‘Barbie Botox’ and Other Ways to Keep Your Neck and Chest Skin Smooth

A plastic surgeon, a dermatologist, and an aesthetician reveal the best procedures and potions for a wrinkle-free décolleté.

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Summer is almost over, but we’re still in the mood to bare some skin. With designers like Bottega Veneta and Lanvin sending dresses with dramatic, plunging necklines down their fall 2023 runways, we’re adamant upon keeping our neck and décolletage in tip-top shape so we can get in on the trends, too. Even if you aren’t experiencing a crepey neck at the moment, a preventative approach never hurts. From the best in-office treatments and surgical procedures to transformative creams and serums, here are key tips from a set of world-class beauty authorities on how to keep your neck and bustline looking great.

The Lowdown

The skin on your neck and décolleté—the triangular area extending below the collarbones to just above the breast—is different from the skin on your face. According to Dr. Anne Chapas, a board-certified dermatologist with practices in the Hamptons and Manhattan, there are fewer oil glands and collagen in this zone. Because it lacks that natural moisturizer, these oft-neglected areas are more prone to wrinkling.

Not to mention that the skin in that region, especially the neck, is notably thin and subjected to repetitive movement, stretching, and sun exposure. As a result, you may see signs of aging—including lack of elasticity, hyperpigmentation and fine lines—on the neck before any other part of the body,” explains Dr. Dennis Gross, the world-renowned dermatologist and skincare innovator.

“Over the past 10 years, I’ve seen an increase of patients—particularly younger patients—coming in with horizontal lines across their neck: ‘tech neck,’” he says. These lines tend to surface before other signs of aging, and are caused by the repetition of looking up and down at our devices. He also notes that rapid weight loss as well as a reduction of natural hyaluronic acid due to menopause are other causes for thinning skin in those areas.

Genetic predisposition plays a large part in how our necks fare, adds Dr. Barry Weintraub, an NYC-based celebrity plastic surgeon. Excess neck skin and fat that crosses below the jawline—that unsightly “turkey gobble”—and protruding platysmal bands (the two cords that pop out from under the chin toward the clavicle)—are a reflection of the 46 chromosomes we receive from our parents. Over this, we have little control. However, a healthy lifestyle consisting of a nutritious diet and exercise can help us stay fit and defer the decline, he advises, “since weight gain stretches the skin and can contribute to a wobbly neck.”

As for the décolleté, the sun plays a major factor, especially if you were big on tanning in your youth. Unprotected exposure to UV rays will lead to splotchy pigmentation, crepiness, and wrinkles caused by a loss of a collagen.

Slowing Signs of Aging

Skincare does not stop at the jaw. First things first: wearing sunscreen daily on your face and body is essential. UV exposure speeds up the aging process, so keep your skin protected by limiting your time in the sun and wearing SPF 30 or higher—as well as reapplying it throughout the day—to keep skin looking its best, says Hollywood’s go-to aesthetician Shani Darden.

Apply your usual skincare routine to your face, neck, and décolletage for best results. Whatever you are using on your visage to combat signs of aging can be used on the other spots, too. According to Dr. Gross, when it comes to topical skincare, you really don’t need a specific product for the neck and décolleté. “The products you use for the face are usually just fine—as long as they don’t cause any redness or irritation,” he says.

Instead, focus on skincare with collagen-building ingredients. Collagen is the protein that gives your skin its structure and helps with firming and tightening. The more collagen present in your skin, the denser and smoother it is—meaning less lines, creases, and wrinkles. For the neck area, Dr. Gross recommends incorporating products with active vitamin C, retinol or using a red LED light to stimulate collagen production.

Vitamin C is one of Dr. Gross’s all-star favorite ingredients. “It not only stimulates collagen production, it’ll also protect your skin from damaging free radicals that accelerate signs of aging,” he notes. Retinol is Darden’s go-to for keeping the locale smooth and youthful-looking. “It helps boost skin’s elasticity and improves cell turnover to help reduce the appearance of fine lines and wrinkles,” she says. However, the skin on your neck can be more delicate, she warns, so it’s important to introduce actives slowly to avoid any irritation. She recommends following up application with a luxe moisturizer, such as Dr. Nigma’s Serum No. 1, to keep the area hydrated and supple.

For the décolleté, Dr. Gross’s recommended arsenal includes retinol, vitamin C ,and peels for diminishing the appearance of hyperpigmentation and wrinkles and helping with the turnover of dull, damaged cells. He also likes administering red LED light to reduce any ruddiness in the area, which can be attributed to past sun-exposure sins. And again, be sure that you are applying mineral sunscreen every single day, he stresses. “Without SPF protection, you are never going to get ahead of dark spots.” Sunscreen combined with a collagen-stimulating skincare routine will help not only slow down signs of aging, but even reverse them—he swears by it.

Aesthetic Procedures to Turn Back the Clock

“When I evaluate someone for treating their neck, I’m looking at their skin quality,” Dr. Chapas explains. “I’m looking at the fat underneath their neck as well as their muscles. Everybody has a different issue.” She finds that with thinner people, there’s a muscle issue; their platysmal bands become tighter over time, pulling down the neck and making the skin sag. Yet, for heavier folks, the unwanted fat underneath their neck is the reason for the droop. For others still, it’s the accumulation of sun damage and skin laxity that’s causing a decline. The chest has similar concerns, she goes on to explain, except for the fat issue.

To bring your neck and décolleté back to their former youthful appearance, there are a plethora of new rejuvenating procedures. For the neck, Dr. Gross loves using the Secret Pro laser, a dual modality system that allows one to safely and effectively treat the deepest dermal layers with radio-frequency microneedling and fractional CO2. RF microneedling uses pins to penetrate the skin and deliver a predetermined depth of radio-frequency energy to create collagen from the inside out—while smoothing out the texture and alleviating fine lines, sagging, and discoloration. “And by using a fractional CO2 laser, only a fraction of the skin is ablated, leaving part of it intact for faster healing, thus mitigating the risk of side effects and downtime,” he adds.

Sofwave, the buzzy new ultrasound device, is Dr. Chapas’s preferred non-invasive tool of choice to address droopy skin. It uses heat to help contract the skin while creating new collagen to give the area a lift, she explains. For hyperpigmentation, she likes employing the Clear and Brilliant Complete, a resurfacing laser that obliterates spots with little downtime. And for those pesky platysmal bands, she employs “trap tox”—also known as “Barbie Botox,” the latest cosmetic trend being hyped on TikTok. Small doses of injectable neurotoxins such as Botox or Dysport are used to elevate the muscles and reinforce the jawline, all of which creates the illusion of a slender, longer neckline. Look for a skilled practitioner and, for best results, limit the treatment to every six months; otherwise, she warns, you run the risk of paralyzing the muscles you use for swallowing.

However, if the neck is too foregone, going under the knife is the only way to go, says Dr. Weintraub, who goes on to explain that surgery is out of the question for the décolleté because “there is nowhere to place the incisions that would tighten it.” If a hanging neck is the issue, Dr. Weintraub usually performs an SMAS (submuscular aponeurotic system) lift. The procedure not only corrects excess skin, but it also reduces unwanted fat or subcutaneous tissue under the chin, creating a sharp, defined jawline and a smoother-looking neckline. It also allows for the rejoining of separated platysma bands, which often produce cords that create the look of an aged neck, he adds. After a neck lift, Dr. Weintraub likes to use a Sciton erbium laser to resurface the most superficial layers of skin to improve its texture and eradicate age spots. “By addressing each of the neck’s issues separately but concurrently during surgery, a miraculous result can be created, turning the clock back 15 or 20 years,” he says.

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