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  • Aesthetic Medicine

Oval, neck and décolleté, the techniques that work!

  • 20th March 2020
  • Thierry PIOLATTO

Dr Ghislaine Beilin

As the face ages, we notice a loss of elasticity and a reduction in the skin’s thickness, as well as increased tonus when the muscles are at rest. 

Nowadays, it is inconceivable to treat the face without also treating the neck, oval and décolleté. It is the chronology of aging, the aesthetic unit of beauty. Seduction and beauty belong to women, and erasing the signs of aging allow us to preserve these assets. The first thing we notice during face-to-face encounters is the face, neck and décolleté, so any signs of aging will not go unnoticed.

1. The skin and sun damage or photoaging

Photo rejuvenation with intense pulsed light (IPL) uses special wavelengths that are absorbed by the melanin or hae-moglobin. This leads to the thermal decomposition of pigmentary and vascular lesions, poikiloderma or benign actinic keratosis, and stimulates collagen synthesis. In conclusion, three photo rejuvenation treatments on the face, neck and décolleté are a must after age 50, providing your skin is not tanned. Tailored medical cosmetology identifies what your skin needs and creates a unique combination of therapeutic ingredients (UNIVERSKIN®).

2. Fine lines and wrinkles

Just like in the face, a loss of proteins (collagen and elastin) in the dermis plus the effects of gravity lead to horizontal wrinkles on the neck and fan-shaped wrinkles on the décolleté. Depending on the severity of the wrinkles, treatment involves hyaluronic acid injections:

  • A medium cross-linked product along the wrinkles or in papules on the décolleté • An intensely-hydrating product as a skin booster (RESTINAL Vital®)
  • Or the mesolift technique (FILLMED®) “Mesobotox” may be recommended to smooth the décolleté. Tissue regeneration:
  • HA + PRP – Matrix Cellular® RegenLab
  • HA + Amino Acids – SUNEKOS 200® or SUNEKOS 1200®
  • Topical growth factors with microneedling – AQ SKIN SOLUTIONS® The new packaging in 2ml syringes or 3ml bottles allows us to cover larger areas. The patient can now maintain the effects at home by applying hydrating, anti-aging and anti-blemish active ingredients – BIOCYTE® décolleté mask, CROMA®.

3. Skin sagging

We cannot envisage treating the neck without first treating the face, particularly the middle and lower third. The superficial cutaneous layers are mobile, so we must first reposition the volumes in the middle and lower thirds of the face.

For the neck, biodegradable PDO (polydioxanone) threads, inserted transversally into the dermis (CROMA® Aqualift®) block any dynamic wrinkles and, secondly, bring about colla-gen synthesis. The firming effect is undeniable and long-las-ting on the neck.

The winning formula is: HA injections into the wrinkle + horizontal insertion of PDO threads vertically for a “corset” effect.

On the décolleté, we need to insert the threads transversally in a mesh pattern. More severe skin sagging in the neck can be treated using polylactic acid or caprolactone suspension threads, either with barbs or cones (SINCLAIR Silhouette Soft®, CROMA®, APTOS®). These new materials and more advanced insertion tech-niques allow us to achieve a visible lift without surgery for one or two years, depending on the number of threads fitted. The treatment can also be repeated.

The “Nefertiti lift” involves botulinum toxin injections under the chin, into the platysma muscle and its cords. It is recommended for the oval and the lower third of the face, providing there is no ptosis or accumulation of fat, no double chin, and no significant jowls.

4. How to treat a double chin and jowls

Radiofrequency is always a good, straightforward solution. Treating skin sagging and fatty deposits makes the oval look more defined. New: Kybella® DEOXYCHOLATE lipolysis, however a decree issued by the French health authority (HAS) prevents it from being used in France. A gentler option is a mesotherapy cocktail with a firming and draining effect (mesoestetic®), lipo-regulating peptides and, best of all, cryotherapy to melt away a double chin (DELEO®, cryosculpt).

New, must-try treatment: HIFU focused ultrasounds. Fractio-nal technology that acts upon the proteins in the deep dermis and the hypodermal tissues. A painful but effective way of tightening up the skin for the long term. There is no maximum age for showing off your décolleté. Older ladies no longer need to hide their chest with a scarf or polar neck jumper: women have the freedom to choose what they wear and which parts of their body they want to flaunt!

The face, décolleté and legs are the hallmarks of femininity! 

Dr Ghislaine Beilin: Aesthetic and anti-aging doctor in Paris with 39 years of experience. Vice-president of the SNME (French National Union of Aesthetic Doctors). Honorary member of the European Society of Preventative, Regenerative and Anti-Aging Medicine. Expert and speaker at aesthetic medicine congresses in France and abroad. drbeilin.fr 

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