Neck Rejuvenation Using a Combination Approach: Our Experience and a Review of the Literature.

Background: Aging of the neck is characterized by changes that include skin dyspigmentation, laxity, rhytides, loss of the mandibular contour, widening of the cervicomental angle, accumulation of submental fat, volume loss and prominence of the platysmal bands. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices.

Objective: To review the existing literature and the authors' experience in safely and effectively combining aesthetic rejuvenation modalities for the neck.

Methods: A Medline search was performed on combination treatments for neck rejuvenation, and results are summarized. Practical applications for combining these procedures are discussed.

Results: Studies examining the efficacy and safety of intense pulsed light, ablative fractional lasers, nonablative fractional lasers, microfocused ultrasound with visualization, thermistor-controlled subsurface monopolar radiofrequency, cryolipolysis, ATX-101, liposuction, laser lipolysis, neuromodulators, and hyaluronic acid dermal fillers in the neck were found. The authors review their experience in combining these techniques.

Conclusion: Review of the literature revealed options for non- and minimally-invasive rejuvenation of the skin and volume restoration of the neck, but little literature was found on the safety and efficacy of combining such procedures. The authors' experience in clinical practice is that many neck rejuvenation techniques can be combined safely. A combination approach often produces the most optimal outcome for the patient seeking neck rejuvenation.