In our office, we use several energy-based devices to help mild or even moderate laxity of the jawline and neck (when someone has severe laxity changes, we send them for a neck-lift). But for these mild-moderate patients, I do not portray these non-surgical results with devices as equivalent to surgery. Surgery can often be a \u201chome-run,\u201d whereas these energy-based devices can be a \u201cdouble\u201d or occasionally a \u201ctriple,\u201d but not a \u201chome run.\u201d<\/p>\n
I have served as an instructor and clinical trial participant with my staff for most of the technology we have at our offices. We have experience and unrivaled \u201cknow-how\u201d with these devices that we believe is unmatched in this region of the country.<\/p>\n
We use microfocused ultrasound (Ultherapy by Merz) for lifting of the laxity at the jawline jowls as well as lifting of some of the neck laxity. We use bipolar radiofrequency (Evoke by Inmode) for lower face and under-chin contouring. And for many patients, we use BOTH modalities to lead to a synergistic result \u2013 \u2013 using different types of energy to get the improvement of both types of energy (ultrasound and radiofrequency).<\/p>\n
For patients with creping skin (what we call \u201celastosis\u201d) of the neck and jawline as well as secondary smile lines outside the corners of the mouth, we use fractional microneedling radiofrequency (Genius RF by Lutronic).<\/p>\n
Most of these treatments are recommended to be a series over a few months (such as radiofrequency is often 4 sessions, and Ultherapy is often two). And again, they can work synergistically.<\/p>\n
For people who have a lot of under-chin fat that is \u201cpinchable\u201d (in front of the platysma muscle), then a series of Kybella injections can be performed for people who want to avoid liposuction under the chin (submental liposuction).<\/p>\n
For some \u201chorizontal necklace lines,\u201d fractional microneedling radiofrequency treatment series plus very dilute fillers (like reconstituted Restylane Refyne or Belotero) can be helpful to minimize these lines across the neck.<\/p>\n
For many of my patients, they seem to have embraced sunscreen and sun-protection on the face (as well as topicals like retinoids and anti-oxidants on their face) well before worrying about the neck. Many of these patients also started cosmetic procedures on the face many years before even thinking about the neck. Patients biggest concerns about the neck are laxity (addressed with radiofrequency and microfocused ultrasound as above), as well as sun-damage discoloration of the neck and \u201cchicken skin texture\u201d called poikiloderma of civatte (addressed with a combination of laser procedures such as hybrid fractional HALO 2.0, pulse dye laser, and for rough texture we add microlaser erbium resurfacing as well).<\/p>\n