Minimally Invasive Neck Rejuvenation with LUXETITE RF Microneedling with PRP, Hyperdilute CaHA Biomodulation, PDO Threading and Botulinum Toxin Clinical Result

Minimally Invasive Neck Rejuvenation with LUXETITE RF Microneedling with PRP, Hyperdilute CaHA Biomodulation, PDO Threading and Botulinum Toxin Clinical Result

By Dr. Sherryl Shipes DO

Presented as faculty at Vegas Cosmetic Surgery and Aesthetic Dermatology Show June, 2022

The neck is usually the first place that men and women show the visible signs of aging.  This is a common complaint at LUXE Medical Spa.  Patients present to me for rejuvenation options almost daily.  The neck undergoes intrinsic changes as well as extrinsic changes in every layer and we as aesthetics physicians must be ready for these patients to grace our practices.  So how do we begin to tackle these aging boomers, who have large amounts of disposable income, and who are looking to do whatever necessary, often short of getting surgery, to achieve their former “vim, vigor and vitality” to the neck tissue.  Nonsurgical interventions are at the vanguard of my practice, either as stand-alone therapies or in conjunction with other modalities with different functions, in order to achieve a successful outcome.

 

Key findings:

 

Methods
Eight subjects were enrolled of various ages and genders.  We began our protocol by taking medical grade photographs using ringlight.  We then numbed the neck, drew blood for PRP and began centrifuging the patient’s blood while they were numbing with BLT anesthetic.  We installed a facial head onto our LUXETITE RF Microneedling device, and set the RF at 150, suction at 2 (max), and depth at 2mm.  We then do a PRP Facial using the 1.0 depth of our microneedling device known as the LUXEGold over the entire bed of freshly microneedled skin on the neck.  We then injected 4:1 diluted CaHA (Radiesse) with 6cc of saline mixed with one 1.5 cc Radiesse syringe and used the SoftFil Cannula at 22 gauge to install the CaHA in the supraplatysmal plane right into the subcutaneous tissue directly below the dermis superficially.  We utilize a fan technique, with two entry points at the sternocleidomastoid superiorly and two entry points at sternocleidomastoid inferiorly for the lateral neck areas.  Then a fan technique is also employed at the mental area.  We install 1.5 cc in the submental area at a 4:1 dilution.  All application of the material is retrograde. We then install barbed polydioxanone threads from lateral aspect of neck to medial in a crosshatch fashion, 2 per side and pull and set the barbs.  The last part of the protocol is 60 units of botulinum toxin diluted to 2.5 mL sterile saline to 100 units of botulinum toxin, injected in 1 cm squares with 31 gauge needle very superficially in order to install the toxin into the platysmal musculature. 

 

The minimally invasive nature of our five pronged approach to neck rejuvenation results in none to scant downtime, making our protocol particularly appealing to the patient. Our recommendations presented on this poster are highly consistent with the previously published consensus guidelines from other studies which have approached neck rejuvenation from a “one to two” choices mentality rather than the proverbial “do everything possible” mentality.  We are enthusiastic about these results but emphasize that the injector has to be highly trained in multiple modalities and the proper depths to inject the CaHA and the botulinum toxin for maximal benefit.  This presentation is to laud our results in the “do everything possible” realm, and the proof is that we have many satisfied patients who have undergone this exact protocol with dramatic results.  Our protocol is intended to serve as guidance based on the experience of expert injectors who have successfully treated the neck with non- to minimally invasive neck techniques.

Z Paul Lorenc ¹, Jeanette M Black, Jessie S Cheung, Annie Chiu ², Roberta Del Campo, Alan James Durkin ³, Miles Graivier, Jeremy B Green ⁴, Gideon P Kwok ⁵, Keith Marcus, Charalambos Babis Rammos ⁶, William Philip Werschler ^7 “Skin Tightening With Hyperdilute CaHA: Dilution Practices and Practical Guidance for Clinical Practice”. Aesthet Surg J 2022 Jan 1;42(1):NP29-NP37. doi: 10.1093/asj/sjab269.

Jennifer Kim Song, Jiyeon Chang ¹, Kae Won Cho ², Chang Yong Choi ³Favorable Crisscrossing Pattern With Polydioxanone: Barbed Thread Lifting in Constructing Fibrous Architecture. Aesthet Surg 2021 Jun 14;41(7):NP875-NP886. doi: 10.1093/asj/sjab153.

Louis DeJoseph ¹, Houmehr Hojjat ², Paul Pedram Daraei ³     Minimally Invasive Triple Therapy of the Presurgical Neck. Facial Plast Surg 2021 Apr;37(2):249-258.doi: 10.1055/s-0041-1725103. Epub 2021 Mar 31.

We would like to acknowledge MERZ Aesthetics, Inc. for the study materials and the literature that confirmed that our protocols at LUXE Medical Spa are backed by good scientific practices.