Décolletage Solutions At A Glance
- Best Results2-4 treatments
- Treatment Recovery1-12 days
- Procedure Time30-40 min
- Skin SpecialistNurse, Dermatologist
- Duration of ResultsYears +
- AnaestheticNumbing
- Back to Work1-7 days
- Cost$$-$$
Chest Neck & Décolletage Solutions
Brisbane’s high UV index accelerates photo aging of the chest, décolletage & neck areas. Skin aging in these areas can present as pigmentation, loose skin, wrinkles, redness and uneven skin texture. Treatments are aimed at treating individual problems. I use a variety of lasers to accomplish an even blend & rejuvenate your skin.
FactsFacts on treating the Chest Neck and Décolletage Solutions
- Skin aging on these areas can present as discolouration and or skin laxity
- Treatments will depend on the predominant colour of skin aging- either brown, red, or a mixture of both
- Some patients present with skin laxity and others with neck banding due to overactive muscles
- Uneven skin texture can be treated with lasers including vascular lasers, fractional lasers, microneedling & IPL
- Skin tone, sun damage, and wrinkles can be improved with fractional laser resurfacing
- A tailored approach will give the best results
Chest Neck and Décolletage Solutions
How to approach neck, chest & decolletage rejuvenation?
There are three variables to consider when rejuvenating this area.
Firstly, discoloration. Sun damage is characterized by mottled red or brown areas on exposed skin in this area.
Solution: IPL or broad- band light, vascular laser, or Fraxel laser resurfacing.
Secondly, laxity. This presents as premature wrinkling leading to neck sag & inevitably severe laxity.
Solution: Biostimulatory dermal fillers, lasers, RF microneedling, HIFU
Thirdly: Neck banding due to platysma bands. Changes in muscle tone results in vertical tension bands.
Solution: Anti-wrinkle injections are very effective in reducing banding.
All treatments are tailored for the type of sun damage or ageing you have around the neck and chest area.
Red neck and chest areas can be treated with lasers, however 3-5 treatments maybe need for optimal outcomes.
What can be done about the mottled discolouration on my neck and chest?
Here is the execution of how I do it. Firstly, consider the color of the neck, chest & decolletage. The normal color is white (look under your chin or further below the chest line). We want to normalize the color discrepancy. You will have one of the following combinations; red, brown or a mix of red & brown. We then employ lasers to treat the different colors.
IPL or Broad Band Light is used most often. The advantage is that IPL can give a better blend than lasers. We employ different filters, depending on the color variation. Most patients require 2-3 sessions for optimal outcomes.
Vascular lasers are best for treating skin discolourations that are primarily red. This laser requires 3-5 sessions for best results. It can also marginally improve fine wrinkles on the neck.
Fractional lasers such as Fraxel, LaseMD, Hybrid can treat brown discolouration associated with fine lines, wrinkles & early sag/ neck laxity. 2-4 sessions are required for best results.
Pigment lasers can be effective if there are areas of sun damage & brown discolouration. We use one of five different lasers (more on that later), including Picosure, Picoway Pro, Spectra Hollywood & other lasers. 2-4 sessions for best results. 
Chest treatments with Fraxel and BBL combinations work well.
How do I approach MILD neck laxity & wrinkling?
Mild cases of neck laxity & wrinkles will respond to new hybrid biostimulator fillers.
2 sessions are typically required with an additional session if you have marked laxity.
This new filler, released in 2022 stimulates new collagen in turn reducing wrinkles, & deep etched horizontal neck lines. Injected with skill & precision, this product can smooth out horizontal lines, & reverse the signs of aging.
How do I approach MODERATE neck laxity & wrinkling?
Moderate neck laxity is treated with biostimulatory fillers & devices that increase collagen & tighten the neck. Combinations include-
- RF microneedling (Genius RF, Infini RF, Morpheus8
- Laser resurfacing (CO2, Fraxel, Hybrid)
- HIFU- Ultherapy (Ultraformer)
- New biostimulatory fillers (Hybrid fillers released in 2022)
Most cases require 2-4 sessions.
