Combined Approach to Neck Rejuvenation: HA and Botulinum Toxin Injection Technique

The appearance of the neck has become an object of increased interest in the field of aesthetic medicine in recent years, since multiple changes in this area require a combined approach.

Doctors Dalvi Humah, Antonello Tateo and Gabriel Siquer talk about neck rejuvenation with Stabilized HA Hybrid Complex and Botulinum Toxin Type A injections and demonstrate the results application of the 10 BET technique and botulinum therapy for neck rejuvenation in patients with varying degrees of age-related changes.   

In youth, the neck has a clear outline, the skin of the neck is smooth, the structures of the medial and lateral borders of the sternocleidomastoid muscle are well visualized, as are the borders of the trapezius muscles with depressions in the supraclavicular region and jugular notch. With aging, there are visible changes in the texture of the skin, the subcutaneous muscle of the neck and the volume of adipose tissue.

This results in visible folds and progressive muscle hypertonicity, resulting in blurred mandibular contours and platysma bands. Further deterioration in the texture and quality of the skin is associated with the loss of dermal structures. A decrease in collagen and elastin leads to further sagging and flabbiness of the skin. Volumetric changes in the neck area have been found to be due to the interaction of sub- and preplatysmal fat pads.

When assessing the degree of age-related changes in the neck, three parameters are taken into account:

•    degree of laxity/sagging of the skin (with or without folds);

•    rings of Venus: horizontal folds of skin on the neck, which become deeper and more noticeable with age;

•    vertical bands of platysma due to tension in the subcutaneous muscle of the neck.

As we age, there are visible changes in skin texture, subcutaneous muscle of the neck, and adipose tissue volumes.

Based on the above parameters, the authors divide patients into three groups:

•    first group: textural changes (increased sagging) of the skin, with or without Venus rings;

•    second group: changes characteristic of the first group, plus bands of platysma and/or blurred contours of the lower jaw and chin;

•    third group: changes characteristic of the second group, plus Venus rings, hypertonicity of platysma and a high degree of laxity / sagging of the skin.

Neck rejuvenation technique with Profhilo® injections; and botulinum toxin

For neck rejuvenation, the authors suggest using a combined approach with Profhilo®; (IBSA Farmaceutici Italia, Srl), a stable hybrid complex of high and low molecular weight hyaluronic acid 32 mg/ml, and botulinum toxin type A.

Group 1: Profhilo® 10 BET for neck rejuvenation

The injection neck correction was performed using the BET technique, which involves the injection of 2.0 ml of Profhilo®, in two procedures with an interval of 1 month.

The 10 BET technique for neck rejuvenation was developed to standardize injection points and minimize the risk of damage to important anatomical structures.

Why the skin of the neck ages quickly and how to slow down this process

Group 2: Botulinum toxin and Profhilo® injections

During the first procedure, 50 units of botulinum toxin were injected into the bands of platysma and the ring of Venus:

•    platysma bands: subdermal injection of boluses (2 units of botulinum toxin each) at a distance of 1-2 cm (patients were in a relaxed state);

•    Venus rings: intradermal injection of boluses (1 & ndash; 2 units of botulinum toxin each) into the mandibular part of the platysma at points located at a distance of 1 & ndash; 2 cm from each other (Nefertiti lifting).

Then, on days 15 and 45 after the first treatment, patients were administered Profhilo®; in an amount of 2.0 ml using the 10 BET neck technique.

Group 3: botulinum toxin and Profhilo® injections; - cannula technique  

Botulinum toxin type A injections were performed in the third group of patients according to the same scheme as in the second group of patients. Then, on days 15 and 45, Profhilo®:

•    cannula entry point location (25 gauge, 50mm): 1 cm lateral to the anterior border of the sternocleidomastoid muscle;

•    Insertion technique: linear retrograde;

•    insertion plane: preplatysmal;

•    amount of drug: 0.2 ml per line.

Starting points of Profhilo® insertion lines:

•    mandibular angle;

•    chin protrusion;

•    thyroid cartilage;

•    tracheal cartilage;

•    jugular cavity.

All patients (20 people in each group) noted a constant, gradually increasing rejuvenating effect after neck correction. Significant clinical improvements have also been documented. The patients tolerated the procedures well and were satisfied with the aesthetic results and the duration of the effect.

An integrated approach to neck rejuvenation, presented by the authors, allows not only to increase skin tone and elasticity, but also to improve the condition of superficial soft tissues.

The integrated approach to neck rejuvenation presented by the authors allows not only to increase the tone and elasticity of the skin, but also to improve the condition of the superficial soft tissues. Combined injections of botulinum toxin type A and a stabilized hybrid complex of HA – an effective and safe method of aesthetic correction of the neck, providing excellent results.

According to Prime magazine