Facial laxity at a Glance
- Best Results2-5 sessions
- Treatment RecoveryTypically 1 day
- Procedure TimeMinutes
- Skin SpecialistDermatologist, nurse
- Duration of Results10 months - years
- AnaestheticNA
- Back to WorkImmediately
- Cost$-$$$$
Facial Laxity
Neck laxity can be treated with dermal fillers, lasers, threads & energy devices such as HIFU, Ultrasound & radiofrequency devices. We also combine collagen stimulating dermal fillers to tighten the neck & reverse neck sagging.
FactsFacts on Neck Laxity
- Mild cases of neck laxity will respond to new biostimulatory fillers
- This new filler technology stimulates the production of collagen
- Moderate cases of laxity can be treated with radiofrequency or high intensity ultrasound – Ultherapy, often in conjunction with biostimulatory fillers
- Severe cases of neck laxity requires surgical treatment
- Neck wrinkles can be treated with fractional lasers
- Neck discolouration responds to IPL or BBL & fractional laser resurfacing
- With all treatments it is important to blend to the face, chest & decolletage
How do I approach neck laxity?
The first step is to understand the degree of laxity. From there I assess if there are skin quality issues, such as redness & or pigmentation. A treatment program is then formulated based on the clinical findings.
What treatments are there for mild neck laxity?
Mild cases of laxity-wrinkling can be treated with fractional laser resurfacing, RF microneedling or better still dermal fillers that stimulate your own immune system to produce collagen.
What treatments are there for moderate neck laxity?
Treatments that have high efficacy for moderate sagging include;
- RF microneedling
- Laser resurfacing
- HIFU- Ultherapy
- New biostimulatory fillers
Most cases require a combination of the above. 2-3 sessions is the norm.
What treatments are there for severe laxity?
Surgical. Followed by surgical, then surgical.
For marked laxity, the most predictable treatment is surgery.
View our Treatment Gallery
Why are combination treatments often required to treat neck laxity?
In most cases, especially in Queensland, neck aging is a combination of laxity, wrinkles & mottled pigmentation.
Laxity can be improved with HIFU, RF microneedling & biostimulatory fillers. Wrinkles do best with energy devices & direct dermal filler placements. Discolouration is best treated with IPL or broad band light, or Fraxel- vascular lasers.
Most anti-aging neck treatments will require 2-4 sessions for best outcomes.
What is the best dermal filler for the neck area?
The best filler is Profhilo. It is a hybrid hyaluronic acid dermal filler that is termed biostimulatory, meaning it addresses laxity by stimulation of your own cells to produce collagen. As a guide, Profhilo:
- Requires 2 sessions for best results
- A third session is required for markedly sun damaged necks
- Downtime is typically less than 10 hours (Not a typo)
- Takes 2-3 minutes to perform
- Tightens the neck
- Reduces necklines
- Reduces fine lines & wrinkles
Lighting could be better, however in the after photos the better light reflex & luminosity reflects the better skin quality following treatment
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👉The Procedure: Jessner TCA peel & low density CO2 in key vectors in addition to 60 PDO threads in vectors, RF at 3.5 mm. One session only. Predicable non-surgical skin tightening follows a complex algorithm based on clinical features, genetics, ethnicity, goals, equipment, & more
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👍🏻The logic: Stimulation of all layers from the mid to superficial dermis (peel), deeper dermis (low density but high power CO2), hypodermis (RFM) & hypodermis & fibroseptal network (PDO threads)
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⏭Next stage: dermal fillers to further improve the outcomes
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🙄Suitable patients: mild to moderate laxity (leaning towards mildish). For lighter types, I prefer lasers or medium to deep peels, for darker skin types I use RF devices (RFM, NuEra, Pelleve) & HIFU
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🎬Action: For an opinion on threads & skin tightening book a consult with Katie or Alison at Cutis Dermatology
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
AU
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#lskintightening #HIFU #pdothreads #threadlifting #skinlaxity #brisbanedermatologist #dermatology #skinscience #facelifting #nonsurgicalfacelift #threadlift #mintpdo #mintthreads #pdothreadlifting
🎇Woooohoooo, new device
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🧐What is it? NuEra. It is a radiofrequency device from Lumenis
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👉Applications: Non-surgical skin tightening. It also does body contouring
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👱🏻♀️👩🏽Candidates: Selection is critical to get great results
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👍🏻Ideally: Mild to moderate skin laxity, thicker dermal layer, with little or no photodamage. Thick dermis means more collagen. No sun damage means better quality unbroken collagen
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😁Can’t wait for my team to show off the before and afters. Non-surgical skin tightening is one of the hardest things to predict, but I think (hope) we found the formula….been working at it for the past 12 months. With each new generation of devices, we come closer to predictable treatments 💯
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😎Davin Lim
Dermatologist,
Brisbane🇦🇺
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#skintightening #skin #skinrejuvenation #collagen #rejuvenation #nuera #lumenis #nonsurgicalfacelift #facelift #radiofrequencyskintightening
Outside or near the outer circle, the less science & predictability. It’s not possibility, it is about probability💯
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🔬Skin Science: stick to the basics. SPF, antioxidants, ABCs, Skin Acids such as alpha, hydroxy acids
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🔫⚡️🍌Lasers, peels, energy devices are somewhat predictable. Less so with threads (however used appropriately & in synergy, there is value). HIFU & RF can work for mild laxity, in appropriate skin types/profiles (little or no elastosis, thick dermis). HIFU is not ideal & can be counter productive in someone with photodamage, low subcutaneous fat & a thin dermis, same applies to RF (though consequences not as severe). PRP? For hair loss 🧑🏾🦲& joints 🦴👊
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💉Hyaluronic acids? You will get far more benefit if it is under, not on your skin
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😎Dr Davin Lim
Dermatologist.
