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Aging of the Neck Decoded: New Insights for Minimally Invasive Treatments

  • Original Article
  • Facial Surgery
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Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Many signs of aging manifest in the neck region, including platysmal bands, excess skin, horizontal neck lines and decreasing contour of the neck. While the clinical signs of an aged neck are well-known, data determining the underlying aging process are limited.

Objective

To decode aging of the neck.

Materials and Methods

This prospective study investigated elasticity and firmness of skin, muscle activity and skin displacement upon muscular contraction in the neck in 77 young-, middle- and old-age individuals. Objective outcome measures, including 3-dimensional imaging, cutometry and surface electromyography, were utilized for all assessments.

Results

Mean firmness of skin decreased significantly from young to old individuals (0.37 ± 0.13 mm, 0.30 ± 0.12 mm and 0.26 ± 0.12 mm in young, middle and old subjects, respectively; p < 0.001). Gross elasticity decreased significantly from 75.1 ± 13.0% in young subjects, to 64.53 ± 15.7% in middle-aged subjects and 55.79 ± 13.0% in old subjects (p < 0.001). The mean y-axis skin displacement increased from 2.48 ± 4.33 mm in young subjects, to 3.11 ± 4.49 mm in middle-aged subjects and 3.61 ± 5.38 mm in old subjects (p = 0.006). The mean signal-to-noise ratio decreased significantly from 16.74 ± 5.77 µV in young subjects, to 14.41 ± 4.86 µV in middle-aged subjects and to 12.23 ± 5.99 µV in old subjects (p < 0.001).

Conclusion

This study provides insights into the interplay between skin elasticity, muscular activity and the reflected movement of the skin of the neck. Appreciation of these age-related changes lays the fundament for aesthetic treatments in this delicate region.

Level of Evidence IV

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Funding

This study was financially supported by a grant of Merz North America Inc. under the Grant Number 2262019.

Author information

Author notes

  1. Nina Engerer and Konstantin Frank contributed equally for first author and Denis Ehrl and Sebastian Cotofana contributed equally for last author.

Authors and Affiliations

  1. Department for Hand, Plastic and Aesthetic Surgery, Ludwig–Maximilian University Munich, Munich, Germany

    Nina Engerer, Konstantin Frank, Nicholas Moellhoff, Michael Alfertshofer, Riccardo E. Giunta & Denis Ehrl

  2. Skin Associates of South Florida and Skin Research Institute, Coral Gables, Florida, USA

    Jeremy B. Green

  3. Private Practice, New York City, USA

    Paul Z. Lorenc

  4. Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Stabile Building 9-38, 200 First Street, Rochester, MN, 55905, USA

    Grace K. Chaney & Sebastian Cotofana

Authors
  1. Nina Engerer
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  2. Konstantin Frank
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  3. Nicholas Moellhoff
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  4. Michael Alfertshofer
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  5. Riccardo E. Giunta
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  8. Grace K. Chaney
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  10. Sebastian Cotofana
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Correspondence to Sebastian Cotofana.

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Engerer, N., Frank, K., Moellhoff, N. et al. Aging of the Neck Decoded: New Insights for Minimally Invasive Treatments. Aesth Plast Surg 46, 1698–1705 (2022). https://doi.org/10.1007/s00266-022-02961-0

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  • DOI: https://doi.org/10.1007/s00266-022-02961-0

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