Multimodal Approach to the Aging Longitudinal

NECK APPEARANCE is one of the main interests of the aesthetic field today; With aging, many changes occur in this area that need to be addressed with a multimodal approach. In young people, the neck is smooth, wrinkle-free skin, spotless, unlined. In the aging process, there are visible changes in the skin tissue, the muscle that we call the platysma, which lays under the skin, thickens, and becomes bandy structures on the neck depending on use. Depending on the changes in the fat layer, sagging is observed under the chin.

In addition, loss of elasticity in the support layer of the skin and decrease in collagen support cause loose, wrinkled appearance and horizontal lines on the skin. With the effect of the sun, reddish, brown spots occur on the neck.

There are three specific parameters to consider when performing neck analysis in the aesthetic patient:

Degree of skin laxity/sagging (with/without wrinkle formation): appears as fine lines running parallel to each other as aging progresses
Necklace lines: horizontal crease lines etched into the skin. They tend to deepen and appear more prominent with age and appear as the first sign of aging.
Platysmal bands: The platysma shrinks with age, causing atrophy of the sharp jawline and vertical neckbands in the area.

Using these parameters, the neck can be divided into three separate groups:

Group 1: textural changes (increased laxity) of the skin with or without necklace stripes
Group 2: As Group 1, with loss of platysmal bands and/or jaw line contour
Group 3: With necklace lines, platysma thickening and advanced skin laxity/sagging + as Group 2.
While treating these different groups, there are also differences in treatment.

GROUP 1: High-intensity hyaluronic acid injections are the ideal treatment.
With this application, significant improvement in elasticity and increase in tension are achieved in two sessions. Afterwards, the treatment is repeated as a single session with an interval of 6-8 months.
GROUP 2: BOTULINUM TOXIN AND High-density HA injections
First, the platysma muscle is relaxed with botulinum toxin. Concomitant high-density HA injection is given. It requires two and rarely three sessions of application with an interval of one month. Botulinum toxin is repeated every six months. HA injection is repeated every 6-8 months as needed.

GROUP 3: BOTULINUM TOXIN AND High-Density HA
This group is treated with botulinum toxin A similar to group two. On the 15th and 45th days, HA is injected between the skin and the platysma with the help of a cannula. Gradual improvement is achieved with these applications.

In all my patients, I apply BBL HERO to the neck décolleté once a month to remove the negative effects of the sun and to restore a spotless, smooth neck area. With this combination, we obtain a more taut, clear skin with increased elasticity.

As a result;

If the neck area, which is the most prominent part of the body after the face and completes the aesthetics of the face, is treated with the appropriate treatment and in a regular manner according to the severity of the problems, observed and re-treated at certain intervals, a taut, shiny, spotless, elastic skin is always obtained.

Multimodal Approach to the Aging Longitudinal