How Old Are You? Check Your Neck!

Thursday, April 23, 2015 at 5:03 am

cyuneckMarilyn Kentz, the brunet half of the comedy duo The Mommies and author of The Mommy Load (HarperCollins, 1998) used to joke about getting sonic “action.” But it wasn’t a roll in the hay she was referring to–it was the jiggle of her “turkey neck” that the 50-year-old comedian was poking fun at.

Thanks to liposuction, Kentz is now action-free. “It worked,” she says. “There’s no question that my chinline looks better.” But a smooth new neck like hers is no laughing matter. It can Cost you–gulp!–$5,000.

While many of its may not choose an expensive treatment like the one Kentz had done, there are less-expensive ways to improve the skin and contours of the neck. Ironically, even though we hold a smooth, graceful neck in high esteem (think Audrey Hepburn), most of its ignore this area entirely,

Unfortunately, tile neck doesn’t stiffer neglect or the passage of time kindly. Prone to sagging and a unique form of sun damage because of its, thin skin, the neck is a prime age-revealer.

“Second to the eyes, the neck shows aging the most,” agrees Fredric S. Brandt, M.D., clinical associate professor of dermatology at the University of Miami School of Medicine in Coral Gables, FL. “Starting in your thirties, you lose strong jawline definition, and fine lines appear on the skin. In Your forties, jowliness begins, skin loses elasticity, and the platysmal bands (the cordlike neck muscle that’s visible on both sides of the Adam’s apple) become more obvious.”

But there are ways to stave off damage. Here’s how, starting with the basics.

At-Home Care The skin on the neck is different from facial skin. It’s thinner, with fewer hair follicles and very few oil glands. So while breakouts aren’t a common concern, lack of moisture is–which is why you should wash with a mild cleanser (never deodorant soap) and use a moisturizer daily, starting in your 30s. Recently, cosmetics companies have touted the benefits of creams formulated for the neck (see “Rating Neck Creams,” page 58). One product to avoid: fragrance, which can irritate sensitive neck skin and is best spritzed on oilier spots like your wrists.

And, never skip sunscreen. Forgoing daily protection puts you at risk for developing poikiloderma, a mottled-looking skin condition characterized by red, brown, and/or white splotches and caused by overexposure to the sun’s ultraviolet rays.

“Poikiloderma is very difficult to treat,” says Seth Matarasso, M.D., clinical associate professor of dermatology at the University of California School of Medicine, San Francisco. “Retin-A and chemical peels could accentuate these discolorations. Multiple treatments with the PhotDerm [a pulsed-light device used primarily on leg veins] may help, but your best bet is to use sunscreen religiously, and over time the blotches may fade.”

Wondering what your neck will look like in another decade or two? Aside from unprotected sun exposure, genetics play the biggest role in the aging process; people with olive or black skin, which tends to be oilier, or those With well-defined jaw- and chinlines fare best. But nearly as important as your genes in predicting how the skin on your face and neck will age is another age-influencer, one you can control-smoking, which reduces blood flow to the skin, says Paul Schnur, M.D., associate professor and chairman of the plastic surgery department at the Mayo Clinic in Scottsdale, AZ.

At the Doctor’s Office Many dermatologists suggest chemical peels for women over 30 whose necks develop fine lines, uneven tone, and less-than-stipple texture.

A series of peels, spaced a month apart, can undo some of the damage, while allowing patients to return to work the same day. The trick, however, is proceeding cautiously and gradually to avoid the neck’s high potential for scarring.

“You’ll need from three to six peels to see an improvement,” says Dr. Matarasso, who treats patients with glycolic acid before introducing them to a stronger peeling agent–trichloroacetic-acid (TCA). Both glycolic acids and TCAs are “light” peels that will make the neck redden and shed a fine layer of flaky skin, hut riot blister. Results can last two to three years if patients are diligent about using sunscreen. Cost: $100 per peel.

The advent of “gentler,” low-heat lasers has prompted a few doctors to try laser resurfacing sun-damaged necks. So far, these new lasers haven’t proven effective in erasing wrinkles or tightening skin, but they carry a lower risk of discoloring and permanently scarring the neck, says Tina Alster, M.D., clinical professor of dermatology at Georgetown University Medical Center in Washington, DC. “We just don’t know enough about laser resurfacing the neck,” she says. “At this point, a chemical peel is a better treatment.”

Surgical Options The following methods are more extreme routes to a younger-looking neck. While these measures may reverse some signs of the aging process, they also involve possible side effects and high price tags.

Liposuction is the most popular cosmetic procedure in the United States; yet, In a national survey of more than 15,000 cases, only 3 percent of all liposuctions were performed on double chins, jowls, and fatty necks. “People don’t realize that the neck can be liposuctioned very easily,” says C. William Hanke, M.D., professor of dermatology, pathology, and otolaryngology at Indiana University School of Medicine in Indianapolis. “Results are dramatic, more so than any other area of the body.”

Again, it’s important to be aware of the discomfort and possible complications that can arise from neck liposuctions. Patients counter the postoperative swelling by wearing a compression chin strap for two days, but bruising can linger for several weeks. While considered extremely rare, serious complications can arise, including a four- to eight-week paralysis of the lower lip and permanent skin dimpling.

Kentz underwent a two-step procedure that took 20 minutes total: external ultrasound (a technique that uses a handheld ultrasound device to massage the surface of the skin, softening the fat before it’s suctioned) and a facial liposculpture (which involves injecting the fat with an anesthetic-saline solution, then suctioning it out), According to Kentz’s surgeon, R. Patrick Abergel, M.D., associate professor of dermatology at the University of Southern California School of Medicine in Los Angeles, external ultrasound reduces postsurgical bruising and swelling. Kentz experienced neither. Says Dr. Hanke, “I’ve found external ultrasound to be very safe. But there’s no data ye to show it’s more effective than the tumescent method [liposculpture] alone.” Cost: $1,500 for a tumescent procedure to $5,000 for external ultrasound and liposuction.

Finally, there’s the option of a face-lift to rejuvenate the neck and the lower half of the face, considered the best solution for necks with lots of loose skin. (Eye and forehead lifts are separate procedures.)

Face-lifts today have evolved from a procedure that tightens only the skin, into a more complicated surgery that also realigns the underlying flat and muscle layers. The results look more natural and fast about ten years, says Dr. Schnur.

Face-lifts are considered major surgery, requiring a three-hour operation under general anesthesia, a night’s stay at the hospital or operating center, at least a week (if at-home recovery, and another two to three weeks of bruising and swelling. Possible complications: Postsurgical hematomas (internal bleeding) occur in 1 to 2 percent of patients; permanent nerve damage or skin loss (when a flap of skin is pulled too tight and loses blood supply) occurs in less than 1 percent. Cost: between $6,000 and $12,000.

If pricey beauty treatments for your neck aren’t on your to-do list this year, it still makes sense to protect your neck’s sensitive skin. When all else fails, you can always hide the droopiness with–what else–a turtleneck.

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