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  • Writer's pictureSkin Worthy

Anatomy of Aging Spotlight: The Neck and Sub-mental Area

Aging starts from the day we are born, but by no means does it happen at an equal rate. Not at the same rate as one another and definitely not that the same rate within ourselves. Genetics, along with environmental factors contribute to the aging process but the reality is that some areas tend to show signs of aging faster than others. Nora Ephron once wrote, “Our faces are lies and our necks are the truth.” And we think this is what she meant...

We spend money on skincare, on injectables and on lasers to care for the skin on our faces, but how often do we extend that care to the skin below? The skin on your neck is particularly vulnerable to damage. Poor posture, insufficient skin care, sun exposure and the natural weakening and decline of your neck muscles can all lead to accelerated aging. At Skin Worthy Toronto, our 54321 Assessment Model takes into consideration all five layers of the face and how each of them contribute to your unique aging process. Keep reading to learn more about possible treatment options at each layer for our facial area of the month: the sub-mental area and the neck.

Anatomy of An Aging Neck and Sub-mental: The Bone

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Over time, bones throughout your skeleton slowly lose mass and volume, subtly shrinking and receding. While this process has distinct complications for the rest of your body, in the face it usually results in a widening of the eye sockets, recession of the brow bone, and losing definition in the jawline and chin. By using HA dermal fillers or biostimulators like Radiesse we can re-create this structure at the bone level, providing support for layers above. The stronger the bone structure, the more tension there is on tissues in sub-mental area and in upper neck tissue draping. Average syringe requirement for this area is 4-6 syringes.

Anatomy of An Aging Neck and Sub-mental: Deep Fat Pads

For both the sub-mental area and neck, deep fat pads are not accessible, nor safe to treat non-surgically.

Anatomy of An Aging Neck and Sub-mental: Muscle

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When it comes to muscles in the lower face and neck, Botox can be used to release the downwards pull from the platysmas bands and add further definition to the jawline and neck border. Typically about 10 units per side are sufficient to improve the area. We can also treat the bands themselves. Platysmal bands are the two strips of muscle that run vertically down both sides of your neck. They’re typically caused by contractions of the platysma, which is the most superficial muscle layer in the face and neck. While they don’t pose any health risks, it’s a cosmetic concern for some as it can create the appearance of saggy skin, resulting in a double chin, neck creases, and what’s often referred to as turkey neck. By injecting the bands directly, we can release the tension it places in the skin above and give the neck an overall smoother appearance. Platysmal band dosing is around 20 units a band, whereas injecting it superficially across the neck with a hyper dilute Botox, requires approximately 20-40 units.


Anatomy of An Aging Neck and Sub-mental: Superficial Fat Pads

In the sub-mental area, the superficial fat layer is what is largely responsible for what we commonly refer to as the double chin. This area is a common complaint of patients, as this fat pad gets larger and heavier with both age and weight gain. Unfortunately, it's also one of those areas that fat tends to stay even when we lose weight. Superficial fat is often treated surgically with liposuction. When it comes to non-surgical options, we have numerous modalities available, including Belkyra, CoolSculpting, Evoke and Morpheus8. In order to determine what treatment is best for you, we do require an in person consultation, so we can assess the size of the fat pad and review the quality of the skin in the area.

For many years Belkyra and CoolSculpting were the leading non-surgical options for sub-mental fat as both are highly effective at permanently destroying fat cells. Belkyra often requires multiple session, however as an injectable, it is highly customizable. Treatment can be slightly uncomfortable, and swelling typically persists for about a full week post treatment. Results can be seen approximately 2-4 months after the final treatment. CoolSculpting is similar in terms of treatment downtimes and outcomes ,  although not as customizable as injections of Belkyra. It is however more tolerable in terms of comfort from a patient perspective.

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As the world of medical aesthetics is continuously evolving, there are now devices that not only take into consideration the shrinking and destruction of fat cells, but tightening the skin as well. At Skin Worthy, we offer two devices that can do both: Evoke and Morpheus8 by InMode. Evoke is a non-invasive, no downtime and hand's free radio-frequency device that shrinks superficial fat pads and helps to tightens skin for up to one year. Treatment protocols require  6-8 sessions every 1-3 weeks minimum to see a result, although many patients do see immediate improvement in the days following treatment.

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As you likely know, Morpheus 8 is a micro-needling device with radiofrequency.  One of the many benefits of this technology is that it has gold plated needles that reach a depth of 4mm with heat and up to 6mm with radio frequency. At these depths, Morpheus8 can target the superficial fat to slightly reduce it and tighten the surrounding skin. For optimal results, 3 sessions 4-6 weeks apart is recommended. Similarly to Evoke, to maintain skin tightening results, annual treatments are recommended. While Morpheus8 is more frequently used to tighten skin, it can also be used after treatments such as Belkyra or CoolSculpting to improve overall quality after fat pad reduction.

Anatomy of An Aging Neck and Sub-mental: Skin

It is the most superficial layer in submental and neck area, and often most neglected. Many patients do not engage in preventative measures, and treatment begins when signs of aging start to show in the early 40s. Thinning, sagging , crepey skin is what often prompts a visit to the clinic. In addition to skin changes we can also see the worsening of necklace bands or tech neck - the horizontal lines across the neck where we bend our neck downwards. If crepey skin is your main concern, there are numerous treatment options available. One of our most popular includes the Beauty Booster, an injectable device that injects Redensity 1 into the treatment area, to layer a blanket of hydration to the upper dermis. A series of three treatments will yield the best results. Morpheus8 and Halo can also be used to target hyperpigmentation, lax skin and sagginess. The results of both may take longer to peak but they do yield longer lasting results. If you are looking for a quick fix while you are waiting for your M8 or Halo results, hyper dilute Botox can give you an improvement in a few weeks for about 3-4 month duration.

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Depending on the severity of your bands your recommended treatment will consist of either hyper dilute dermal filler or a combination of dermal filler with the Beauty Booster to yes, boost hydration with our Skinergy treatment Neck Worthy. Dermal filler is injected in small boluses into the necklace bands to help smooth out any deep set lines and the Beauty Booster is then used immediately afterwards to further blur the lines and improve overall hydration. Our Neck Worthy treatment is 2 sessions done 4-6 weeks apart. This is for optimal outcomes, often 1 session is not enough.

No matter what your concern when it comes to the anatomy of the aging neck and sub-mental area, there are endless non-surgical options to help give you the results you are after. While in clinic treatments can help target all five layers of the face, it is essential that you are ensuring to extend your at-home skin care routines past your chin, along with your daily SPF. This will help to both delay visible signs of aging and compliment your visits to Skin Worthy. To book your Beauty Evolution consultation call or text the clinic at 647-350-7546 or click here.

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