The aging neck is one of the most challenging areas to treat noninvasively. It often requires a combination of treatments to rejuvenate the skin. The anatomy of the neck, as outlined in recent studies, is complex. Therefore, multiple factors contributing to the appearance of aging. Treatments like fat removal, skin tightening, muscle relaxation, and skin resurfacing are often needed to address various neck issues. In particular, the horizontal neck lines, which appear at a surprisingly young age, present a unique challenge.
Horizontal neck lines are etched furrows or wrinkles that appear across the neck. You can often see them in people as young as their twenties. Unlike typical signs of aging, these lines are not caused by the usual process of aging skin. Instead, they develop due to the repetitive motions and positions of the neck. Such as, bending or flexing the head forward. Factors like adipose tissue distribution and fibromuscular bands also contribute to the deepening of these lines. Additionally, the widespread use of smartphones, tablets, and laptops has led to an increase in the prevalence of these neck lines, particularly among individuals under 30.
How to Treat Them
In my practice, horizontal neck lines are one of the most common concerns for younger patients. The prolonged habit of looking down at devices often accelerates the formation of these lines. While there are many treatments available for neck rejuvenation, including hyaluronic acid fillers and dilute calcium hydroxylapatite, I’ve found that they do not adequately address the problem of horizontal neck lines. More importantly, these treatments may not prevent the lines from reappearing over time. Using fillers for this issue can also lead to complications, such as lumps, irregular corrections, and the Tyndall effect, especially if the wrong filler is used or the injection is not performed at the correct depth.
One of the most challenging aspects of treating horizontal neck lines is dealing with the fibromuscular bands that run along these lines. I have found significant improvement in my patients by performing subcision, a technique that involves using a 27-gauge needle to break apart these fibrous bands. This step helps to release the tissue and create a smoother surface for further treatment. After subcision, injectable fillers like hyaluronic acid can be used to fill in the lines. However, this method alone is not always effective, particularly in patients with excess fatty tissue in the neck area. In such cases, the use of deoxycholic acid is beneficial. I recommend one to six treatments of deoxycholic acid to break down the excess adipose tissue before using fillers. This not only helps to reduce the bulges caused by fat but also improves the overall contour of the neck.
Tech Neck
The rise of working from home and the increased use of handheld devices has made horizontal neck lines more prominent in younger populations. Despite the array of treatments available for neck rejuvenation, there is still no perfect solution for treating these lines in younger individuals. We need more research and a deeper understanding of the causes behind these lines, as well as better treatment options that can provide long-term solutions. While there are options available, achieving a lasting, effective solution requires a combination approach and an individualized treatment plan. With better studies and more research, we will hopefully find more effective ways to address this issue.
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