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Coming & Going
By: Miles Graivier, MD
Nora Ephron famously said that she hated her neck and was a fan of turtlenecks for exactly that reason. “Our faces are lies and our necks are the truth. You have to cut open a redwood tree to see how old it is, but you wouldn’t if it had a neck,” the author and film maker quipped.
But thanks to a host of new minimally invasive treatments that volumize the neck, such as fillers and microfat, turtlenecks are so yesteryear. In their place are halter, empire and sweetheart necklines that show a whole lot more skin.
Anatomic studies have shown that aging shrinks cervical fat compartments. Shallow injections of hyaluronic acid-based fillers can erase lines on the neck, filling them from the inside out, and microfat gives fat grafts a better shot at survival, which can also help naturally volumize the neck. Instead of line filling alone, diffuse subdermal and deep dermal injections can help fill and rejuvenate the deflated neck. After all, what’s good for the face …
Platysmal bands? Not as much a problem thanks to careful neuromodulator injections, temporary radiofrequency nerve ablations, absorbable thread lifting, and repeat IPL, which can improve neck skin and muscular bands without invasive surgery. Now women and men can show off their necks without fear that it will reveal their real age.
There’s another reason we are showing more neck lately too—the uptick of minimally invasive treatments that reduce submental fat, such as CoolMini, Kybella, and SculpSure, as well as radiofrequency or laser-assisted submental and jawline contouring—has also led to a rapid rise in less invasive treatments. This trend is here to stay.
SMOKE AND MIRRORS
Play on words aside, we are seeing a dip in smoking and the use of traditional mirrors.
Aesthetic surgeons who encourage patients to quit smoking before a procedure may be putting a serious dent in the tobacco epidemic. It’s true! New research shows that those who quit smoking for at least two weeks before a cosmetic procedure will stay the course or at least smoke less in the years after the surgery. In fact, about 40 percent of patients said they no longer smoked cigarettes on a daily basis, and nearly one-fourth had not smoked at all since their cosmetic surgery procedure. The findings appear in the September 2017 issue of Plastic and Reconstructive Surgery.
And with the smoke goes the mirrors. Growing numbers of people use their smart phones or devices to make sure their lipstick isn’t running or that their hair is not out of place instead of a pocket mirror. Some may use the built-in camera app and others choose to download one or more of the many available mirror apps. (And if they don’t like what they see, well there’s an image-enhancing app for that, too—along with some evidence that such selfie scrutiny is sending more patients to our doors for consults.)