There was an abstract in the recent Aesthetic Surgery Journal, April 2022. “Hyaluronic Acid Compound Filling Plus Mesotherapy vs. Botulinum Toxin A for the Treatment of Horizontal Neck Lines: A Multicenter Randomized Evaluator Blinded Prospective Study in Chinese Subjects.”
Long title, but what they are talking about are those horizontal wrinkles in your neck, what I refer to as the “necklace lines.” These wrinkles are due to volume loss- you can actually feel the difference in the skin thickness in these areas. These wrinkles expose your aging neck.
I have tried everything. BOTOX® Cosmetic is great for vertical banding, but I have not found it to be much use for the necklace lines. Vertical bands are caused by muscle movement, therefore BOTOX makes sense. The horizontal lines are tissue breakdown from bending your neck all the time (raise those phones up ladies! Good for your neck AND your back). There is actual loss of tissue thickness. BOTOX won’t help that. I have done facial peels to the neck- those are great for fine wrinkling, but those deep lines? It doesn’t do a thing.
I love nanofat fat grafting for this- not microfat to add volume, but NANOFAT to add stem cells. I have good results.
In this study, they sued 2-3 sessions of a non crosslinked hyaluronic acid plus mesotherapy, or 1 session of BOTOX injection. They were then evaluated at 1, 3, 6, and 10 months after final treatment.
What did they find? There were 25 patients in each arm. the HA filling group significantly improved the horizontal neck lines on all follow up visits, the patient satisfaction was higher. There were higher pain raitings and longer recovery (redness, swelling, bruising).
My thoughts?
FILLING these lines makes sense to me. Again, if you roll your neck skin tissue, you can feel the “dip” where the tissue is not as thick. When you need volume, you need to add a filler. (Again, BOTOX is best for vertical lines, which are due to muscle banding)
As I stated above, I like fat for this purpose. I am not a fan of mesotherapy, and HA fillers are always temporary. I think using your own body fat with the lovely stem cells which come with it is the best bet.