Figure 2. Clinical case, M/44, plain thread(100 strands) / Retense S(8 strands).

 

1.     Aggressive Treatment of Horizontal Neck Lines

 The horizontal neck wrinkles have anatomical structure similar to the palm lines or armpit creases where fibers directly attached to the skin and muscle pull them downward forming the deep lines. Therefore, a procedure that cuts this adhesion and fills the volume is needed.

 

In cases with thin skin and little fat, I use a thin screw thread(Dermaspring, N-Cog) and in those with thicker skin, fat pads and deeper wrinkles, I use mesh type thread(Retense, Estra) and follow it with PN injection to promote wound healing and tissue regeneration.

 

Focus on severing the fibrous attachment between the skin and platysma that form the wrinkle and supplement lost volume with screw thread through new generation of fibrous tissues. Simultaneous injection of PDRN/PN, which promote cell activation, can enhance the outcome.

 

Figure 3. PN injection following thread placement can promote wound healing and tissue regeneration.

 

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It is important to select the right approach for each type of neck wrinkle and more invasive means should be considered in severe cases. The best outcome can be achieved by improving not just the neck lines and skin elasticity but also pursuing an aesthetic balance with surrounding structures such as the cervicomental angle, mandibular border, under chin fat accumulation, and submandibular gland ptosis, etc. and implementing a comprehensive approach to address them.

 

-To be continued