title: Neck Rejuvenation Using a Combination Approach: Our Experience and a Review of the Literature.
abstract: BACKGROUND
  Aging of the neck is characterized by changes that include skin dyspigmentation, laxity, rhytides, loss of the mandibular contour, widening of the cervicomental angle, accumulation of submental fat, volume loss and prominence of the platysmal bands. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices.
  
  
  OBJECTIVE
  To review the existing literature and the authors' experience in safely and effectively combining aesthetic rejuvenation modalities for the neck.
  
  
  METHODS
  A Medline search was performed on combination treatments for neck rejuvenation, and results are summarized. Practical applications for combining these procedures are discussed.
  
  
  RESULTS
  Studies examining the efficacy and safety of intense pulsed light, ablative fractional lasers, nonablative fractional lasers, microfocused ultrasound with visualization, thermistor-controlled subsurface monopolar radiofrequency, cryolipolysis, ATX-101, liposuction, laser lipolysis, neuromodulators, and hyaluronic acid dermal fillers in the neck were found. The authors review their experience in combining these techniques.
  
  
  CONCLUSIONS
  Review of the literature revealed options for non- and minimally-invasive rejuvenation of the skin and volume restoration of the neck, but little literature was found on the safety and efficacy of combining such procedures. The authors' experience in clinical practice is that many neck rejuvenation techniques can be combined safely. A combination approach often produces the most optimal outcome for the patient seeking neck rejuvenation.
authors.affiliation: *Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois; †Goldman, Butterwick, Groff, Fabi, & Wu Cosmetic Laser Dermatology, San Diego, California; ‡Department of Medicine/Dermatology, University of California, San Diego, California; §Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina; ‖Department of Dermatology, Duke University, Durham, North Carolina.
authors.forename: Monique
authors.initials: M
authors.lastname: Vanaman
authors.forename: Sabrina Guillen
authors.initials: SG
authors.lastname: Fabi
authors.forename: Sue Ellen
authors.initials: SE
authors.lastname: Cox
mesh_terms: D000273:Adipose Tissue / Q000601:surgery; D003131:Combined Modality Therapy; D017679:Cryotherapy; D003840:Deoxycholic Acid / Q000627:therapeutic use; D000067548:Dermal Fillers / Q000627:therapeutic use; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D062325:Intense Pulsed Light Therapy; D053685:Laser Therapy; D015187:Lipectomy; D009333:Neck; D009465:Neuromuscular Agents / Q000627:therapeutic use; D000078702:Radiofrequency Therapy; D012060:Rejuvenation; D015361:Rhytidoplasty; D015595:Skin Aging
chemical_list: C000599116:ATX-101 compound; D000067548:Dermal Fillers; D009465:Neuromuscular Agents; D003840:Deoxycholic Acid