Derm Topics

What Every Aesthetic Dermatologist Should Know About Neck Anatomy

Next Steps in Derm, in partnership with ODAC Dermatology, Aesthetic & Surgical Conference, interviewed Dr. Robyn Siperstein, an expert cosmetic dermatologist in Boca Raton and Boynton Beach, Fla. Knowing neck anatomy is vital not just for improved outcomes, but also for safety. Watch as Dr. Siperstein shares what you should know about neck anatomy and how that should influence your treatment decisions. Learn Dr. Siperstein’s technique for injecting into the neck, how to identify good candidates, and why you should be extra careful when using lasers on this part of the body.

Further Reading

If you want to read more about performing aesthetic procedures on the neck, check out the following articles published in the Journal of Drugs in Dermatology:

Assessment of the Interference of Hyperdiluted Calcium Hydroxyapatite for Neck Rejuvenation in the Ultrasonographic Evaluation of Thyroid


Background: Sagging neck skin is a common complaint, and the use of calcium hydroxyapatite injection is a traditional treatment approach for this region. The published literature is limited concerning the possible interference in imaging exams of hyperdiluted product, which presents radiopaque features, for the assessment of deep structures to the application.
Objective: To assess possible interferences in the ultrasonographic evaluation of thyroid after application of hyperdiluted CaHA on the neck region.
Methods: This was a prospective, blinded, and controlled study. Patients had their cervical regions treated with diluted CaHA (1:4). Ultrasonographic evaluations of thyroid were conducted on day 0 (pre-procedure), day 15, and day 60 by two radiologists blinded to the application.
Results: On day 0 no exclusion criteria were observed. On day 15 technical artifacts that difficulted the evaluation but did not make the complete assessment of the thyroid unable, were seen. On day 60 the artifacts of posterior acoustic shadowing were considerably reduced, not bringing any difficulty whatsoever for evaluation of the gland.
Conclusion: Treatment of sagging neck skin with diluted CaHA in 1:4 does not negatively impact the ultrasonographic evaluation of the thyroid as early as 15 days, and particularly after 60 days from the procedure.

Evaluation of Micro-Focused Ultrasound for Lifting and Tightening Neck Laxity


Background: A novel device using micro-focused ultrasound with high-resolution ultrasound visualization (MFU-V) produces non-invasive lifting and tightening of lax skin on the face and neck when treatment is delivered at a single focal depth (Ulthera® System; Ulthera, Inc., Mesa, AZ).
Objective: The following study was performed to test the hypothesis that customized application of MFU-V at two focal depths will produce clinical results that are superior to treatment at a single focal depth.
Methods and Materials: Adult subjects (N=71) with skin laxity in the lower face and neck were enrolled; 64 met all entrance criteria and received treatment. On the basis of physical and anatomical characteristics, patients were assigned in nonrandomized fashion to one of three treatment groups to undergo treatment on the submental, submandibular, lower neck, and platysmal areas with MFU-V at single or dual depths.
Results: Among evaluable subjects (N=64), investigator-assessment and subject-self-assessment demonstrated improved aesthetic changes at 60, 90, and 180 days after treatment. Overall, subjects that received MFU-V at two focal depths to the entire treatment area achieved slightly greater aesthetic improvement than subjects receiving MFU-V at single focal depths. There were no unexpected adverse events.
Conclusion: Applying treatment with MFU-V at two focal depths may provide improved aesthetic results in some subjects.

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