Best procedure for neck wrinkles?

Question

I’m 51 and would like to know what the safest procedure would be to improve a pronounced neck wrinkle? I’ve tried neck creams, serums and LASEMD (3 tx’s) but none of those worked for me. Thank you!

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Since topical treatments and LASEMD have not provided the desired results, here are some other procedures you might consider:

Injectable Fillers: Dermal fillers can be used to plump up the skin and smooth out wrinkles. Hyaluronic acid-based fillers are commonly used for this purpose and can provide immediate results with minimal downtime.

Botulinum Toxin (Botox): Botox can be used to relax the muscles that contribute to neck wrinkles, particularly horizontal bands, resulting in a smoother appearance.

Microneedling with Radiofrequency: This procedure combines microneedling with radiofrequency energy to stimulate collagen production and improve skin texture and elasticity.

Ultrasound Therapy: Treatments such as Ultherapy use ultrasound energy to stimulate collagen production deep within the skin, which can help tighten and lift the neck area over time.

Laser Resurfacing: Ablative and non-ablative laser treatments can help reduce wrinkles by removing damaged skin layers and stimulating new skin growth.

Surgical Options: For more pronounced wrinkles, a surgical neck lift might be considered. This procedure provides more dramatic and long-lasting results but involves more downtime and higher costs.

It's important to consult with a board-certified dermatologist or plastic surgeon to discuss these options and determine the most appropriate treatment based on your individual needs and skin condition.

Wishing you the best in finding the right solution for your concerns!

Nelson Lee Novick, MD · Answer

Unfortunately, without photos that show what kind of wrinkles or sagging you have i can only comment in the most general ways, For example, for horizontal "necklace lines," superficial injections of Botox alone may be sufficient to improve them. If still necessary, a low viscosity, cohesive, malleable HA filler may be added for further elevation and smoothing of the neck.
If you have sagging of the upper neck, a robust HA volumizing filler may be needed to better define and straighten the jawline, which then can secondarily improving sagging of the under chin and upper neck regions. If a deep hollowing is present in the center of the neck,  the use of a robust HA lifting filler appropriately in injected in the proper location can help to draw the sagging neck upward and thereby diminish this problem. 
If this is just a superficial wrinkle, then a series of professionally performed manual microneedling sessions (no need for the added expense or risks of RF microneedling) may be all that is required. 
The bottom line is that if you are looking for simple solutions to avoid expensive, invasive surgeries, you would be wise to consult with an experienced board certified cosmetic dermatologist filler expert and best of luck.

Tulsi Kotecha, MD · Answer

Thanks for the question. Based on the extent of wrinkles quality of skin and goals (tightening, wrinkle elimination, multiple treatment options are available - all focused on either hiding the wrinkles(neckTox - botox on the neck) or stimulating collagen with biostim (Radiesse, Sculptra) or tighten skin (PDO Threads, RF Microneedling)
Would recommend a consult with a skilled injector

Best procedure for neck wrinkles?

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