Neck Rejuvenation for a younger-looking neck

Your neck reveals your age akin to the rings on a tree trunk. Sagging and loose skin on the neck and under the chin are familiar signs of ageing. This results from an underlying breakdown of connective tissue, decreasing collagen production, loss of fat volume, and thinning of neck skin. The fullness and firmness of a youthful neck gives way to a wrinkled, lax, drooping aged neck. It’s really not a pretty sight, and is often referred to as ‘turkey neck’ or ‘accordion neck’.

The neck is an area that’s often overlooked in terms of sun protection and moisturising, yet it is where ageing begins to show. Damage from the sun and weight loss further add to the picture of wrinkling and loss of elasticity. Smoking compounds the issue contributing greatly to neck creasing. Genetics play a role too. Another skin change in overweight people is the proliferation of soft pink tags (acrochordons), especially around the neck. They are not cause for alarm as they do not grow and are not cancerous. But they aren’t pretty.

We go to great lengths to achieve a youthful face, but if the neck is neglected its deficiencies will stand out even more. The platysma is a sheet of superficial muscle extending upwards from the shoulder over the collar bone along both sides of the neck. Unlike many muscles it actually inserts into the skin along the jaw. Decreasing elasticity with age causes the platysmal bands to form longitudinal wrinkles on either side of the neck. This accentuates the jowls and drags down the corners of the mouth. Treatments that can relax these bands allow the lifting muscles to do their job unrestrained, leading to a smoother neck and firmer jaw.

Cosmetic doctors have coined the term ‘smartphone face’, for the poor posture and resultant neck shortening with pulling on the jowls, from hours of gazing down at mobile phones and laptops. Sleep is another factor, years of sleeping in certain positions, especially when the head is angled towards the chest lead to neck creasing.

In the past the only way to handle loose skin on the neck was a surgical ‘neck lift’, with accompanying extended recovery and potential for serious complications. Today emerging technologies offer many non-invasive more affordable options.

Treatments include:

  • cosmetic injectables and fillers
  • ultrasound therapy
  • radiofrequency tightening and skin resurfacing
  • laser skin resurfacing
  • platelet-rich plasma rejuvenation
  • chemical peels
  • combination techniques

We will focus here on exploring the most effective procedures offered at Shine Clinicin Brisbane, including electro-optical synergy treatment (ELOS), anti-wrinkle injections, dermal fillers, and platelet-rich plasma rejuvenation. ELOS treatment is a combination therapy using Intense Pulsed Light (IPL) with radiofrequency (RF) energies that has demonstrated positive results in scientific studies. It is effective for contouring facial and neck skin laxity by stimulating repair processes, while also being relatively risk-free with minimal recovery time. The TRINITI ELOS system uses three different types of devices to enhance the application of IPL and RF in combination. The Sublative Rejuvenation applicator uses radiofrequency energy alone.

It is most important that when interested in any anti-ageing skin treatments you thoroughly investigate and research all options available to you. This will ensure you are making an informed choice and one that will work best for you. Make an appointment with our doctor, Dr Kathy Gallagher, to discuss the treatments and treatment combinations and develop a plan that is tailored to your needs.

Elos Triniti Series

Our trio of facial treatments, the Elos Triniti series, addresses loose skin on the neck as well as providing total facial renewal. It’s the ultimate in facial skin care, when done in one session, synergistically delivering more even skin tone, with lifting and tightening of face and neck, together with improvement in overall texture.

The first step is always a consultation regarding your individual expectations and requirements. At the time a patch test will also be done and a discussion will be had about whether these combined treatments are the best solution for you. Photos of the face and neck will be taken for comparison.

The three treatments are:

  • A combination of intense pulsed light (IPL) with radio frequency (RF) energies to give the skin better tone by evening out the brown and red pigments in the skin.
  • A combination of bi-polar radio frequency and pulsed infrared light to stimulate new collagen production, as well as immediately contracting collagen and tightening the skin.
  • A bi-polar radio frequency treatment (Sublative RF) that stimulates collagen to improve skin texture and increase elasticity in the skin.

Intense Pulsed Light (IPL) with Radiofrequency (RF) Treatment

What is it?

A high intensity beam of light is generated by passing an electrical current through a chamber filled with (xenon) gas. Red and brown elements in the skin absorb this specific light, causing them to heat up, while the outer skin surface is not disrupted.

Overall, IPL produces equivalent cosmetic effects as certain laser treatments (without skin peeling or possible burns or scarring), however there are some key differences. IPL flashes out light over a range of wavelengths (or colours) while lasers deliver only a burst of light at one specific wavelength. The same IPL device can simultaneously treat several kinds of skin problems that would otherwise require different lasers.

It can be used for pigmented areas (eg age spots, sun spots, freckles, rosacea), as well as acne and wrinkles, though the effects on wrinkles are less dramatic. Further, the IPL spot size (or footprint) is larger than that of laser, so IPL treatments are generally faster than laser. However, more IPL sessions are generally required to achieve the desired effect when compared to laser skin care.

Our Elos IPL with RF treatment is the first and only technology that combines light and radio frequency energies for gentle neck rejuvenation.

How does it work?

Heating the pigmented components in the skin causes skin cells to release their pigment, which rises to and is shed from the skin surface. It also triggers the contracting and unravelling of collagen in the dermis (known as denaturation). Inflammatory responses are also set off aiding the removal of old or damaged collagen, and replacing it with new healthy matrix. This leads to at least partial replacement of the skin volume lost with age. What results is tighter, smoother texture, and increased softness with reduced lines.

The same device can be used to treat different targets by using ‘cut off filters’. These limit the wavelength reaching the skin to more selectively target the desired element. Sometimes IPL is used in conjunction with a chemical that sensitises the skin to the effects of IPL. This is termed ‘photodynamic photo-rejuvenation’, and can improve results as it increases the absorption of light energy into the target tissue.

Micro-dermabrasion of the treated area approximately two weeks following IPL will enhance the shedding of old skin cells. This accelerates the process of evening out transient skin discolouration. Injections of a muscle relaxer combined with IPL have been shown to be more effective on wrinkles.

What about side effects?

Recovery is rapid after the procedure, and you may return to work soon after. Most side effects are minor and subside within 24 hours. Temporary itching and redness may be experienced, but is easily covered with makeup. There may also be some skin peeling for a few days after treatment.

Some dark areas in the treatment zone may temporarily get a little darker instead of lighter; this is not cause for concern. It will quickly settle after old skin cells are pushed to the surface and peel off. Applying a moisturiser twice a day speeds up the process. Those with a darker skin type may not be good candidates for IPL treatment due to the risk of post inflammatory hyperpigmentation.

When in doubt, a test patch first is recommended. Protect the treated area from the sun for at least two weeks to minimise any risk of pigment changes. Preferably use a broad-spectrum sunscreen, every day, regardless of weather. Also, if you have a susceptibility to scarring this treatment may not be right for you.

Bi-polar Radiofrequency (RF) with Pulsed Infra-red Light Therapy

What is it?

RF is another exciting new facial rejuvenation technique used to target the deeper layers of the skin in a carefully controlled manner, without damaging the surface. The procedure is often alluded to as ‘a non-surgical facelift’ like laser therapy, and used for treating skin laxity and sagging, including loose skin on the neck. Our Refirme procedure allows you to attain tight and firm skin without downtime.

How does it work?

Our skin is resistant to the passage of electricity, thus it heats up when an electric current is passed through it. Radiofrequency like laser therapy works by precise heating of the matrix proteins (mainly collagen) in the skin. By doing this very gently, it is possible to heat the deep layers of the skin to between 65˚C and 75˚C.

At this temperature, the collagen fibres of the matrix denature, contract and almost immediately tighten lax skin. The outer skin surface is kept cool, so it is not affected and remains completely intact. Over the next few months, the heat-damaged matrix is progressively removed by the body and replaced with young, healthy collagen. Ultimately, this leads to stronger, firmer, smoother skin with a more youthful appearance.

RF is far less effective in smokers and anyone who is overweight. Its tightening outcome may be more marked in younger people. This is thought to be because the bonds that hold collagen together are more easily broken by heating young skin compared with older skin.

The effects of RF do not equate to a surgical lift. However, it has the advantage of being safe and quick, and delivered in a few simple treatments, unlike surgery, with its long recovery time and risk of complications.

Only modest changes are achievable with RF treatments on their own; however it works synergistically with conventional ablative laser therapy. The laser can treat the outer part of the skin, while the RF component penetrates deeper into the skin for more complete results. For more information on ablative laser therapy click on Skin Rejuvenation to be taken to that fact sheet. Other combination treatments can also be used. For example, RF in combination with dermal fillers can augment the collagen responses; RF together with anti-wrinkle injections helps relax the muscle while the skin contracts. RF coupled with microdermabrasion may also stimulate increased collagen formation and improved blood supply.

What about side effects?

Radiofrequency can be used safely for patients of all skin types (it is said the treatment is ‘colour blind’) and is not normally associated with pigment changes in the skin, even in those prone to it. Side effects are minor and temporary. Typical concerns are minor discomfort during the procedure, and redness and swelling afterwards which usually lasts for a couple of hours. A cold compress or an ice pack placed on the treated area will soothe and help to reduce discomfort and swelling.

There’s little or no downtime and a quick return to normal activities is expected. A soothing cream may be applied following the procedure and continued for several days. Makeup can be applied immediately after treatment as the epidermis is unaffected.

