by Eric J. Wyble, MD
To understand how the neck ages, we first need to understand the basic anatomy of the neck. Ideally, the profile of the neck has a nice cervical mental angle. As we age, the skin, the muscle of the neck (platysma) and the fat in between the skin can affect the neck profile.
When treating the skin of the neck, particularly with sun damage, discoloration and fine lines, a resurfacing laser such as the Fraxel can help improve and diminish the surface irregularities in the neck. At some point in life, everyone can benefit from resurfacing the skin of the neck.
A relatively new treatment for excess submental fat is Kybella. An FDA approved injectable drug that permanently dissolves fat. Patients usually need two to three treatments six weeks apart. The procedure is done in the office with no downtime. Since no surgery is needed, this is an excellent choice for fat reduction/removal.
Laser liposuction can also be used as a single, outpatient surgery to remove fat, and also will tighten skin mildly. Some downtime is necessary for the bruising and swelling to dissipate.
As we age, especially in women ages 38 and up, the platysma muscle bands can become more prominent. These can be softened and improved by a Botox treatment, which will relax the muscle.
As the skin and the platysma muscle start to demonstrate farther laxity or “sag,” use of a skin tightening device called Ulthera becomes an option. Ulthera uses ultrasonic waves to heat the dermis of the skin and fascia covering of the platysma muscle of the neck. This heating will allow for tightening of both layers. Although usually a single treatment works, if repeated appropriately, results can demonstrate cumulative improvement. Ulthera has mild discomfort and no downtime.
For necks demonstrating greater laxity, a more aggressive skin tightening treatment may be needed such as ThermiTight. This device offers the newest technology using radiofrequency to heat the under surface of the skin by inserting a thin probe beneath the skin by the surgeon. Treatment includes the jowls at the jawline and the entire frontal neck, and this minimally invasive procedure is performed in the office. The area to be treated is anesthetized and a special thin probe is placed beneath the skin through a small one millimeter incision. The undersurface of the skin is gently heated to optimal temperature to maximize the collagen and elastin regrowth and tighten the skin. During the entire process, the area treated is monitored both internally and externally with an infrared military grade camera. This allows for exact control of the heating process and maximizes the skin tightening. ThermiTight is the most aggressive option before one considers surgery. Individually, there may be one to two days of downtime.
ThermiTight is the last step to consider before surgical neck lift or face and neck lift. For advanced laxity of the skin, muscle and excessive fat in the older patient, a traditional neck lift, usually combined with face lift, will maximize your results and is still the “gold” standard.
Depending on the results and budget, there is a procedure that can be tailored to your individual needs. Additionally, different treatments can be combined to maximize the result.
If you’re not sure what’s right for you, we offer free consultation appointments at your convenience.
Reach Dr. Wyble at Gulf Coast Aesthetic Center located at 1133 45th Ave., Gulfport or call (228) 865-7299.