By the Doctor Antoni Calmon
The neck and hands are two areas that really give away our true age. They are difficult to restore and the treatment options are fairly limited.
By focusing on collagen stimulation, we can successfully address skin sagging and can densify, smooth and plump the skin with treatments carried out over several sessions.
Collagen inducers, a subtle and adjustable treatment
For many years now, I have performed collagen stimulation with Radiesse, a filler product containing calcium hydroxyapatite. This allows me to work on the skin’s texture to visibly rejuvenate the face without altering its volumes or features. Over time, I noticed its restructuring and densifying effects, and my patients noticed that their skin had become firmer, more elastic, smoother and denser in texture.
Neck treatments are generally sought by women over the age of fifty who want to maintain their face’s appearance without altering their features, and most of the time they also have their hands rejuvenated at the same time.
The advantage of this filler is that we can adapt its dilution according to the desired results and the area targeted. This filler product is particularly interesting because, even when diluted 1:4, it has significant collagen-inducing properties. Patients like this protocol because, as the treatments go on, they see a visible and tangible improvement in the skin. These women become loyal patients as they seek to maintain, rejuvenate and plump their skin without visibly altering the volumes of their face. In general, one top-up treatment per year is enough.
Rejuvenating the neck, a real challenge
A saggy neck often means a stretched and undefined oval. I usually start by tightening the skin, injecting the undiluted product in a retrotracing pattern along the line of the jaw, then I focus on the areas that need filling such as mandibular notches or chin indentations (most often using hyaluronic acid).
Since the product is not hydrophilic, it tightens up the lower face without weighing it down, creating a clean and dynamic line. For the neck, the idea is to stimulate collagen synthesis as much as possible, to make the skin look younger while creating as little volume as possible so as not to weigh it down and to preserve its slender appearance.
I dilute a syringe of filler (1.5ml) with 3 volumes of physiological saline. I inject using a cannula (25g, 50mm) under the dermis, carrying out nappage in a fanshaped pattern diagonally towards the back of the neck, in order to tighten the skin as much as possible. The cannula is very fine, which allows me to get very close to the dermis. In general, two syringes and 7ml of saline allow me to place 5ml on each side. The immediate “plumped neck” effect only lasts 24 hours, so I warn patients that they have to wait until the third week for the collagen induction to start, which is when the skin starts to feel fleshier. The final results appear after a month and a half, and if we want to further thicken the skin and add some texture, a second session is recommended in most cases. This treatment gives best results on thin skin that lacks substance.
Collagen stimulation to rejuvenate and thicken the skin on the hands
Hand treatments are often requested by younger women with damaged hands, like nurses or chefs who are required to wash them a lot. With the pandemic, and the use of hand sanitisers that weaken the skin, demand has increased.
For thin, loose skin, I recommend treating the hands with a 1:1 dilution to thicken the skin and recover its texture, but without altering the shape of the hands. However, for bony, hollowed-out hands, I inject the product without diluting it in order to fill in the hollow areas and achieve a visibly rejuvenated appearance in addition to densifying the skin. I inject using a cannula, sub-dermally, for safety and comfort. In some cases, there can be significant swelling for 3 to 4 days, so I always warn my patients that there may be some temporary oedema. But this oedema means the treatment is working! It means the skin is producing rejuvenating collagen.
By the Dr. Antoni Calmon
Aesthetic doctor. Graduate in general medicine from the Faculty of Medicine of Reims.
DU of aesthetic medicine Paris Créteil (DUTIC). DU of medical lasers Faculty of Medicine of the Sorbonne.
Diploma of the GMC, United Kingdom Professor of medical rhinoplasty at the Faculty of Paris Créteil.
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