摘要

Objectives: Showing the different neck layers that get affected with aging and how to combine treatments to treat all the different layer deteriorations. Simplifying the neck anatomy and aging effect and show different treatment options. Show different treatment options demonstrate which layer would benefit from it & best vs worst patient for each treatment. Show how to check for which layers are deteriorated to combine the proper treatment including fillers, Toxin, bio-stimulators, skin booster, lipolysis, thread lift and lasers for best results. Introduction: Most women care the most of their faces but many of them they forget about their neck making it the only mark that show their true age. Different layers of the neck are affected with aging, including the skin, Muscles (platysma), Fat (subcutaneous and sub-platysma fat ) that leads to skin discoloration roughness and sagging, neck bands , double chin and loss of the sharp definition of the jawline and cervico-mental angle become wide all these changes coming form different layers requires combining treatment that targets all the affected layers to get the best results. Materials / method: Starting form deep to superficial first: Lipolysis for the Superficial fat herniation , then ,Botulinum toxin which is very effective ONLY with hyperactive strong platysma with strong bands and horizontal lines reduction, Nefertiti lift as well improve the neck and jawline with proper patient selection. Finally the skin quality improvement : using Skin boosters and or biostimulators ( Ca hydroxyapatite, PLLA, or Profhilo), mesolifting material,PRP , lasers and LBDs, as well as PDO thread lifts are all very effective to get better quality of the skin. Results: Combining Toxin and Biostimulators with botulinum toxin, Lasers or threads is far more is effective then using one of these treatments as the cause is always combined in the different neck layer. Always nonsurgical options show good results only with mild to moderate neck aging. Comparing different combinations 2 sessions of Ca Hydroxyapatite to Profhilo 3 sessions (Very close results). Combining Meso lipolysis followed by Jawline fillers, or threads, depending on the amount of sagging and skin elasticity. Conclusion: With sever muscle laxity & advanced sagging avoid toxin injection, surgery is usually the best option. With mild to moderate sagging with strong platysma combininf biostimualtor with toxin is very effective. also lasers & thread lifts are very effective. Always start from deep to superficial with the neck ( Sub cutaneous fat dissolve, then , botulinum toxin for the muscle, then skin enhancers and biostimulators). Keep in mind with advanced laxity, muscle laxity surgery remain the best option.