Brisbane🇦🇺
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#dermatologist #drdavinlim #brisbanedermatologist #skincare #dermatology #skinscience #skinrejuvenation #dermalscience #dermaltherapy #cosmeticscience #skinrepair #retinol #retinoids #antioxidants #chemicalpeels #retinoicacid #laserrejuvenation #AHApeels #HIFU #threadlifts #PRP #vampirefacials #microneedling
#dermalfiller #hyaluroniccid
One treatment only, by Alison using a combination of energy devices in the same session. HIFU, CO2 & Thulium 1927. 6 weeks between before and after photos, I expect better results in the next 8-10 weeks
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🔬Skin Science: Logic as follows 1927 for superficial aspects of skin, fine lines, pigment, dyschromia & dysplasia (mild), CO2 high energy but low density, matching healing time of thulium (6 days). Bulk heating of thulium adds to the collagen stimulating effects of carbon dioxide laser. #HIFU for jawline area to stimulate deeper collagen💯
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💪🏼🔫How we employ HIFU/Ultherapy/Ultraformer: We only use this device if solar elastosis is minimal on clinical examination. ‘Lax’ collagen has a better chance to contract, compared to ‘fragmented’ collagen
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👉Combination therapies can be effective. Skin feels & looks firmer. Firmness can not be easily measured, it is often subjective. We are getting the similar results with a combination of PDO threads combined with HIFU or RF
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😎Dr Davin Lim
Dermatologist
Brisbane🇦🇺
@drdavinlim
#drdavinlim #dermatologistbrisbane #dermatology #skinscience #skincare #skinrejuvenation #skin #HIFU #ultherapy #ultraformer #thermage #pelleve #skintightening #skintone #skinclinic #dermatologistbrisbane #collagen #skintightening
Special thanks to Danae Lim for the videos. Give sis a follow>>
@drdanaelim
This video discusses PDO monofilament threads. This is the most commonly used thread type
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👉What are thread lifts?
This procedure is meant for mild to moderate skin laxity.
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👉What is the difference between monofilament & barbed/suspension threads?
Monofilament treads are made from suture material, most commonly used PDO. Other substances like poly-lactic acid are also used.
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👉What areas & concerns can be addressed with monofilament PDO threads AND who are good candidates for threads?
Lower face, neck, mild jowling. Patients with good dermal thickness & minimal sun damage do best.
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👉Do threads work on everyone?
Nope. They are good for mild laxity. Moderate laxity can be corrected with suspension - barbed - conical threads. If your collagen is lax, with minimal breakage (solar elastosis- sun damage), & if your dermal thickness is good, threads may be an option.
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👉How long do the results from threads last?
About 6 to 12 months. Honestly, more towards the former than the later. PDO threads dissolve in 6-7 months however histological studies have shown collagen stimulation for up to 9 months.
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👉What is the science behind thread lifts?
Thread in the dermis & hypodermis causes tissue fibrosis, meaning collagen stimulation. This improves laxity. Another theory is that threads in the subcutaneous tissue cause mild apoptosis of fat cells & tightening of the fibrous septae between fat lobules.
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👉What combinations work best?
Really depends on your clinical presentation, age, dermal thickness, ethnicity & expectations. Dermal fillers can be placed under threads. RF & HIFU can give synergistic effects. If skin quality needs improvement, certainly lasers can be beneficial.
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👉What threads can not do?
They can not give meaningful volumetric displacement. They are not a substitute for surgical intervention
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😎Davin Lim
@drdavinlim
Dermatologist
Brisbane🇦🇺
#threads #pdothreads #pdothreadlift #pdothreadslift #mintthreads #mintthreadlifting #facelifting #monothreads #drdavinlim #dermatologistbrisbane
What is the best laser to address skin laxity of the neck?
