Often times, anti-aging approaches are focused on the face; however, equally important regions that must be given appropriate skincare and anti-aging regimens include the neck and the decolletage. After the periorbital area—which is the region surrounding the eyes—the skin on the neck is the most delicate. This is because the skin on the neck contains far less elastin fibers compared to the rest of the face. Elastin fibers are important protein components of the connective tissues that primarily account for the youthful elasticity of the skin. A lesser amount of elastin fibers will only result in a weaker framework of the skin collagen matrix. In addition, the lack of fatty tissues in the neck also results in premature aging of the inelastic skin.
Besides the natural aging process, the skin of the neck and decolletage is also affected by numerous movements. The constant overuse of mobile phones only means that patients spend more time looking down at their gadgets instead of looking upwards. The constant downwards head tilt, coupled with the aging process, will only lead to excessive pressure and creasing of the delicate skin in the neck area, resulting in premature formation of aging signs.1 The disharmony between a youthful face and aging neck and decolletage gives away a patient’s true age.
Aesthetic and clinical assessment of the neck and decolletage
Most patients only resort to corrective aesthetic treatment instead of a preventive one when the damage had already been done on their skin. Nevertheless, these cosmetic treatments require extensive clinical and aesthetic assessments just like any other medical procedures. For starters, physicians should closely examine their patients’ medical history. Information like their existing medical conditions; previous history of aesthetic procedures done; medications and supplements taken will definitely help them to determine the best treatment option for their patients. Complete and extensive aesthetic assessments will also allow the physicians to determine the severity of skin condition as well as the degree of correction needed.
Some of the commonly reported aesthetic imperfections in the neck and décolletage areas are:
- Turkey Neck: This condition—also known as a neck wattle—is used to describe the loose and sagging skin on a patient’s neck.
- Sagging Jowls: This condition is used to describe the excess and sagging skin on the chin or jawline.
- Double Chin: As the name suggests, this condition refers to excessively full chin.
- Formation of Platysmal Bands: Platysmal bands are formed when the vertical platysmal muscles in the neck shorten and contract.
- Loss of the Cervicomental Angle: Cervicomental angle is the angle between the horizontal place of the submental region and the vertical plane of the neck.
Once the patients are thoroughly assessed, physicians can proceed to choose the best treatment for their patients.
Cosmetic Treatment for the aging neck and decolletage
Thanks to modern advancement of science, there are numerous treatment options available.
- Threadlift: This non-surgical treatment instead involves inserting threads that are usually made of polydioxanone (PDO) into the dermis to create a mechanical lift. The threads can be free floating cogged or barbed and suspension threads. While the former is integrated with traction cones and requires no suspension, the latter can only lift the skin if it is anchored to a secure structure like the scalp.
- Nefertiti Lift: Named after the famed youthful and well-defined jawline of the Egyptian queen, this non-surgical procedure involves injecting botulinum toxin into the neck and lower jaw.5 Botulinum toxin is a muscle relaxing neurotoxin that is extracted from Clostridium botulinum bacteria. Once injected, the toxin temporarily paralyzes the muscles in the neck and jawline and improves the appearance of mild jowls and platysmal bands. Care must be taken to maintain the depth of the injection at an intradermal layer, so as to prevent diffusion of toxin into deeper structures of the neck, resulting in adverse side effects like speech and swallowing difficulties.
- Dermal Fillers: These medical devices are made of different types of injectable materials, including hyaluronic acid, calcium hydroxylapatite, and poly-L-lactic acid. These implants are injected into the skin to fill and support collapsed skin structure so that the wrinkles and creases are smoothened out. Hyaluronic acid-based fillers are commonly used to treat this area.
- Alternative treatments: Nowadays, technological advancements have paved the way for the use of innovative devices and techniques in the field of aesthetics. Most of these devices share a similar fundamental action, which is to use thermal energy, resulting in overall improvement of the health and texture of the skin.
Under certain circumstances, the treatments listed above can be combined for better results. Procedures such as skin peels, microneedling, platelet rich plasma (PRP) therapy, and mesotherapy can be used to support treatments in between sessions to maintain the effects.
Medical practitioners must always educate their patients on the importance of appropriate skincare regimens. Using an adequate sun protection product will shield the skin from harmful ultraviolet (UV) rays and prevent damage. As well, anti-aging creams must also be applied on the neck and decolletage, so that the outcomes of the cosmetic treatment are maintained for a prolonged period of time. Besides that, lifestyle modifications like quitting smoking and reducing alcohol intake will also improve the overall health status of the skin.