Nonsurgical Aesthetic Improvement of the Neck

BACKGROUNDAesthetic aging of the neck is usually multifactorial, reflecting variable contributions from submental and cervical adiposity, dermal and septal laxity, platysmal activity, skeletal deficiency, and loss of lower-face support. Isolated nonsurgical treatment may therefore underperform when the dominant anatomical driver is not correctly identified.

OBJECTIVEThis narrative review presents a practical, multimodal, algorithm-based framework for nonsurgical neck rejuvenation, integrating current evidence with clinical experience across commonly used treatment modalities.

METHODSRelevant literature on lipolytic therapies, energy-based devices, structural fillers, collagen stimulators, intradermal treatments, and neuromodulators was selectively reviewed and synthesized with clinical experience to develop an experience-informed treatment framework.

RESULTSPatients may be broadly categorized into three dominant but overlapping phenotypes: volume excess, skin laxity, and structural deficiency. Volume-dominant patients may benefit from initial volume reduction before tightening or structural refinement, whereas laxity-dominant patients may require energy-based remodeling and dermal-quality improvement. Patients with structural deficiency may benefit from chin or mandibular support to improve cervicomental balance. Adjunctive intradermal therapies and neuromodulators can be incorporated according to residual skin-quality changes and muscular contribution.

CONCLUSIONNonsurgical neck rejuvenation is best approached as a staged, multimodal, lower-face-inclusive process rather than treatment of an isolated cervical concern. The proposed framework is intended as a practical decision-support tool for individualized treatment planning, not as a validated or prescriptive treatment protocol.

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