The Women's Journal

Rejuvenating The Aging Neck

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With SmartLipo & Other Age-Defying Modalities

By Nadiv Shapira, MD, Medical Director, First State Vein & Laser Med-Spa

The neck is difficult to hide, so many people are self-conscious about how it looks and are eager to refresh its appearance.

Why Does Our Neck Age Before Our Face Does?

Compared to the face, the skin on the neck is thinner and has less fat underneath it.

The neck is constantly in motion and with time the skin becomes depleted and saggy.

With age, fat accumulation in the neck results in the loss of definition in the jawline and can result in a double chin.

Drooping of the cheeks over the jaws towards the neck adds to the neck’s older-than-expected appearance.

Exposure to the sun and the elements further adds to the neck’s aging.

In the past, correction was almost exclusively done by surgery which was aimed to stretch the skin in a ‘neck or face lift.’ These are invasive, you cannot change the results if you are unhappy, it leaves scarring, and it may restrict your ability to show facial expressions. Skin texture and wrinkle issues will also not be solved. Luckily, there are new and less invasive options available now.


Smartlipo Triplex is effective to remove excess fat from the neck while it also tightens the skin. It’s a short office procedure, done by the insertion of a laser fiber through tiny incisions while under local anesthesia.

Aqua Contouring is a similar procedure employing water-jet liposuction instead of laser to remove unwanted fat. It can be a little less effective than laser in tightening skin but, it is safer for the fat removal from the lower face and the jowls. 

Body Contouring Machines: 

These devices emit energy aimed to reach underneath the skin in order to cause controlled local injury, which stimulates collagen synthesis and tightens the skin. 

 Ulthera utilizes focused ultrasound energy to precisely target the SMAS layer beneath the skin. Just one treatment is needed and the ultimate improvement is shown over 3-6 months, as your body naturally regenerates collagen.

Laser-based machines emit tiny laser beams that penetrate the skin in multiple points while sparing the skin between them. This modality requires 3-4 treatments but, laser can damage dark skin tones.

Radiofrequency machines emit energy from one point to another and are aimed to heat the tissue in-between. With Viora Reaction the combination of RF with vacuum stimulates collagen and reduces fat cells. 


Botulinum Toxin, like Botox® can relax longitudinal neck folds caused by tightening of the superficial neck muscles.

Fillers, particularly those that stimulate collagen synthesis like Radiesse® are effective in redefining the jaw line and the chin.

Kybella, a synthetic copy of a natural bile enzyme, is injected into the fat beneath the chin to dissolve it. Multiple treatments are required.

PDO Threads:

Threads are placed underneath the skin using a small needle which will then lift the skin. Some have tiny barb-like protrusions and are used in the mid-face, along the jawlines, and the neck. They are absorbable over time and result in the synthesis of collagen which helps to further improve your youthful and natural appearance.

A single modality usually cannot accomplish everything you wish to improve, and a treatment plan that combines different modalities and medical-grade skincare will yield the best results and be the most cost effective. 

Fusion Neck Rejuvenation: 

This is our proprietary solution to reverse the clock without surgery, as we combine various modalities to improve wrinkles, skin texture, and lift skin laxity. It includes treatments of injections and microneedling with healing blood platelets or PRP, rich in proteins to support cell growth and repair damaged tissues. Next, we insert threads to lift and tighten the skin, and then various injectables are used to complete the transformation.

Our suggestion is to start with a thorough consultation with a medical professional and discuss your options to see how you can get the results that you desire.

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