Rarely, some patients develop abrasions (crusting) in the treated area. These usually heal or drop off within three to four days. It is rare to experience changes in sensation in the treated area, such as itching or numbness. These symptoms are temporary, usually mild, and resolve completely in days to weeks.

Bi-polar Radiofrequency (RF) Therapy (Sublative Rejuvenation)

What is it?

Over time, our skin’s youthful appearance and texture is affected by the cumulative effects of collagen and moisture loss, as well as sun exposure. By stimulating collagen production and increasing cell turnover, sublative rejuvenation enables the achievement of a more youthful appearance. This technique is a type of fractionated skin resurfacing, which means only a fraction of the skin’s surface is subjected to the treatment.

There is less surface disruption with smaller entry wounds as compared with fractional laser treatment. Maximum effect occurs in the deeper layers of the dermis. This technology has been shown to effectively treat mild to moderate wrinkles, red and brown spots, and textural irregularities. This is truly the next generation of safe and effective technology. However, skin conditions like eczema may preclude some patients from receiving the treatment. For information on fractional laser treatment click on Skin Rejuvenation to be taken to that fact sheet.

How does it work?

Pulsed radiofrequency energy is precisely directed to the upper dermis of face and neck in an array of tiny matrix spots. As only these spots create tiny wounds, there is just minor surface disruption, and the wounds are already sealed by the completion of treatment. Healthy skin around the spots accelerates the healing process of the affected skin. Post treatment, increased levels of beneficial new collagen and new healthy skin cells are produced. Mild to moderate wrinkles and superficial skin discolouration are reduced. The texture of skin becomes smoother and more elastic.

What about side effects?

Sublative rejuvenation with RF treatment is a very safe and effective solution for all skin types. There is some discomfort, patients feel a warm prickly sensation, an anaesthetic cream makes the procedure more tolerable. After treatment redness and swelling is experienced reminiscent of a sunburn, which entails recovery time of two to three days, rarely up to one week. A cold compress or an ice pack will soothe and help to reduce pain and swelling. A cooling mask, and/or a soothing restorative cream may be applied following the procedure and continued for several days.

A matrix pattern of red squares will be evident that will fade soon, generally within a few days. As the tiny dots heal they will crust over and flake off the skin. This is a normal part of the healing process and may take from 5–10 days. It is important to not pick at the crusting, letting it proceed at its own natural pace.

Repeat Treatments with Trinity

The best results for treating loose skin on the neck are obtained with a series of three Triniti treatments at approximately 4–6 week intervals. After each session collagen production will be boosted further and ultimately skin will be smoother. Reduced pigment will be observed.

A further session after 6–12 months may be beneficial to maintain the skin’s improved colour, tone and texture. A series of Triniti treatments can be combined with many other cosmetic procedures to give maximum benefits. Muscle relaxing injections will further reduce wrinkles, and dermal fillers can assist in reducing lines and lifting sagging skin.

Follow-up

After a series of Triniti treatments the skin is again assessed and post treatment photos taken. There may be further benefits to focusing a little closer on pigment or perhaps on texture, depending on the condition of the skin. It can be further refined with Sublative RF, working on problem areas such as acne scarring. Or there may simply need to be a maintenance plan to counter loose skin on the neck. The Triniti treatment, and each of its components, will positively impact not only the appearance of the skin, but also its health and resilience.

Anti-Wrinkle Injections

What is it?

Anti-wrinkle injections are probably one of the most sought out treatments. This is because the natural movement of our skin on our faces creates wrinkles that deepen over time. The more we age, the deeper these lines become as we repeat the same movements over and over.

These injections can treat a wide range of areas including the prominent vertical platysmal bands in the neck. The platysma pulls the lower face, including the lip corners, downwards. Tiny doses of anti-wrinkle injections placed along these vertical bands and the jawline not only softens their appearance in the neck, but also gives the lower face a subtle lifting effect. For best results we recommend reviewing and repeating the treatment every 3–4 months. Emphasis is always placed on a completely natural appearance with the neck looking more relaxed and less stressed.

Women who are pregnant, think they may be pregnant or are nursing should not have these treatments. There are no known side-effects for the babies of women who were treated unknowingly, but care should be taken nevertheless. In addition, anyone with a history of breathing problems, difficulty swallowing, or certain rare neurological disorders should not have this treatment. A medical consultation with our cosmetic doctor assists with ruling out the possibility of having particular conditions that may affect the nervous system.

How does it work?

Anti-wrinkle injections work by blocking the chemical signals that trigger muscular contractions. This relaxes the muscles that are standing out in the neck or creating a line. The neck will have a softer appearance when these muscles are relaxed.

Photographs are taken both before and after the treatment to better evaluate results. These will be taken both with the muscles at rest and contracted. If possible, it is best to avoid taking non-essential blood thinners for a few days prior to the treatment, eg aspirin, anti-inflammatory medications and high dose fish oil.