How do I approach SEVERE neck laxity & wrinkling?
For extreme cases of neck laxity & sagging, part of the answer is surgical. Surgery improves tone & platysma banding, however if you still have fine lines & wrinkles, biostimulatory fillers are required. Skin quality can be improved with IPL & lasers.
Powerful CO2 & erbium lasers, RF & HIFU will have minimal impact in cases of severe neck laxity.
Can skin care help?
Creams have a minimal impact on established cases of laxity & pigmentation. The use of fruit acids, combined with bleaching agents can marginally improve brown discolouration.
A simple anti-aging routine for the neck & chest is-
AM: Ascorbic + Ferulic acids, SPF
PM: Retinoids as tolerated
How can neck bands be treated?
Vertical neck bands are associated with age. They are due to overactive muscles known as the platysma. This muscle is superficially placed in both the neck & face. Though highly visible when you say ‘eeeeee’, platysma is not a powerful muscle. It responds well to anti-wrinkle injections that reduce muscle tone.
Neck bands; summary
- As a guide, anti-wrinkle injections:
- Take 3 minutes to perform
- Takes action within a week or two
- Lasts 3-4 months
- Can provide a non-surgical neck lift in some cases
- Are often combined with collagen stimulation dermal fillers.
Before and after treatment with anti-wrinkle injections. Treatment takes 5-10 minutes and is virtually painless. It last for 3-4+ months.
What can dermal fillers do, & why are they so important in neck & chest rejuvenation?
The most common dermal fillers (as of 2022) are made from a synthetic form of hyaluronic acid (HA), a naturally occurring substance in the skin. HA’s can function in two ways;
Firstly by adding volume, rehydration & subtleness to the skin as it attracts moisture.
Secondly by stimulation of dermal collagen, skin & fat cells. This new filler was released in September 2022 in Australia. This groundbreaking dermal filler can markedly reduce skin laxity & wrinkles in only two sessions. Unlike lasers, there is no downtime associated with dermal fillers.
In some cases I also use older technology fillers such as poly-L-lactic acid, & hyper diluted calcium hydroxyapatite. Fillers can be combined with other collagen stimulating procedures such as fractional lasers, RF & HIFU/Ultherapy.
Can new biostimulation fillers be performed on the same day as laser?
In most cases, yes. Filler is placed in the lower dermis & fat. Lasers target the upper layers of skin. The caveat is when there are deep wrinkles or marked skin laxity, in this case we separate the procedures 5-7 days apart.
How to know what is best for me?
Neck, chest & decolletage rejuvenation follows a very complex algorithm based on key factors such as-
- Clinical findings- degree of red/brown & mixed discoloration
- Degree of laxity- mild, moderate or severe
- Degree of wrinkles, fine lines & sun damage
- Your age
- Your ethnicity
- Your expectations
To ensure the highest probability of success, a clinical examination is required. You can book an appointment with my senior nurses, or with myself.
How do I approach double chin/s with or without neck laxity?
Double chins are usually due to pre-platysmal fat. The most effective procedure that has the shortest downtime is neck liposuction. This is performed in our operating theater under conscious sedation.
- Is effective in over 90% of cases
- Tightens the neck
- Sharpens the jawline
- One session only
- 48 hour recovery
- Can be combined with RF microneedling or HIFU for better results
Other less effective treatments that my nurses perform include;
Coolsculpting Mini
- 2-3 sessions depending on the amount of chin fat
- Recovery of 2-5 days
- Some tightening, especially if inflamed
Deoxycholic or fat dissolving injections
- 2-4 sessions
- Marked swelling for one week
- Nerve damage in 1-3% of cases (self resolving in most)
- Can tighten the area due to inflammation
View our Treatment Gallery
What lasers do my team & I employ for rejuvenation of the neck & chest?