Lasers are useful to contract & stimulate new collagen. The best laser is the fractional CO2 laser, followed by erbium & non-ablative laser resurfacing. As a guide;
CO2 + erbium lasers
2-4 sessions
Healing time 5-8+ days
Non-ablative lasers
3-6 sessions
Healing time 3-6 days
How do I address pigmentation on the neck, chest & decollage areas?
Pigmentation is best treated with IPL or broad band light. 2-4 sessions are required, depending on the severity of discoloration.
We also employ Fraxel (for pigment, wrinkles & sun damage) as well as vascular lasers to treat resistant redness.
When do I employ HIFU - Ultherapy for neck laxity?
HIFU is used for mild to moderate cases of laxity. This widely popular treatment can rejuvenate the neck by stimulation of collagen. In summary, HIFU:
- Is best used for laxity & not discolouration of the neck
- Is best combined with biostimulatory fillers
- Can be used with lasers, threads, & RF
When do I use RF microneedling Genius for neck tightening?
RFM is useful for mild to moderate skin laxity of the lower face & neck. RFM works by stimulating the production of collagen, in turn providing tightening of skin. Most cases require 2-4 sessions spaced 4-6 weeks apart.
RFM is frequently combined with IPL/BBL (pigment) as well as new biostimulatory hybrid dermal fillers.
What are other types of dermal fillers I use to tighten skin?
I also use 3 other filler types to rejuvenate the neck skin, reduce lines & wrinkles.
Since the introduction of Profhilo I am using less of these fillers.
- Calcium hydroxylapatite dermal fillers: Radiesse. Usually requires 2-3 sessions, spaced 5-8 weeks apart. Gives volume correction as well.
- Poly-L-lactic dermal fillers: Sculptra, 2-4 sessions. Can improve skin quality.
- Hyaluronic acid, cross linked fillers: Provides volume correction. Can be effective for neck lines, but can give blue color changes (Tyndall) as it is placed superficially.
Dermal fillers can reduce wrinkles on the chest, neck & décolletage areas.
When do I use threads to lift the neck?
Threads rock. They need to be used in combination with other skin tightening methods for best results. I regularly use PDO mono threads for areas such as facial laxity. For the neck area, threads are underwhelming.
I used to perform cogged-anchoring-barbed- asymmetrical threads, however based upon the short lived & often unpredictable results, I hardly use them nowadays.
Why is it super important to blend in treatments?
The neck extends to the lower face, & to the chest-shoulders-back. Bottom line, we need to blend in treatments, especially when it comes to sun damage & pigmentation.
What is BBL SkinTyte & does it work?
BBL or IPL SkinTyte is Sciton’s advanced light device that employs IR technology to gently heat up the underlie tissue. This heating stimulates blood flow & over time can improve skin quality, in turn improving fine lines. It can marginally improve very mild neck laxity, however it requires 5-8 sessions for best results.
I used this device for 2 years on the new Joule platform. I firmly believe that long heating devices such as NuEra gives better outcomes than SkinTyte.
What is Morpheus8?
This branded RF microneedling system is made by inMode. It is a good device for skin tightening on both neck & facial skin. The main difference of Morpheus8 from Genius is that the needle of Morpheus goes deep into the tissue & can deliver heat sequentially from deep, medium to superficial aspects of skin. Genius however has the advantage of providing a great amount of energy in the deeper layers of skin.
I do believe that Morpheu8 & Genius RF are on the same par, with good results expected after 2-4 sessions, depending on the degree of neck laxity.
Can anti-wrinkle injections work on the neck?
It depends on the clinical scenario. Anti-wrinkle injections can be used to:
- Reduce neck bands – platysmal banding (those ropey lines on the neck when you say ‘eeeeee’.
- Provide a modest lift of the jawline when injected in small units.
- Improve fine lines & wrinkles when injected with hyaluronic acid delivered with the Aquagold system.
What is the best skin care to use for neck laxity & rejuvenation?
No amount of skin care is going to make a difference if you have neck laxity, wrinkles or sun damage – pigmentation. Skin care however, can prevent sun induced laxity, known as solar elastosis. I recommend the following;
AM: Acorbic & ferulic acids, tocopherol, SPF 50+
Midday: SPF 50+
PM: Retinol over retinoids
Every 2 weeks: Alpha hydroxy acids, or low concentrations of beta hydroxy acids.
Good formulations include Skinceuticals, Medik8, Aspect Dr & more.
When is surgery indicated?
If you have moderate-severe neck laxity, the only solution is surgical. Most often, a face lift is performed at the same time as a neck lift.
Remember, lifting treats skin laxity, in turn improving skin tone. Surgery is best to treat deeper laxity, however superficial wrinkles will benefit from lasers & or Profhilo fillers.