Before treatment makeup will be removed and the neck cleansed thoroughly with an antiseptic agent. The platysmal bands are identified by contracting the muscles and tiny doses of anti-wrinkle agent are injected along their length. Because the needles are so tiny and the dose so small, there is little in the way of pain during the procedure. If you have a low tolerance for pain you may want to request a numbing cream, but this is generally not needed. If used the numbing cream should be applied 30–40 minutes prior to the procedure. The actual anti-wrinkle treatment will only take 5–10 minutes.

After the procedure it is important to not touch or rub the treated area for the next four hours. Also do not lie down or engage in any strenuous physical activity during this period. Normal activities, going back to office work, or for a walk are all fine. There is no downtime. Effects become evident after 3–4 days and will be maximally seen after 7–14 days. A review appointment two weeks later is recommended, especially after an initial anti-wrinkle treatment. It is an opportunity to take an “after” photo to compare with the “before”, and to check that you are obtaining the best results possible.

What about side effects?

Anti-wrinkle injections have been used in cosmetic medicine for over 30 years. The medication has been used extensively for many other medical reasons, eg cerebral palsy in children, or to treat an over-active bladder. There is a great deal of research establishing the safety of these injections.

There are no serious side effects from the cosmetic use of anti-wrinkle injections. In the neck, there is the possibility of bruising following the treatment. Using the appropriate doses should not affect adjacent muscles in this area.

Dermal Fillers

What is it?

Dermal fillers are injectables that work by drawing in water and holding it there as a means to plump up the skin in the target area. A filler draws water to the area bulking up the layers below the skin, thus softening and smoothing out skin making it look fuller. The filling effect of these injections is immediate, but eventually they are broken down by the body and must be reinjected at regular intervals to maintain their effect.

How does it work?

The filler used at Shine Clinic in Brisbane is made from a naturally occurring sugar that is a component of the skin (so no allergic reactions). It attracts many times its own weight in water which serves to plump the skin. An abundance of sugars like this contributes to the moisture and volume of young skin. As we age, the production of these sugars declines, resulting in a loss of skin hydration, volume and elasticity.

Dermal fillers have limited indications in the neck. However, injecting fillers along the jawline can not only give definition to this area, but can have a subtle lifting effect on the neck.

The procedure is simple, takes very little time and requires minimal preparation. At Shine Clinic, we prefer to use a cannula to inject a firmer dermal filler along the jawline. A tiny injection of local anaesthetic is placed first. A cannula can then be placed to inject the filler evenly along the jawline. Using a cannula is a very safe and comfortable technique that minimises the risk of bruising.

What about side effects?

If you are pregnant or think you may be pregnant, it is not recommended that you have any kind of dermal fillers. The same is true for anyone who is breast-feeding. If you have never had this type of procedure before and are prone to scarring it is best to avoid any kind of injectable treatment. Some bruising, redness and tenderness at the injection site may be experienced, but usually disappears after a few days. Some patients may feel small lumps at the injection sites, though they are seldom visible.

Platelet Rich Plasma (PRP) Treatment

What is it?

PRP is a treatment that rejuvenates the skin by stimulating collagen, elastin, and hyaluronic acid at all levels – including the epidermis, the dermis, and the subdermal tissues. It is becoming more popular as a cosmetic treatment, but has been used in other areas of medicine for some time, eg wound healing and to promote healing in sports injuries. The procedure is particularly suitable for delicate areas, like the loose skin on the neck. It is excellent for improving overall texture and is perfect to follow other skin treatments that stimulate collagen production, for example after the Elos Sublative RF resurfacing procedure.

How does it work?

The term platelet rich plasma is used to describe plasma that has been concentrated to contain a high percentage of platelets. Platelets are rich in growth factors and other substances that promote tissue healing and collagen production. During a typical treatment session, blood is taken from the arm, and then separated in a centrifuge to concentrate the platelets. The platelet rich plasma is activated with calcium and then injected under the skin using a very fine needle.

At Shine, we will often inject the PRP solution into the skin of the neck using the Dermastamp device. This is a needling device that has a chamber to place the PRP solution, along with hyaluronic acid. Tiny needles penetrate the skin to a controlled depth injecting the PRP. Needling alone is an effective collagen stimulator. Combined with PRP, results are enhanced further.

An initial course of three treatments performed 6–8 weeks apart is recommended. Every treatment will further stimulate collagen production. Skin quality and texture will continue to improve over several months. Generally a single follow-up treatment every 6–12 months will help to maintain results.

What about side effects?

Because your own blood is being used for this treatment, PRP is safe for just about anyone with no possibility of an allergic reaction. Patients should expect to have some swelling, minor bruising and redness after the treatment and this can take 24–48 hours to settle.

For information on ultrasound therapy click on US – Cellulite to go to that fact sheet.

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