Non-Surgical Neck Lifts

Non-Surgical Neck Lifts
www.skinsavvy.fromyourdoctor.com
by Nelson Lee Novick, M.D., FAAD, FAACS

The face is by no means the only area of our body that reflects the ravages of the passage of time. The neck, too, is vulnerable to assault from long-term ultraviolet exposure, the dictates of our genetics, gravitational effects, and changes in muscle mass and elasticity with chronological aging. The interplay of these factors gives rise to several cosmetically troublesome hallmarks of the aging neck. The somewhat playful names "turkey gobbler neck," "turkey wattle," or "chicken neck" describe the effects of both sagging skin under the chin and the presence of long, vertically-aligned and parallel, ropey-looking cords that stretch north to south along the front of the neck. An equally fanciful term, "necklace lines," refers to parallel bands of wrinkles that encircle the neck like a series of thin chains.


Striving for balance and symmetry between the face and the neck can be as critical for attaining overall cosmetic improvement (i.e. the appearance of "total" rejuvenation) as it is for achieving these goals when concentrating only on the face. If you restore fallen cheeks, for example, but ignore prominent tear troughs under the eyes or heavily drooping brows, you will no doubt look better. But an apparent age discrepancy and aesthetic asymmetry between the cheek region and the eye unit can sometimes result. In the same way, neglecting to treat the aging neck and focusing exclusively on the face may give rise to a similar incongruity in appearance. Put another way, if your face looks refreshed and youthful, but the neck weather-beaten, the results may appear odd and jarring, the way it is when you spot someone with severely wrinkled skin who has dyed his hair and left no hint of gray. It also becomes a dead give-away that cosmetic work was done on the face – a fact that you may not wish to share with friends (or family, for that matter).

A variety of surgical options exist for dealing with neck problems. These include full lifts, mini-lifts, minimal incision lifts, and S-Lifts. All are predicated on removing excess skin, shoring up the underlying tissue, and reinforcing the long, thin, sheet-like muscle layer, known as the platysma. This muscle extends from our jaws down to the upper chest and is responsible for much of the structural support and elasticity of the neck. For this reason, a surgical neck lift procedure is referred to as platysmaplasty.

But all these methods of repair are true surgery, which are expensive, postoperatively painful, and demand protracted recuperative times away from work and social activities. Happily, a number of completely non-surgical approaches, several of which I have either improved upon or developed myself, may be used to get rid of unsightly necklace lines and turkey necks.
Since the platysma is after all a muscle, once again the unique muscle-relaxing properties of Botox Cosmetic can be marshaled to play an important role.

Micro droplets of Botox can be implanted along (and sometimes above and below) the necklace lines at approximately half inch intervals. The immediate appearance of the treated areas looks like a series of tiny mosquito bites strung like beads around the neck. These little bumps are quickly and completely absorbed usually in the next twenty-four hours. For most people, diminution or elimination of the lines is seen somewhere between twenty-four hours and two weeks afterward. Benefits tend to last up to six months, after which touch-ups for maintenance may be given as needed.

Combining Botox Cosmetic and volumizers is best for dealing with the vertical neck cords. In order to accentuate the ropeyness of the neck, you will first be asked to grit your teeth tightly together. Next, tiny amounts of Botox are injected down the entire stretch of each cord to slightly weaken the underlying muscle sheet. This allows the platysma to redrape itself over the length of the neck, diminishing the appearance of the cords. To supplement the effect, small amounts of Botox can also be injected along the underside of the jaw line. This serves to dampen the downward pull of the uppermost portion of the neck muscles. It gives the facial musculature immediately above the jaw line just enough of a competitive edge to act like a sling and pull the neck upward on both sides of the lower face.

To enhance and to prolong the improvement, Radiesse a calcium hydroxylapatite-containing volumizer can be instilled along the jaw line, into the depression immediately under the chin, as well as horizontally and vertically as needed along the angle between the neckline and chin line (about a half-inch above the Adam's apple). The pull exerted in all directions by volumizing these regions further reinforces the sling effect created by the Botox. Radiesse not only imparts immediate volume to the treatment areas, but stimulates native collagen production several months later on, which serves to lengthen the duration of the overall improvement to somewhere between nine and eighteen months in my experience. Juvederm UltraPlus and Perlane, two heavy-duty hyaluronic acid fillers, have also been used successfully for this purpose, with results lasting between eight and twelve months.

The choice of which agent to use will depend upon a number of factors. If budgetary considerations come into play, if you are unsure of how you will like the effect, or if you have a big business or social event very shortly afterward, you would do well to choose the hyaluronic acid products. They are less expensive, are less likely to cause significant bruising or swelling immediately afterward, and offer a relatively shorter period of time in which to "try out" the new look. If you are not completely satisfied, Radiesse may be used instead the next time for longer-term improvement.

The accompanying images illustrate a dramatic “before” and “after” of a non-surgical neck lift using Botox and Radiesse. In this case, the “after” was taken immediately following treatment. The relatively minor redness toward the center of the neck from the injections of the volumizer was easily masked with a cover up makeup, and disappeared in a few days.

Fees for the procedure may range from $2,000 - $3,000, depending upon locale and the type and amounts of materials used. These days, with non-surgical neck lifting, you will have ample reason to hold your head up high.