Cutis Dermatology has the largest portfolio of lasers in the Southern Hemisphere. This ensures patients are getting the very latest in laser tech. We have the following devices (in writing as of 2022)
Lasers to treat red necks: VBeam Prima, Perfecta, 1064 Scition, DermaV 532, 1064, Alex 755 Lumenis, IPL & BBL, Lumenis M22 & Sciton.
Laser to treat brown pigmentation: Picoway, Picosure Pro, Hollywood Spectra, Fraxel 1927, Frax Pro, LaseMD Pro, Pastelle
Lasers to improve neck laxity & wrinkles: eCO2, MixTo, Ultrapulse, Hybrid Alma, Fraxel 1550, Sciton Joule, MC Juliette erbium
Other devices: HIFU, RFM Genius, Infini, eMatrix, Tempsure, NuEra
How many laser sessions will I require for neck and chest rejuvenation?
This will depend on the severity of your pigmentation, sun damage and the amount of wrinkles. As a guide-
- Discolouration of the neck (poikiloderma)- 4-6 treatments
- Neck rejuvenation – 3-4 treatments
- Fraxel – fractional lasers for neck and chest rejuvenation; 3-4 treatments
Fractional lasers such as Fraxel can provide good tightening in mild cases of neck laxity.
How long is the recovery following laser treatment on the neck and chest?
This depends on the laser we use, as a guide-
- Vascular Lasers– 3-4 days of bruising, can be covered up with make up
- Lasers for brown pigmentation- 7-9 days recovery
- Lasers for skin tightening- neck tightening 7-10 days recovery
Laser treatment for the neck, chest and décolletage area takes longer to heal compared to facial areas because of the lack of pilosebaceous or hair units. New skin is generated from these key unit areas. Unlike facial laser resurfacing, neck, chest & décolletage areas will require multiple sessions over 3-7 months
What RF devices do I use to treat the neck & chest?
I prefer slow heating radiofrequency collagen contracting devices. These include Tempsure, Pelleve, & Nuera. Slow heating RF amplifies collagen production at regular intervals of 4& 8 week after the main procedure. These forms of RF are more comfortable than Thermage or RF microneedling (explained below)
When do I use HIFU for neck & chest rejuvenation?
HIFU stands for High Intensity Focused Ultrasound. This popular treatment is a safe, non-invasive method to tighten neck & facial skin. This device emits ultrasound waves to stimulate collagen, in turn reversing skin laxity & sagging. 
Ultherapy is an excellent option for clients who want noticeable results & younger skin without the downtime associated with more invasive procedures. Treatment takes 10 to 35 minutes to perform & patients can resume their normal activities immediately.
HIFU is best combined with collagen stimulating fillers for best results.
What microneedling RF devices do I use & when do I use them?
Microneedling RF is classed as high heat RF. It is a good treatment for mild to moderate laxity of the neck & lower face.
I normally combine RFM (Genius, Infini or Morpheus8) with other skin tightening procedures such as collagen stimulation dermal fillers
RF microneedling
- Improves skin laxity with minimal downtime
- Work to tighten skin
- Does not address color change
- Requires 2-4 sessions for best results
- Is frequently combined with other treatments
What can threads offer in neck & chest rejuvenation?
I love threads, however they offer marginal improvement in the neck *& chest area. Biostimulatory fillers, lasers, RFM, & HIFU are more predictable methods for rejuvenation the chest.
We will be performing MyElevate advanced suspension threads in 2023, so stay tuned.
*If you are thinking about PDO monos, save your money for something that actually works.
Do I treat the neck at the same time as treating the face?
In some cases I treat both face & neck in the one sitting. If the job is extensive (requiring more anesthetic), I treat these areas separated to prevent anesthetic toxicity.
Do not underestimate the healing time following bigger procedures such as ablative laser resurfacing.
What types of chemical peels do I use to rejuvenate the chest & neck area?
I employ one of four chemical peels to treat the neck & decolletage.
