Neck Aging and Rejuvenation: A Balanced Approach to Assessment and Treatment

ABSTRACT Introduction The neck is typically the earliest and most visible site of aging‐related esthetic changes; it is an area about which patients frequently express esthetic concerns and seek approaches to rejuvenation. This narrative review examines the current understanding of age‐related structural and cellular changes in the neck and skin, treatment approaches to neck rejuvenation, specifically noninvasive and minimally invasive approaches including skincare, and key patient factors to consider. Methods A literature search of relevant publications was performed. Experience‐based recommendations for clinical assessment and treatment approach are provided to complement the current literature. Results Neck aging results from a combination of intrinsic factors, such as genetic background, and extrinsic factors, primarily ultraviolet light exposure. Positive treatment outcomes begin with thorough patient assessment, including neck aging status, patient‐specific intrinsic and extrinsic factors, and evaluation of skin type, which may help predict positive (e.g., skin tightening) and negative (e.g., dyspigmentation) dermal responses to specific procedures. In addition to skincare, a range of noninvasive, directed‐energy techniques (e.g., chromophore‐based lasers, ablative lasers, intense pulsed light, microfocused ultrasound, cryolipolysis, laser‐assisted lipolysis, and radiofrequency irradiation) and minimally invasive techniques (e.g., neurotoxins, microneedling, and fillers) are currently used for neck rejuvenation. A comprehensive approach to assessment and treatment contributes toward improved patient outcomes. Conclusions The neck aging process develops over time, and a prejuvenation strategy, including effective skincare, should be considered. The development of comprehensive noninvasive and minimally invasive techniques geared toward the neck and face as a single entity should provide better outcomes and fulfillment of patient esthetic goals for this critical area.