The Latest on Neck Therapies Dr. Irwin May 21, 2020

Q & A
QUESTION: I received a neck tightening treatment and there is no change, The Venus v treatment was utilized. Would it be feasible for me to have Sublative, Exilis or Ulthera done at any given time ? Your information has assisted me vastly in terms of selecting a doctor who specializes in these specific areas for now on.

ANSWER: Thank you!! Okay… this a really interesting area and very much in the news everywhere. And….like anything that seems easy with not too much money, a lot of it isn’t real. Before you decide whether to spend money on this, it’s helpful to understand the differences.

Radiofrequency versus Deep Radiofrequency

Radiofrequency. In the past (and still), radiofrequency (RF) has been applied to the surface of the skin, with a cooling technology of some type. Systems in this category were Thermage, Ultherapy, Exilis, Thermi, and Pelleve. They all gave more or less the same results and worked better on face than the neck. Most appropriate for visible tightening in a younger group (usually 30s-50s). In an older group 50s-70s, they could also be used for jawline maintenance. Still a good goal, but not a visible lift or facelift-like effect. Everyone builds collagen with these systems which thickens the skin in a good way. We liked Thermage on the face and Exilis on the neck because it was less painful, but good result.

Deep radiofrequency (RF). In the past few years, we seen a true break though in systems that deliver the energy directly into the deeper skin (dermis) with tiny, highly engineered needles. Several are now on the market, for example, Profound, Venus V and Sublative eMatrix. Be sure to distinguish between the systems that supply the RF from the skin side with tiny engineered pins (above), and the systems that supply RF from under the skin with a long canula and insertion points (ex. Thermitight).

  • Sublative eMatrix Rejuvenation uses fractionated bi-polar radio frequency to penetrate through the skin, sending more energy beneath the surface of the skin to maximize collagen production, all while keeping the top layer of the skin intact. Sublative Rejuvenation is clinically proven to treat fine lines and wrinkles, acne scars and stretch marks and textural irregularities caused by excessive sun exposure. With little to no downtime post-treatment – patients can return to regular activities following treatment.
 Sublative Rejuvenation is the “all-natural” approach to enhancing your youthfulness.

  • Profound is a minimally invasive skin rejuvenation procedure for the face and body. It combines radiofrequency energy with microneedling to tighten loose skin, add volume, and reduce the appearance of wrinkles and other signs of aging by reinvigorating the body’s natural production of hyaluronic acid, elastin, and collagen, the building blocks that keep skin firm and elastic. The temperature-controlled Profound device uses microneedles to deliver RF energy in the form of heat directly into the reticular dermis, the skin’s lower level, where most collagen fibers reside. The RF microneedling device gives your provider real-time feedback on the energy level and the precise temperature of treated tissue, making it easier for them to control the level of injury and stimulate a healing response that remodels skin.

  • Venus V treatment is one of the best noninvasive, no-downtime-necessary ways to tighten and rejuvenate the skin. The treatment melds both radiofrequency energy and pulsed electromagnetic field energy to naturally kick-start the body’s own renewal process and is considered the gold standard in nonsurgical skin tightening and sculpting. The RF energy that is delivered causes ions in the treated tissue to collide, creating kinetic energy, which is transformed into thermal energy (heat), and which induces thermal changes. The heat basically causes a controlled injury to the tissue that triggers the body’s own natural wound healing process.

  • stimulates new collagen growth

  • Helps remodel existing collagen in your skin

  • Skin looks tightened and lifted

  • Immediate glow and rejuvenation

  • Shrinks fat cells

ANSWER (cont’d): To answer why your neck treatment didn’t yield the results you wanted. There are a number of reasons, and for those considering treatment, remember to address these issues in your consultation.

  • Provider didn’t do well technically with proper placement in the dermis.

  • Not enough energy delivered either temperature, placement of pins, length of pulses, # of pulses.

  • Provider didn’t set realistic expectations.

  • Health and/or age not conducive to good collagen, elastic fiber repair and regeneration

  • Very thin skin (speaks to realistic expectations)

Skincare for the Neck
It’s really important to protect this skin as much as your face and use actives. Here’s a good sunscreen for neck and chest and one great neck cream for ongoing maintenance.


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