and prolong the results. This has remained my gold standard until the present despite the introduction of this or that expensive, supposedly "next big thing" bells and whisltes fraxel lasers, RF and ultrasound gizmos whose hard science to support their use unfortunately lags woefully behind the heavy marketing and social media hype to promote them. Make sure to consult with an experienced board certified cosmetic dermatologist injector and best of luck.

Jason Emer, MD · Answer

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

Camille Cash, MD · Answer

From your photos and description your neck bands are likely genetic.  There are various options to consider.  A surgical neck lift would remove excess skin and contour the neck.  Non surgical options may bring improvement, but won't be as powerful.  You can consider FaceTite.  This minimally invasive procedure uses RF technology to stimulate collagen and elastin and tighten the skin.  See a board certified plastic surgeon near you to learn more.

Kristine Brecht, MD (license suspended) · Answer

Dear Sammie,
Great question. Low neck lines are very difficult to get rid of with surgery. A non surgical option would be a multimodal combination of treatments over time. Microneedling with prp, viora bipolar radio frequency ultrasound and fillers in combination will be of benefit.
Best. DrBrecht 
Seattle, Wa

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