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    Nonsurgical neck tightening: What works best?

    Surgical options, such as the neck lift, facelift or platysmaplasty, still reign for optimal outcomes in neck tightening. But there’s good news. Nonsurgical options are getting better and better results, according to Jason D. Bloom, M.D., a facial plastic surgeon in Ardmore, Penn.

    Dr. Bloom presented “Nonsurgical neck tightening: What has worked for me and what has not” yesterday during the Vegas Cosmetic Surgery and Aesthetic Dermatology 2016 meeting in Las Vegas.

    Nonsurgical neck tightening is a big deal to patients, Dr. Bloom says.

    “Last year, alone, if you look at RealSelf data, there was over a million page views for nonsurgical neck lift topics, like Ultherapy (Ulthera), Thermage (Valeant Pharmaceuticals), ThermiTight (Thermi)…,” he says.

    Today’s options range from devices that heat tissue from the outside in to newer technologies that work from inside out.

    Treatments that tighten neck skin from the outside in start with lasers and IPL devices, according to Dr. Bloom.

    “The problems [with those options] are that results have been inconsistent and multiple treatments are needed,” Dr. Bloom says.

    The next generation of devices includes transcutaneous or external contact radiofrequency, which includes Thermage, Exilis (BTL Aesthetics), ThermiSmooth (Thermi) and Pellevé (Cynosure). Transcutaneous RF devices tend to use lower energies and require multiple passes to heat up a large volumes of tissue. That leads to new collagen and elastin formation.

    “The problem is, as a surgeon, I want to see results that are close to surgery or something that bridges the gap to surgery. In my opinion and in my hands, external radiofrequency (and I have a number of the devices) is not so incredibly sufficient to cause a ‘clinical change,’” Dr. Bloom says.

    Micro-focused ultrasound, or Ultherapy, is the first mechanism that bypasses the epidermis to work on the deeper tissues. Ultherapy, according to Dr. Bloom, produces a “nice” change if one chooses the right candidate for neck lifting and tightening.

    “People who need it the least do the best,” he says. “The more lines, or treatments, you do, the better the result. There are downsides: it’s not very comfortable. To get really good results, you need to start adding lots of lines, which is expensive both for the patient and doctor. I think the results are modest.”

    NEXT: Microneedles, Microinvasive Technology

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...

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