TCA peels can be very effective in treating sun damage and pigmentation on the neck and décolletage area, however lasers are safer, and achieve a more natural outcome. In the past few years, Fraxel & fractional lasers have replaced TCA Chemical peels in the context of neck treatments. I still employ TCA for facial rejuvenation.
Glycolic acid or AHA. This can be very effective in reducing brown discolouration associated with mild wrinkles. AHAs do not have downtime, however you will require 4-6 sessions for best results. Highly effective, but very under-rated.
Jessner peels. I like a modified concentration of lactic, salicylic acids & resorsinol. I frequently combine Jessner with TCA.
Chemical peels performed by Specialists like Dr Lim can be effective, however patients will still require several treatments. Over the years TCA Peels have been replaced by Fraxel laser. Laser is safer, and is more comfortable for recovery.
Extra facial pigment including sun damage /actinic/ poikiloderma can be challenging to treat. This was after two BBL treatments by Alison @cutis.dermatology
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🔫Options: Vascular lasers, BBL, thulium 1927 or 1940, diode 1927, other superficial fractional wavelengths. Chemical peels can be useful if leaning towards pigment rather than vascular
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🧴Sunscreen & cover up clothing: is mandatory. For life
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😎Davin Lim
Brisbane🇦🇺
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#neckrejuvenation #sundamage #poikiloderma #skinrejuvenation #davinlim #drdavinlim #dermatologist #pigmentationtreatments #skinlightening #brisbanedermatologist #sciton #scitonBBL
Antioxidants form the second layer of defence after photoprotection
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🔬Skin science: these molecules reduce free radical damage by donation of electrons. In the context of skin, exogenous free radicals are due to UVR & environmental pollutants
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👉Keep it simple: A combination of ascorbic acid, ferulic acid & tocopherol or vitamin E can be used under your sunscreen as part of your morning skincare routine. 3-6 drops of your favourite serum will do the trick
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👍🏻Other antioxidants include #niacinamide, #retinol, #resveratrol & botanicals such as green tea, blueberries & raspberries🍓
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
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#dermatologist #brisbanedermatology #antiaging #antioxidantskincare #antioxidants
#ceferulic #skincaretips #skincareroutine #skincarecommunity #drdavinlim
Retinoids are one of the most widely prescribed drugs for treating skin conditions. Uses include acne & anti aging all the way to genetic disorders of cell turnover
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🔬Skin science: Retinoids exert their power through interactions with retinoid receptors known as RAR or retinoic acid receptors. In the skin, gamma is the most prevalent, hence why I have changed my prescription habits & favor a fourth generation retinoid called trifarotene (gamma specific retinoid)
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👍🏻Tips: start with an OTC formulation. Retinol 0.5-1% is a good starting point. From there understand your skin’s threshold & know how to modulate & optimise topicals 💯
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📖My practice: I prescribe topical retinoids to a small minority of patients (in the context of anti-aging), usually post laser or deep chemical peels. Your dermatologist may have a different algorithm. Prescription retinoids are tricker to use cf OTC, but with a sensible approach, most people will work it out. More on how to use in next week's post
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#retinoids #retinol #skinscience #skincarecommunity #retinoicacid #skincaretips #drdavinlim #dermatologistbrisbane
Why is blending essential for the neck & chest?
The MOST important concept to grasp is BLENDING. See the transition zone from the neck, to the face above, and the chest below? The rationale behind treatments is to reduce contrast change, & not totally rejuvenate the area, otherwise the treated areas will have better skin than the rest.
On this basis we use the bigger footprint of the IPL or a bigger spot size with our lasers. Fractional lasers such as Fraxel can deliver a natural transition zone.
Can dermal fillers make a difference?
Dermal fillers including Hyaluronic Acid & collagen stimulating fillers are useful in the treatment of deep neck lines. HA fillers last between 9 to 14 months, whilst collagen stimulating fillers last up to & often beyond 2 years. They are best combined with neck tightening devices like Tempsure or gentle fractional laser resurfacing.
Can skin care make a difference?
