A NOVEL Compound Filler treatment
• Causes of neck lines
• Scale to grade neck lines
• Studies of neck line treatment
Causes of necklines?
Why do I have neck lines?
• Genetic inheritance
• Exercise : Vertical head movements – yoga
• Posture: This situation could be due to the tendency of many people to tilt their head downward when using a computer or a smartphone
• Sun exposure
• Natural ageing
• Facial skin VS local neck dermis | Which is more susceptible to environmental factors. Why? – Your neck is more susceptible, because of the reduced sweat and sebaceous glands.
How do I get rid of the lines on my neck?
How to erase neck wrinkles?
- Exfoliate YOUR neck.
- Opt for dermal fillers.
- Get Botox injections.
How severe is my neck line?
Wrinkle Assessment Scale (WAS)
Here is an international grading scale for wrinkles
• 0 No wrinkles
• 1 Just perceptible wrinkle
• 2 Shallow wrinkle
• 3 Moderately deep wrinkle
• 4 Deep wrinkle, well-defined edges
In a Korean Neck line treatment study
Hyun MY, Li K, Kim BJ, Kim MN, Hong CK, Kim H, Koh HJ, Park WS. Novel treatment of neck wrinkles with an intradermal radiofrequency device. Ann Dermatol. 2015
Intradermal Radiofrequency X 6 was done.
18 W (level 7 at 1 MHz), by using an insulation-coated 27-gauge needle electrode.
Monthly treatment with good results.
Generalized light brownish discolouration on the neck were reduced with the use of chemical peel before treatment.
In a Taiwanese neck line treatment study
Tseng F, Yu H. Treatment of Horizontal Neck Wrinkles with Hyaluronic Acid Filler: A Retrospective Case Series. Plast Reconstr Surg Glob Open. 2019 Aug 19;7(8):e2366.
• Patients received injection of CPM-HA (Esthelis Basic, 22.5% HA, Anteis SA, Geneva, Switzerland)
• 1 ml Hyaluronic acid
• only 1 touch-up was allowed within a month of receiving the first dose. Results lasted 6 months on average.
In a Chinese study
Wang S, Niu H, Liu Y, Tan Y, Gao H, Ren S, Wang L. Clinical Efficacy and Safety of Non-Cross-Linked Hyaluronic Acid Combined with L-carnosine for Horizontal Neck Wrinkles Treatment. Aesthetic Plast Surg. 2021 Dec;45(6):2912-2917. doi: 10.1007/s00266-021-02307-2.
• Objectives: The purpose of this study was to investigate the efficacy, safety, and subject satisfaction of a combined treatment of non–cross-linked hyaluronic acid (HA) compound filling plus mesotherapy for the correction of horizontal neck lines, VS BTX-A.
• Methods: This multicenter, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to severe horizontal neck lines corrected with either 2 or 3 sessions of non–cross-linked HA compound filling plus mesotherapy or 1 session of BTX-A injection. Improvement of the neck lines grades, Global Aesthetic Improvement Scale (GAIS), patient satisfaction, and adverse events (AEs) were evaluated.
• Results: Significantly higher pain ratings, higher incidence, and longer recovery of AEs (erythema, edema, and ecchymosis) were noticed in the combined treatment group (P < 0.001). No serious AEs occurred.
• Conclusions: Compared with BTX-A, combined treatment with HA compound filling plus injector gun therapy significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patient satisfaction.
• The patients’ comments revealed several major concerns about the filling plus mesotherapy combined treatment: pain, recovery time, treatment frequency, and duration of efficacy.
• Developing novel filler compounds might contribute to reducing the recovery time and number of treatment sessions.
• Additionally, given that de-nerving the muscle would lessen local tension, and hence possible filler translocation and degeneration, further investigation including neuromodulators would be necessary.
• Subdermal injection of CPM-HA is safe and effective for treating horizontal neck wrinkles.
• Sustained improvement of wrinkle intensity up to 36 weeks and
• Minimal AEs with no Tyndall effect were observed.
• In conclusion, our results show the short-term efficacy and safety of non-cross-linked HA combined with L-carnosine for mild-to-severe horizontal neck wrinkle.
• The non-cross-linked HA could immediately smoothen the neck folds
• L-carnosine could possibly prolong the duration of efficacy possibly by reducing the UV-related damage and promoting the collagen regeneration, despite the HA degenerating shortly after injection.
What is neck line treatment process?
• 1. 30 min numb
• 2. Clean
• 3. Medical peel x 3 min – Followed by injections
How do we treat neck lines?
Serial injections gently
Compound Filler, rejuran, botox
Avoid laser, HIFU, RF treatments for 1 month after so as not to degrade the injectables
How will my neck look immediately after treatment?
How to speed up recovery post treatment?
• Ice packs 15 min
• Abx ointment
• Avoid vigorous neck movements, yoga
Endpoint | After postcare
How long will the bumps persist?
These bumps usually subside over the next 2-5 days.
How long will the results last?
When performed by an experienced injector with the right dose, at the right plane, majority of cases can last 6 months and more.
• Lemperle G et al (2001) A classification of facial wrinkles. Plast Reconstr Surg 108(6):1735–1750
• Tseng F, Yu H (2019) Treatment of horizontal neck wrinkles with hyaluronic acid filler: a retrospective case series. Plast Reconstr Surg Glob Open 7(8):e2366
• Rohrich RJ, Bartlett EL, Dayan E (2019) Practical approach and safety of hyaluronic acid fillers. Plast Reconstr Surg-Glob Open7(6):e2172
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Good write up!!
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