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09-26-12 | Posted by

A sleek and subtle neck, free of lines and wrinkles, is a classic sign of beauty. This has been true for thousands of years as The Bible’s Old Testament Song of Solomon claims, “Thy neck is as a tower of ivory.” Still, a beautiful neck may be one of life’s gifts that we all take for granted, until signs of aging creep in.

Unlike other body areas, the neck unfortunately is more vulnerable to gravity and aging. That’s because neck skin is especially thin, there’s less collagen to provide support, and there are fewer sebaceous glands to deliver natural suppleness. Overtime, even in thin adults, neck skin may become crepe-like and loose.

One day we may catch our reflection and note a less than sleek jawline. As a 40 year-old, we may note the early signs of jowls, or a modest turkey gobbler. Facing the morning mirror, we see the muscles under the chin, once tight and invisible, now form two bridle-like stringy cords.

If we don’t wish to wear turtleneck sweaters forever, then what can be done, short of undergoing a surgical neck lift, to rejuvenate the neck area?

Luckily, the past few years have presented a variety of innovations—ranging from simple office “lunch time” procedures to topical cosmetics you can buy at the beauty counter—which produce meaningful results on necks with mild to moderate signs of aging.

Here is a BITB round up of the better non-surgical and less invasive options. We chose those options because they deliver realistic results while keeping pain and downtime to a minimum.


Pelleve® Wrinkle Reduction System represents a revolutionary skin-tightening system that uses radiofrequency to slowly heat the deep layers of the skin. The heat is delivered through a device some call the “Wrinkle Wand.” Its circular motion helps firm and tighten skin. In a self- protective response, more collagen is produced. This plumps the area. Many patients report that the office treatment feels like a warm, relaxing massage. According to Santa Monica Dermatologist Ava Shamban, “A benefit of the device is that it delivers instant results, and though three sessions may be needed, the results improve with each consecutive treatment as Pelleve continues to stimulate the growth of more collagen.”

Pelleve® is generally a 3 treatment series. Average series cost: $1,500-$2,500.


Thermage® also relies on radiofrequency to penetrate beneath the skin’s surface. One difference is that Thermage® is stronger and penetrates the skin deeper, causing the collagen fibers to contract instantly, similar, say, to a cashmere sweater placed in hot dryer. Since radiofrequency delivers a “controlled” injury, the under layers respond by producing more protective collagen. The result? A plumper, smoother area.

Both Pelleve® and Thermage® are used “off label” for neck treatments and await FDA approval.

Thermage® typically requires 1-2 treatments. Average series cost: $1,500-$4,000.


Sublime™ combines safe and effective levels of radiofrequency and infrared light; these bipolar energies remodel the dermal layer of the skin by delivering skin tightening with little discomfort and no downtime. Sublime™’s heat and infrared delivery system stimulate new collagen growth so that the area plumps up; wrinkles and some contours associated with aging are diminished. As Orange County Dermatologist Vincent Afsahi explains, “I use Sublime where I want to get the most tightening, such as the lower face, jowls, and the neck. This non invasive skin tightening procedure gives a lifting effect, without needles, scabs, or crusts. There may be some redness for a few days.”

Fine lines, texture – sublative on the whole face

A series of 3 treatments is recommended for optimal results. Average series cost: $2,250-$3,000.


One of the issues with any older liposuction technology is that healthy tissue often was removed along with the unwanted fat. The tube inserted for suction was often used as a cutting instrument, and complications could arise. Plus, the mechanical force of the procedure often unnecessarily traumatized the area. Bruising. Uneven results. Pain. Today, someone with a little extra fat under the chin with healthy, elastic skin might benefit from a HydraSolve™ treatment—which is a superior, less invasive, gentler style of liposuction that targets only the unwanted fat. A gentle method of contouring, HydraSolve™ re-defines the jawline and creates a smoother result, with little or no bruising. The system uses an energized saline solution to liquefy the fat before it is sucked through the tube. In sum, by targeting the stream of solution where it needs to be, fat can be removed with a greater accuracy than ever before. And you can leave your doctor’s office with just a few small Band-Aids over each of three points of entry—near each ear and under the chin.

HydraSolve™ neck procedure average cost is approximately $3,000.


Since Botox® acts directly on the muscle, this tends to be where the best neck results are seen. In most cases, Botox® helps relax the bridle shaped neck bands that run vertically from chin to lower neck. In some cases, the bands seem to disappear completely. Botox®, however, cannot remove sagging skin, which is best treated surgically. Similarly, Botox® may be used to treat thickened masseter muscles (the active ones we use for chewing); these often relax and soften the jawline with one injection. Eventually, Botox® benefits decline over time and injections must be repeated, on average every six months or so. “Nothing beats Botox for dynamic facial wrinkle, such as forehead creases and crow’s feet. In some cases, it can also be used in the neck. With age, the platysma muscle often separates, producing vertical cords in the neck. We can inject Botox to relax these cords and smooth the neck, especially in thin patients without much excess skin or fat,” says New York City Dermatologist Lisa Donofrio, MD.

Botox® average cost: $500-$750

How Else to Win The Battle?

As with any cosmetic procedure, your degree of improvement will fade over time but the treatment can be repeated as often as is necessary to maintain your youthful look. And other newer treatments are already in the pipeline, such as the “ATX-101” approach by Kythera Biopharma. Here a diluted acid is injected into the extra flesh of a double chin. The fat cells dissolve, and the fat is carried away by the body’s lymphatic system. Three to six treatments, spaced a month apart, may be required (along with sleeping with a chin strap), though there is no estimated cost yet for the procedure since it’s still in clinical trials.

Still, there are some other things you might do. Always treat your neck as well as your face when it comes to exfoliating and moisturizing. Be rigorous in your routine, gentle in your application. A special neck cream is likely to be more effective; most utilize special emollients that are lighter and enrich the area better than a heavy facial cream. We suggest NeoStrata Euviance Toning Neck Cream ($45) or Lierac Paris Coherence Neck Firmer ($70) for best results. Exfoliation—again gentle application is crucial—will restore a healthy glow, reducing crepe-like patches. Build a sensible routine into your regimen. Neck massage, too, will increase circulation and relax those muscles that improve posture. And in case you were wondering,  standing and walking without a slouch open the shoulders up and elongate the neck.

Finally, be vigilant with your sun screen year-round. Sun damage and weight fluctuations are two factors you can manage to keep you—and your neck—looking youthful.


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