Skin care is aimed at prevention & maintaining good skin quality after procedures. The use of vitamin A analogues such as retinol & retinoid acid can prevent sun damage & increase collagen. Antioxidants including ascorbic acid, ferric acid & tocopherol should be used as UV protectants on a daily basis.
For more advice on skin care, consult our dermal therapist & nurses at Clinic Cutis.
Let’s focus in depth: HIFU & neck rejuvenation
What is it?
Ultherapy uses ultrasound to stimulate collagen production, in turn reducing neck laxity. Although skin restoration begins immediately, Ultherapy can produce a significant lift of tissues over a 2-to-4 month period.
What is the difference from lasers?
Lasers employ light energy that is most useful for surface issues such as pigmentation. Radiofrequency can reach deeper than lasers, it does not allow for precise heating of tissues at a preset temperature. With Ultherapy, ultrasound imaging is used, which allows the clinician to see the tissue layers during treatment. This ensures that the sound energy is applied where it is most beneficial.
Who is a good candidate for Ultherapy?
Men or women who exhibit mild to moderate skin changes including;
- Sagging of the lower face
- Loose skin in the neck area
- Sagging skin on the eyelids
Ultherapy is typically recommended for people in their thirties or older. It can provide some lifting and a more toned and refreshed look for people who are not ready for surgery.
How many sessions are required?
Only one treatment is required to achieve desired results, with annual touch-up treatments to help them maintain results. Some people with a fair amount of laxity in the skin may need more than one treatment.
What treatment pairs well with Ultherapy?
Derma fillers & IPL complement Ultherapy. Fillers are often used to draw water into the areas of dehydration. Biostimulatory fillers also improve neck lines & laxity as they stimulate collagen production. IPL is used to reduce skin color changes & improve skin quality on the neck.
Let’s focus in depth: Biostimulator fillers & rejuvenation
What is it?
Biostimulatory dermal fillers are new in Australia, released in late 2022. This filler has been available in Europe for the past 5 years, so we know that it works well, & importantly it is super safe.
What is the difference from other fillers?
Unlike other dermal fillers, Profhilo works by simulating your own immune system to produce collagen as well as rejuvenating the upper layers of skin. This translate to better skin quality, & importantly skin tightening without the bulk seen in older fillers. 
Who is a good candidate for biostimulation?
Men & women who have mild to mild-moderate-
- Sagging of the lower face
- Loose skin in the neck area
- Wrinkles on the chest & decollage
How many sessions are required?
Officially 2, spaced 4 weeks apart. Given the high UV rate in Brisbane, with resultant sun damage, 20% of candidates will require a third dose.
What treatment pairs well with biostimulation fillers?
Ultherapy, RF & IPL are typically combined with biostimulation. Remember, to achieve good neck rejuvenation, one has to treat multiple layers. Discolouration responds well to IPL, vascular lasers & fractional lasers such as Fraxel.
Let’s focus in depth: radiofrequency devices of the neck, chest & decolletage
What are they?
These devices provide controlled heating to the deeper dermal layers of skin, sparing the epidermis. Heat increases protein known as heat-shock, in turn producing more collagen & elastin.
What is the difference from other devices?
We have several heating devices ranging from deep powerful RF microneedling with the Genius, Profound RF, & Morpheus8 systems, to gentle devices such as Pelleve, Tempsure, & NuEra. I did have Thermage for several years, however given the consumables & low efficacy rate, my practice has switched to slow heat devices.
Who is a good candidate for radiofrequency?
Men & women who have mild to mild-moderate-
Sagging of the lower face
Loose skin in the neck area
Wrinkles on the chest & decollage
RF devices work to contract collagen that is lax with minimal sun damage. For broken collagen, the number of sessions range from 3-6.
How many sessions are required?
Most cases require 3-5 sessions, depending on the device, clinical findings & expectations. Powerful RFM devices require less sessions compared to slow heat devices such as Tempsure, Pelleve & NuEra.
