Neck and Décolletage Rejuvenation Treatments

Last updated: 5 August 2026

The neck and décolletage are among the first areas to reveal the signs of ageing, yet they are frequently overlooked in both daily skincare routines and treatment plans. Practitioners recognise that comprehensive facial rejuvenation must extend below the jawline to achieve natural, harmonious results. Here, we explore the latest evidence-based approaches to neck and décolletage rejuvenation.

Why the neck ages differently

The skin of the neck and chest differs structurally from facial skin in several important ways. Research published in the Journal of the American Academy of Dermatology has demonstrated that:

• The epidermis is thinner, with fewer sebaceous glands producing protective lipids
• The dermis contains less collagen and elastin, which gives reduced structural support
• Blood supply is comparatively reduced, slowing cellular renewal
• The platysma muscle, a broad, thin sheet of muscle spanning the neck, contributes to banding and laxity as it weakens
• Chronic sun exposure on the décolletage (particularly in women) accelerates photoageing

These anatomical differences mean that the neck and décolletage often age more rapidly than the face, creating a visible disconnect that can undermine the results of facial treatments alone.

Common concerns we address

Patients most frequently present with the following neck and décolletage concerns:

• Horizontal neck lines (sometimes called “necklace lines” or “tech neck”)
• Vertical platysmal bands caused by muscle laxity
• Crepey skin texture from collagen and elastin degradation
• Mottled pigmentation and sun damage on the décolletage
• Loss of skin elasticity and mild to moderate laxity
• Poikiloderma of Civattea combination of redness, pigmentation, and skin thinning

Non-surgical treatment options

Botulinum toxin for platysmal bands

Botulinum toxin injections into the platysma muscle, a technique sometimes referred to as the “Nefertiti lift”, can effectively soften vertical neck bands and create a subtle lifting effect along the jawline. A 2020 study in Aesthetic Surgery Journal demonstrated that this approach produces visible improvement in 85% of patients, with results lasting three to four months.

Practitioners use precise micro-injection techniques to achieve natural-looking results whilst preserving normal neck movement and expression.

Dermal fillers for horizontal lines

Hyaluronic acid dermal fillers can be carefully placed into deep horizontal neck creases to restore volume and smooth the skin’s surface. This requires an experienced injector with detailed knowledge of neck anatomy, as the skin here is thinner and the vascular network differs from the face.

We typically use softer, more fluid filler formulations specifically designed for areas of thin skin and natural movement.

Radiofrequency skin tightening

Radiofrequency (RF) devices deliver controlled thermal energy to the deeper dermal layers, stimulating neocollagenesis, the production of new collagen. A systematic review in Dermatologic Surgery (2021) confirmed that RF treatments produce measurable improvements in skin laxity and texture, with an excellent safety profile for the neck area.

Results develop gradually over three to six months as new collagen matures, and are typically maintained with annual maintenance sessions.

Microneedling with growth factors

Microneedling creates controlled micro-injuries that trigger the skin’s wound healing cascade, promoting collagen and elastin production. When combined with topical growth factors or platelet-rich plasma (PRP), the results are enhanced. Research in the Journal of Cutaneous and Aesthetic Surgery has shown significant improvements in neck skin texture and crepiness after a series of three to four treatments.

Chemical Peels

Medium-depth chemical peels using trichloroacetic acid (TCA) at concentrations of 15-25% can effectively address pigmentation irregularities and improve overall skin quality on the décolletage. However, the neck requires more conservative concentrations than the face due to its thinner skin and reduced healing capacity.

Laser Treatments

Fractional laser resurfacing, both ablative and non-ablative, offers significant improvement for sun-damaged décolletage skin. Non-ablative fractional lasers are particularly suitable, as they stimulate collagen remodelling with minimal downtime. A 2022 study in Lasers in Surgery and Medicine reported that patients experienced a 40-60% improvement in décolletage photoageing after a series of treatments.

Topical treatments and prevention

Effective neck and décolletage care should include:

• Daily broad-spectrum SPF 30+ applied to the neck and chest, this is the single most important preventative measure
• Retinoids (starting at 0.025-0.05% for the neck) to stimulate collagen production
• Vitamin C serum for antioxidant protection and brightening
• Peptide-rich moisturisers to support barrier function
• Niacinamide to address pigmentation and strengthen the skin barrier

Creating a comprehensive treatment plan

We believe the most effective results come from combining complementary treatments. A typical neck and décolletage rejuvenation plan might include:

1. Initial assessment and skin analysis
2. Botulinum toxin for platysmal bands (if present)
3. A course of three to four microneedling sessions at monthly intervals
4. Radiofrequency tightening sessions between microneedling appointments
5. Medical-grade homecare programme
6. Six-monthly maintenance reviews

Each plan is tailored to the individual patient’s concerns, skin quality, medical history, and lifestyle factors.

Frequently asked questions

At what age should I start treating my neck and décolletage?
Prevention is always preferable to correction. The evidence supports incorporating SPF and basic anti-ageing actives (vitamin C, retinol) into your neck care from your late twenties. However, there is no wrong time to start, we see excellent results in patients of all ages.

Are neck treatments painful?
Most patients describe mild discomfort rather than pain. Practitioners use topical anaesthetic for microneedling and filler treatments, and most energy-based devices have built-in cooling systems. Botulinum toxin injections in the neck use very fine needles and are generally well-tolerated.

How long do results last?
This varies by treatment. Botulinum toxin results last three to four months, filler results six to twelve months, and collagen-stimulating treatments (microneedling, RF, laser) produce progressive improvements that can last one to two years with proper maintenance.

Can I have neck treatments if I have a thyroid condition?
In most cases, yes, though we always conduct a thorough medical history review. Certain energy-based devices may need to avoid the thyroid gland area. Your practitioner will discuss any specific considerations during your consultation.