Non-Surgical Treatments for the Ageing Neck: A Comprehensive Guide

1. Botulinum toxin - The Nefertiti Lift

   The Nefertiti Lift is a non-surgical technique designed to redefine the jawline and neck. The primary agent in this treatment is Botulinum toxin. The mechanism of action for this neck-lifting treatment revolves around carefully targeting the superficial platysma muscles which run as vertical bands with low-dose injections. These muscles, located superficially in the neck and extending to the lower jaw, are responsible for the downward pull on the lower face and can contribute to sagging and the appearance of stringy “turkey” neck bands and jowls over time. By injecting Botulinum toxin into these muscles their activity is temporarily reduced and the turkey neck appearance will reduce. This relaxation of the platysma results in an upward counter effect by the facial muscles, creating a subtle lift in the jawline and neck area. The outcome is a smoother, more refined neck contour and a softened, more youthful jawline.
   
   

2. Jawline Fillers

   
   As we age, the definition between the neck and the jaw can become less prominent. The premise of jawline filler treatments lies in the careful injection of dermal fillers, often composed of hyaluronic acid, into strategic points along the jawline, where bony volume has been lost over time. Hyaluronic acid, which has a capacity to retain moisture and maintain volume in the tissues, provides an immediate lifting and filling effect. This results in a redefined jawline that not only defines the lower face but also harmonises facial features by balancing proportions and improving the profile. Given the diverse anatomical structure of jawlines, a personalised approach to filler treatments is important, replacing volume where it has been lost, without adding too much to give an abnormal or overfilled appearance.
   
   The practitioner will assess the individual’s facial structure, skin quality, and aesthetic goals to determine the optimal injection sites and filler volumes. As the lower face is closely related to the appearance of the neck, a refined jawline, achieved through expertly administered fillers, can indirectly improve the appearance of the neck by providing a discernible demarcation and subtle lift. This non-surgical approach to jawline enhancement is not only minimally invasive but also offers the flexibility of gradual modifications, making it a favoured choice for those seeking to maintain a natural and youthful appearance without surgery.
   
   

3. Skin Boosters for Horizontal Lines

   Skin boosters, including treatments like Profhilo, Polynucleotides and Teosyal Redensity 1, are an innovative, non-surgical solution that can help improve the appearance of horizontal neck lines by harnessing natural repair mechanisms within the skin itself.
   
   Profhilo, for example, is formulated with hyaluronic acid, a molecule that not only can improve the skin’s natural hydration levels by acting as a humectant, but can also stimulate new collagen and elastin production in the dermis of the skin, when injected at high concentrations. Profhilo is ideal for faint, superficial neck lines but is also great for thinning, crepey skin on the neck. Nucleofill acts in a similar way, but uses polynucleotides to stimulate collagen and elastin production in the dermis of thinning neck skin.
   
   By contrast, Teosyal Redensity 1 is a skin booster that is a hybrid between a skin booster and a dermal filler, which can help improve deeper neck lines, without risking lumpiness that might be an issue with thicker fillers.
   
   With skin boosters, this dual-action of immediate visual improvement and gradual skin enhancement makes skin boosters a compelling option for those looking to reduce the appearance of horizontal neck lines and prevent them deepening over time.
   
   

4. Energy-Based Treatments

   The neck is often a giveaway of ageing, due to less underlying support from deeper structures compared to the face. A number of energy-based treatments, including lasers, IPL and fractional radiofrequency devices can be used to address all of the signs of ageing in the neck.
   
   Advanced technologies like Morpheus8 and CO2 lasers, can help to improve textural issues related to collagen and elastin damage in the neck. Morpheus8 is one of the best known skin boosting treatments of recent years. It combines advanced microneedling with radiofrequency (RF) energy, reaching into the dermis of the skin to encourage the production of collagen and elastin, not only smoothing the skin but also tightening the entire area, reducing the prevalence of fine lines. In parallel, fractional lasers, such as CO2 laser (or even Morpheus8 resurfacing), create tiny injuries on the surface of the skin to stimulate a healing response, which over several months’ will improve the surface texture of the skin, diminishing wrinkles and age-related pigmentation by harnessing the skin’s intrinsic reparative processes.
   
   Pigmentation changes in the neck, such as solar lentiges, or age spots (also known as liver spots), can be effectively treated using devices such as lumecca IPL.
   
   

5. Fat Dissolving Injections for Submental Fat Pad

   The submental fat pad, located under the chin and often leading to what many know as a “double chin”, can be notably stubborn, often resisting dietary and exercise interventions. Fat dissolving injections, including Aqualyx and Belkyra/Kybella, provide a non-surgical method to address this common concern. These treatments generally use a substance known as deoxycholic acid which is injected directly into the problem area. This substance is directly toxic to fat cells, causing their breakdown and removal from the area injected. Over a period of weeks and through a series of sessions, the body naturally processes and eliminates these disrupted fat cells, gradually reducing the fullness under the chin. Despite the apparent simplicity, it's crucial to manage expectations; optimal results typically aren't instantaneous and necessitate patience and potentially multiple treatment sessions. Swelling is fairly common post treatment (usually for 7-14 days), so this should be considered if you are thinking about doing an aqualyx or belkyra treatment. As a non-invasive, FDA-approved option, fat dissolving injections offer a viable alternative to surgery, sidestepping extended recovery periods and inherent surgical risks, while providing a targeted solution to submental fullness. Ensure that any treatment is administered by a qualified professional to guarantee both safety and efficacy in addressing submental fat, as well as managing any potential side-effects of fat dissolving.
   
   

6. Semi-Surgical Treatments: Endolift

   
   
   Endolift is a novel non-surgical method for tackling sagging and laxity in the neck area, providing a targeted solution for those seeking subtle lift and tightening without resorting to more invasive procedures like neck liposuction. Utilising laser technology, Endolift works by delivering controlled laser energy to the deeper layers of the skin and fat, aiming to stimulate collagen production and incite a tightening effect within the tissue. It also has the ability to directly kill fat cells The treatment consists of injection of local anaesthetic to numb the treated area, followed by introduction of a fine optical fibre (around the diameter of a hair) under the skin, which directs laser energy to specific areas. The wavelength of light used has a direct effect on water molecules in the skin and fat which then causes tissue contracture and fat breakdown. Unlike surgical options, Endolift allows for fairly minimal downtime (about a week of swelling and bruising can be expected) and is often celebrated for its ability to deliver noticeable results with less disruption to daily activities. It is crucial to note that while Endolift can provide notable improvements in skin tightness and texture, expectations must be managed realistically, as results may vary and optimal outcomes may necessitate a series of treatments.

Considering the Lower Face in Neck Treatments

Any treatment addressing the neck must also take into account the harmony and balance with the lower face. The interplay between the jawline, chin, and neck is crucial in achieving natural-looking results. An overly treated neck paired with an untreated face, or vice versa, can lead to a disjointed appearance. Thus, a holistic approach by an experienced aesthetic doctor is key.

Conclusion

The signs of an ageing neck are no longer something we must simply accept. With an array of non-surgical treatments available, achieving a youthful neck and jawline is more accessible and easier than ever. However, it's essential to consult with a skilled practitioner who can guide you through the options, ensuring treatments are tailored to your unique needs and anatomy, and preserving the delicate balance and harmony between the neck and lower face. 

Useful Resources

onlinelibrary.wiley.com
ncbi.nlm.nih.gov
onlinelibrary.wiley.com
link.springer.com
onlinelibrary.wiley.com
pubmed.ncbi.nlm.nih.gov