What treatment pairs well with radiofrequency devices?
Biostimulatory fillers such as Profhilo can compound collagen production, in turn giving superior results than monotherapy. For skin quality issues we also employ vascular & fractional lasers, or IPL.
Let’s focus in depth: fractional lasers-Fraxel for the neck, chest & decolletage
What is Fraxel?
Fraxel is a form of fractional laser resurfacing. It uses a wavelength of light that is delivered superficially, targeting pigment & blood vessels. The actual target is water with the benefits of non-selective photothermolysis (unlike typical lasers).
What is the difference from other lasers?
It is not the laser that counts, it is the wavelength. We get similar results with high pass Frax Pro 1940 & other thulium-diode lasers. Downtime following Fraxel is typically 3-7 days, depending on the settings.
Who is a good candidate for Fraxel?
Men & women who exhibit pigmentation on the face, neck, decollete & chest areas.
How many sessions are required?
Most cases require 2-4 sessions for optimal outcomes.
What treatment pairs well with Fraxel?
Fraxel resurfacing treats pigment & superficial concerns such as fine lines & wrinkles on the neck & chest.. If you have deeper sun damage & wrinkles, we often combine CO2 or other deeper laser wavelengths.
IPL can also provide a good outcome-especially if there is redness. For patients who have neck laxity, biostimulatory dermal fillers such as Profilo can make a huge difference.
How much does skin rejuvenation of the neck and chest area cost?
Unlike faces, chest and necks will require more sessions to get a good result.
As a guide-
- Fraxel or LaseMD laser chest & neck starts from $990 per session (2-3 needed)
- BBL or IPL laser from $390
- Vascular laser for treating red – Pricing varies with areas treated, starting from $390 (nurse)
For a formal assessment & quote, a book to see my clinical team at Cutis Dermatology
What are natural ways to rejuvenate the chest, neck & decollete areas?
The best natural treatments include focused light, this is called a laser. A laser is one wavelength of light. You can’t get more natural than that.
If you are into microbial rejuvenation, consider streptococcus. Add some naturally sourced good bacteria into a pot, wait for them to ferment hyaluronic acid, separate them, then treat with heat for over 110 degrees for several minutes. You now have A-grade hyaluronic acid, derived from nature’s own stock. This can be used to inject the goodness of nature into your skin, in turn reducing wrinkles, stimulating dermal collagen & correct volume loss.
Other reported natural remedies for neck laxity & sag include neck patches & neck exercise to lift the neck.
Are laser treatments covered by Medicare or private health insurance?
No. This treatment is considered as cosmetic and not covered by Medicare, nor health insurance companies.
Davin’s viewpoint on treating the décolletage, chest and neck areas
Living in Brisbane, the Sunshine State’s capital exposes us to marked UV indexes, as a result, sun damage to exposed areas of the face, neck, chest & décolletage is a very common condition. With the event of new lasers, this once ‘impossible to treat’ condition can now be safely and effectively managed with excellent results that look natural. The flip side? Unlike facial skin, the chest, neck and décolletage areas take many more treatments to achieve the same result.
Patients will present with a combination of either pigmentation and/or skin laxity. A detailed examination will reveal what lasers will be best suited to the skin type. Lasers such vascular lasers will target redness, whilst fractional lasers will target skin laxity, sun damage and brown areas. Most patients will require a combination of treatments for best results.
In late 2022, introduction of a new biostimulatory dermal filler has taken neck & chest-decolletage rejuvenation to a whole new level. It has surpassed lasers & other devices as the treatment of choice for skin laxity as it can tighten mild to moderate cases of neck sagging. Unlike lasers, Profhilo has no downtime. Treatment typically takes 10-15 minutes to perform. With the marked sun damage seen in Queensland, about one quarter of patients require a third dose.
To summarize, my team & I perform bespoke treatments, tailored to clinical findings. We use various fillers, energy devices, injectables & lasers to improve skin laxity & quality of the chest, neck & decolletage areas.
