Neck and décolletage rejuvenation

A guide to understanding aesthetic concerns of the neck and décolletage

As with the hands, the skin of the neck and décolletage tends to show signs of ageing earlier and more visibly, for several reasons. On the one hand, these areas have very limited supportive musculature, which makes them particularly vulnerable to the effects of gravity and predisposes them to early sagging. This laxity is further aggravated by the fact that the dermis of the neck and décolletage contains lower levels of collagen and elastin—two key components responsible for skin firmness and elasticity.

In addition, the skin in these areas is thinner and more fragile, with little or no hair and very few sebaceous glands. This makes it inherently more vulnerable to the passage of time and to external aggressors. Furthermore, the neck and décolletage often receive less consistent care than the face, particularly in terms of sun protection and hydration, which contributes to premature ageing.

Aesthetic concerns affecting the neck and décolletage

Some of the most common aesthetic concerns observed in the neck and décolletage include the following:

Horizontal neck lines (Venus rings)

Venus rings—also known as the “necklace of Venus”—are horizontal wrinkles that appear across the neck. They are primarily caused by age-related loss of skin firmness, although they may appear earlier due to genetic factors, significant weight loss or repetitive movements. In any case, the neck naturally contains less collagen and elastin than other areas, making it more prone to these lines.

Vertical wrinkles on the décolletage

Vertical wrinkles on the décolletage typically result from excessive sun exposure without adequate protection or from habitual postures that repeatedly crease this area, such as sleeping on one’s side or stomach. These wrinkles tend to worsen in dry skin or in patients who neglect regular skin hydration. As collagen production declines with age, these lines become increasingly pronounced.

Double chin

A double chin refers to the accumulation of fat beneath the chin. This condition alters facial contours and jawline definition and may be exacerbated by genetic predisposition, age-related skin laxity, excess weight and certain postural habits, such as prolonged forward head posture when reading or using electronic devices.

Pigmentation

The skin of the neck and décolletage contains lower levels of melanin—the natural pigment responsible for skin, hair and eye colour. This makes these areas particularly susceptible to sunburn and pigmentary changes caused by ultraviolet radiation. Sunspots and solar lentigines are therefore very common, especially as sun protection is frequently overlooked in these regions.

Skin laxity

Skin laxity is the result of the progressive loss of collagen and elastin within the supportive tissues, including the skin. This decline becomes more evident from the age of 35 and accelerates around the age of 40, leading to sagging and loss of firmness. These signs of ageing tend to appear earlier and more prominently in the neck and décolletage due to their naturally lower collagen and elastin content.

Platysmal bands

Platysmal bands are vertical, cord-like structures that become visible on the neck, extending from the chin to the clavicle. They are caused by weakening of the platysma muscle—a thin muscle with limited physiological function that contributes to lowering the jaw and pulling the corners of the mouth downward, particularly during expressions of tension or stress.

These bands may become more pronounced with excessive muscle contraction during speech or facial expression. This hyperactivity can accentuate sagging in the lateral chin area and contribute to a squarer, less defined appearance of the lower face and jawline.

“In most cases, the best results are achieved by combining different therapeutic options and acting at an early stage.”

Neck and décolletage rejuvenation

Some of the most commonly used aesthetic treatments for rejuvenating the neck and décolletage include the following:

Laser and intense pulsed light (IPL)

Laser and IPL are among the most effective options for treating sunspots and solar lentigines caused by cumulative sun damage in the neck and décolletage. These treatments can be combined with dermatologist-prescribed topical depigmenting agents applied in the weeks prior to treatment, or with chemical peels that renew the skin surface.

Mesotherapy

Mesotherapy involves the injection of hydrating active ingredients, vitamins and trace elements to revitalise the skin, improve vascularisation and provide an immediate refreshed and rejuvenated appearance. The microinjections themselves activate the body’s natural repair mechanisms, enhancing the overall effect of the treatment, which does not require specific recovery measures.

Injection of a muscle-relaxing medication

The injection of a muscle-relaxing medication at strategic points in the neck is effective in softening platysmal bands. The result is a smoother, more youthful-looking neck and improved definition of the lower facial contours.

Regenerative techniques

Regenerative treatments stimulate the skin’s natural repair processes and promote the production of new collagen and elastin. The result—a firmer, brighter and higher-quality skin—develops progressively over the weeks following treatment and is maintained for several months.

Skin tightening systems

These systems consist of resorbable devices that are inserted and anchored beneath the skin of the neck using fine cannulas, without the need for surgical incisions. Prior to placement, the trajectory of the device is carefully mapped to guide accurate positioning. Once implanted, these systems have a dual effect. They provide immediate improvement in skin laxity and associated wrinkles through a mechanical lifting and anchoring effect, while also stimulating the production of new collagen and elastin over the following weeks. This leads to progressive improvement in skin firmness and quality. Severe cases of neck laxity and tissue sagging that do not respond to minimally invasive treatments require surgical correction with a neck lift.

Submental fat reduction

There are two effective treatments for eliminating a double chin (localised fat accumulation in the submental area):

Injectable treatment for double chin reduction

This treatment consists of injecting an active substance that dissolves fat deposits beneath the chin, resulting in a more defined profile and a slimmer-looking neck. Although these injections may exert a mild skin-tightening effect, injectable fat-dissolving treatments are not indicated in cases of significant skin laxity or pronounced tissue sagging.

The procedure may cause some discomfort during injection, although it is generally well tolerated by patients. Several sessions are usually required, and visible results typically begin to appear around one month after the start of treatment.

Cryolipolysis for double chin reduction

Cryolipolysis eliminates localised fat through controlled cooling. The cryolipolysis device used at our centre includes a specialised applicator designed for the submental area, which destroys adipocytes by exposing them to temperatures of approximately –11°C. A protective membrane ensures that the surrounding skin and tissues are not damaged. The results of cryolipolysis are permanent, as the destroyed fat cells do not regenerate.

Before selecting a treatment for submental fat reduction—and in order to ensure optimal results—careful patient selection is essential. Candidates must present with localised fat without significant skin laxity. Otherwise, removing submental fat may worsen tissue sagging and compromise aesthetic outcomes.

For this reason, our specialists perform a comprehensive skin examination, along with pre-treatment ultrasound imaging, which allows precise localisation of the fat deposit, assessment of its volume, and evaluation of skin thickness, density and quality. This detailed assessment also enables us to determine which complementary treatments may be appropriate to further improve the appearance of the double chin and neck area.

These systems consist of resorbable devices that are inserted and anchored beneath the skin of the neck using fine cannulas, without the need for surgical incisions. Prior to placement, the trajectory of the device is carefully mapped to guide accurate positioning. Once implanted, these systems have a dual effect. They provide immediate improvement in skin laxity and associated wrinkles through a mechanical lifting and anchoring effect, while also stimulating the production of new collagen and elastin over the following weeks. This leads to progressive improvement in skin firmness and quality. Severe cases of neck laxity and tissue sagging that do not respond to minimally invasive treatments require surgical correction with a neck lift.

More information

Below you will find the authorship and references for the information provided on this page: