title: The aging neck: a diagnostic approach to surgical and nonsurgical options.
abstract: BACKGROUND
  The neck is a prominent indicator of aging. Loss of subcutaneous fat, prominence of platysmal banding, jowling along the mandibular border, and excessive skin laxity due to loss of collagen and elastin are common conditions that are treated. Laser technology provides additional benefits when treating the first two anatomical layers of the neck.
  
  
  METHODS
  A 7-category classification system of anatomic skin layers of the lower face was developed. Based on the classifications treatments include the use of laser, ultrasonic technology, and toxins.
  
  
  RESULTS
  A classification system offering surgical and nonsurgical treatments including a 1440-nm laser fiber with a specifically designed tip to allow targeted energy delivery managed through a thermal sensing device.
  
  
  CONCLUSIONS
  Treatment options correlate with the presence and severity of conditions. Categories 1 and 2 have only a fat excess condition. Laser application alone, without skin intervention, is utilized. The amount of fat with subsequent aspiration follows guidelines of categories 2 through 5. The 1440-nm laser helps in all treatments. The surgeon may elect to address skin tightening with surgical tightening in categories 6 and 7. Modalities such as toxins and focused ultrasound can be used to address muscle laxity.
authors: University of Medicine & Dentistry of New Jersey, Surgery, Division of Plastic Surgery, and New Jersey Plastic Surgery, 29 Park Street, Montclair, USA. DrD@NJPSMD.com
authors: Barry E
authors: BE
authors: Dibernardo
mesh_terms: D000273:Adipose Tissue / Q000528:radiation effects / Q000601:surgery; D000375:Aging / Q000502:physiology*; D003357:Cosmetic Techniques / Q000295:instrumentation*; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D018482:Muscle, Skeletal / Q000528:radiation effects / Q000601:surgery; D009333:Neck / Q000033:anatomy & histology* / Q000528:radiation effects / Q000601:surgery; D012060:Rejuvenation