Skin quality is improved with lasers or IPL-broad band light.
What types of chemical peels can rejuvenate the neck & chest?
Chemical peels are useful for mild wrinkling & discolouration of the chest, neck & decolletage areas. They require multiple treatments over a course of 3-6 months. As a guide:
AHA or glycolic acid peels: 3-6 sessions, best for mild sun damage.
Retinoic acid peels: 2-4 sessions, best for skin cell renewal, often combined with LARI or laser assisted retinoic acid infusion.
TCA or Jessner TCA peels: 1-3 sessions. Can be used to reduce pigmentation, wrinkles & mild neck laxity.
How much are treatments?
As a guide;
- Biostimulatory dermal fillers $800 per session. 2 sessions required.
- Hyaluronic acid dermal fillers start from $690 (Nurse)
- IPL or BBL $460 – $690
- RF microneedling: From $690 (nurse)
- Fraxel lasers: From $890 (nurse)
- HIFU: From $590 (small area, nurse)
All treatments are classed as cosmetic, a Medicare rebate does not apply.
How do I treat neck lines or wrinkles?
Deep horizontal wrinkles can be treated with cannula subcision or direct injection of the areas involved. We normally use one of three different filler types-
- Hyaluronic acid fillers
- Dilute Radiesse
- New generation biostimulatory fillers; Profhilo
Horizontal neck lines rarely respond to lasers or energy devices.
What causes neck laxity?
Skin laxity of the neck & face is due to two factors. Firstly genetic & age related factors that reduce collagen, elasticity & fat.
Secondly extrinsic factors such as smoking, poor diet, & excessive UV exposure.
Treatments are aimed at replenishing collagen to tighten neck skin, in turn reducing sag.
Can microneedling or PRP work to reduce neck sag & laxity?
Microneedling can help very early stages of neck laxity, especially in cases of prolonged elastic recoil (more on that later). The depth of needling should be around 0.5 to 1.3 mm for clinical microneedling, however with caution you can DIY using depths of 0.2 to 0.25 mm at home. Microneedling can enhance the penetration of topicals such as retinoids & vitamin C.
What can a plasma pen neck lift do, apart from giving me scars?
Plasma pen is an awesome treatment for skin tags & genital warts.
In the context of skin tightening, results are marginal at best. Marketed as a substitute for neck lifting, plasma pen is applied to every area of skin laxity- from the neck, eyelids to the knees. The industry term is ‘fibroblasting’. I see at least one case a week from plasma gone wrong, namely deep scars from this procedure.
Can you tighten neck skin naturally?
For the best neck tightening results, the use of fermented streptococcal byproducts gives the best results. This bacterium is used to produce hyaluronic acid. It then undergoes a heat cycle to kill off the bacteria (usually over 110 degrees for 5-12 minutes), leaving behind pure hyaluronic acid. This is then cross linked or heat treated again to form bigger molecules of hyaluronic acid. This naturally derived product is then injected back into the skin, to reduce wrinkles, laxity & neck sag. 2-3 sessions spaced one month apart for best results.
Other natural ways to tighten neck skin include neck exercises & warm stone massage. Antioxidants such as argan oil can help mild laxity, whilst glycolic acid from sugar cane or lactic acid peels can help reduce neck discolouration.
Collagen supplements can have a placebo effect. Given the low cost & potential side effects, supplementation is up to the patient.
Davin’s Viewpoint on treating Neck Laxity & Sag
Given the marked UV index in Queensland, rejuvenation of the neck, & chest areas is frequently requested. Think of your neck as an extension of your face.
The most important step is to protect this area. This means twice a day use of sunscreens & preferably clothing. It is never too late to develop good habits. My team & I can reduce/remove wrinkles in this area, but to get long lasting results, sun protection is paramount.
For improvements in skin quality, I prefer lasers over chemical peels in this area. The former is far safer, however in select individuals I still perform medium depth Jessner TCA (usually sun damaged skin with thick dermis & elastosis, pigmentation, sunspots).
My team and I use various lasers, depending on the job. The most popular devices include IPL/BBL, CO2 fractional lasers, erbium fractional lasers as well as RF & HIFU (Ultherapy or Ultraformer). I am cautions in applying microneedling devices including Morpheus 8, Infini, Secret RF & Genius RF because the skin of this area is thinner (dermal layer). In higher treatment settings, gridding is not infrequent; especially in more powerful devices.
Dermal fillers are popular for treating volume loss in facial areas; however they are invaluable for treating neck lines (‘necklaces’) as well cross hatching & those pesky vertical lines on the mid-chest/between the breasts. The biggest leap in the past decade is the development of biostimulatory dermal fillers, namely Profhilo. This filler tightens neck skin without addition of volume. It also improves skin quality including reversing dull skin.
