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Traditionally, the neck has been the most difficult area to manage, and I’m not talking about surgically, That’s obviously a facelift or neck lift. So, if you’ve got a sagging neck with platysma area, that is the bands that are the turkey gobbler hanging, that’s simply a necklace for facelift, which to me are synonymous terms. What I’m really talking about is neck skin. So, the sort of the creepy sun-damaged appearance. And what’s interesting is, if you look at that neck, you can actually see the demarcation of areas that have been exposed by sun. So, for example, if you look at the upper neck, which is wears a hat known as the chin, that over shelf of the chin oftentimes protects the upper neck from sun damage. And then the lower neck, which is not a which is more exposed, and the upper chest are typically very sun exposed. And if you tend to wear V-necks, you’ll see that it goes down all the way into the chest area. And sometimes women for the area between the breast tissue, where there are wrinkles. And so, this sun-damaged skin has been an area that has traditionally been very, very hard to manage. In the past I was focused on using fractionated CO2 laser because if you use a non-fraction laser, you can lead to scarring. The reason why the neck scars is that the oil glands called sebaceous glands that are used to heal the skin are much less plentiful in the neck. And so, there’s a higher risk of scarring when using lasers. By doing multiple passes of light lasers I simply did not see the results that I wanted to see in the neck. And as you know, if I do really good fillers or fat grafting, eyelid surgery, facelift, and then your neck skin and chest skin looks damaged, that really gives a way that there’s an unbalanced appearance. So, summary is, what do we do then? What? How do we fix the neck skin? If we want to create balance and better attractiveness that area, how can we improve that? So, lasers are not the way to do it, in my opinion. So, the way to do it for me is sort of breaking it down into surface damage, color, color appearance and then looking at texture and wrinkles. So, we break it down into those two layers. We think about the epidermis being more the color issues and the dermis being more the quality of skin, the wrinkles, and the texture. So how do we manage epidermis? So, the epidermis is the color damage on the outside. Well, first of all, you got to limit your sun exposure. If you continue to get sun exposure, you can’t treat the epidermis because one the color will come back, and the discoloration and the areas there. So, if your love playing golf, then I would say, wear a turtleneck or where a high collar, and try to limit the exposure during the day. And if you do love the sun, then any treatment I do for the epidermis is really going to fail, because it’s going to come back. So, the way to treat the epidermis is through a combination of a bleaching cream that I call BrightNow, which is a very inexpensive, easy product that makes things better. IPL technology that can help manage some of the vascular the red blush, the discoloration, Etc. And also, just light therapies, nothing very heavy, not big lasers, big therapies. But IPL, which is basically like a photo facial, which it doesn’t really have much downtime, or this bleaching cream to me are my two methods that I go to to help with these surfaces epidermal damage. Now, Part of the epidermis is also just texture. And there’s a part of that as well, but I’m going to call that damage more epidermal. I’m sorry, more dermal. So, like pores, texture, creepiness, especially when you like, move your arms or move your chest. You see those vertical striations coming down those wrinkles that come down that you don’t like. So, the way I do that is through two methods. One is radiofrequency, microneedle RF microneedle, micro needle by itself to make does very little. You need to heat up the dermis using radiofrequency device. And that makes such a big, big, big difference, and with a few treatments done as an office-based therapy, the dermis starts to tighten and become thicker like it was and its youth. And so what happens is the device I use where the needles go through the skin and engages and has a vacuum seal, so that the needles when they heat up, they don’t damage the epidermis or create issues on the surface, like burn injuries and things like that, it can heat up the dermis and then disengage with the release of the vacuum, and it moves on. And so, you can see the square pattern. So, it follows very, very effectively across the skin. And after a few sessions, you’ll start to see that area start to get better and tighter. The other technique I use is, which is called Mesotox, which is basically made dilute Botox, dilute botulinum toxin, which is the same thing you think about when you’re treating the upper face with Botox to get wrinkles. And it was very interesting if you look at people that have had really, really excellent Botox but extensive sun damage is that their lower face, neck, and chest actually begin to look much older than their upper third of the face. And to me, it’s a dead giveaway. They’ve had Botox because the area that you should have the most wrinkles, which is the upper third of the face, has the fewest wrinkles and the lower third of the face, or lower two-thirds of the face and the neck and the chest looks so much older. And I use this photo of this woman from the New York Times I saw that has like flawless upper facial skin with no wrinkles, pores, texture tone. There’s no vascular Lesions. Everything’s been cleaned by Botox and, and the lower third of the lower two-thirds of the face and the neck and chest look like 30 years older. And so, the question then is, how do you manage that? Well, Botox botulinum toxin, or Botox has incredible rejuvenate capacities, not only just toward wrinkles and creepiness and collagen regeneration, long-term Improvement. Not just the three-month fix that you’ve been told by your med spa, or someone else that really is not educated an understanding Botox, but it provides deep collagen regeneration. It also can limit. I cannot, I always say, can, because in your situation, with one or two treatments, I can promise you is going to do that. But you’ve done a lot of years of Botox. You’ll see that your skin is significantly better, so it can improve. the vascularity. Vascularity means those weird, red blushes that go across the skin. That’s a sign of sun damage. It can manage Dechromes with fancy medical term, describe color issues. As I just said, hey, I try to divide this into epidermis and dermis, and the boat botulinum toxin or Botox is trying to manage the deeper tissues. But no, it also manages the epidermis. It can manage quality of skin on the surface as well. So, with a few of these dilute Botox injections of the into the skin, you should start seeing some remarkable improvements. So, what should I go? RF microneedle or Botox? What’s interesting is two together are like Reese’s Peanut Butter Cups minus the calories. They work synergistically together, they improve the skin incredibly well, and that’s what I really had to me. They’re the best together. But for someone on a smaller budget, I do the RF microneedle. Someone has a little bit more generous budget. I do the Botox, the dilute Botox into the neck. And the combination together is incredible, as I said, so these therapies really work well, that was interesting, was with a neck or face lift a lot of that tissue that sagging should be improved. But a neck lift or facelift doesn’t manage surface damage to the skin or crepiness. So that’s an area that really needs its own independent therapy. And some people that have had a facelift come back and do these minor treatments. And so, people that are not ready for facelift, they do these minor treatments and some people, you know, so it’s either before or after, or in lieu of, but it’s not going to manage sagging neck tissue. Sort of like, if your timeout, the banding of the neck, where the jowls. This is not, it’s not strong enough to lift all of that. It’s just meant it’s just here to manage the surface damage to that neck and chest area.

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