TL;DR
The neck and decolletage are often called the forgotten zones of anti-ageing, yet they are among the first areas to reveal true age. This guide provides a comprehensive approach to…
The neck and decolletage are often called the forgotten zones of anti-ageing, yet they are among the first areas to reveal true age. This guide provides a comprehensive approach to rejuvenating these challenging but important areas.
Reviewed by the Axiom Aesthetics Clinical Team | Last updated: February 2026
Why the Neck and Decolletage Age Differently
The neck skin is thinner than facial skin, contains fewer sebaceous glands, has less subcutaneous fat for structural support, and is subject to constant mechanical stress from head movement. The decolletage is among the most sun-exposed body areas, yet receives far less skincare attention than the face. Both areas lack the muscle tone that helps support facial skin, leading to earlier and more pronounced laxity, crepiness, and photodamage compared to the well-maintained face above.
Common Concerns
Neck
Horizontal necklines (necklace lines or tech neck from looking at devices), platysmal bands (visible vertical muscle cords), skin laxity and jowling, turkey neck (loose hanging skin), and submental fullness (double chin). Each requires a different treatment approach or combination.
Decolletage
Solar lentigines (sun spots), crepey skin with fine lines, poikiloderma (redness, pigmentation, and telangiectasia from chronic sun damage), loss of skin quality and radiance, and sleep wrinkles from side sleeping. The chest is particularly prone to photodamage due to decades of sun exposure.
Non-Surgical Treatments
Botox for Platysmal Bands and Necklace Lines
Botulinum toxin injected into the platysma muscle softens visible bands and can provide a subtle lifting effect (the Nefertiti lift). For necklace lines, small doses placed along the horizontal creases can soften these static lines. Typical dosing is 20-40 units for bands and 10-20 units for necklace lines.
Biostimulators
Profhilo is particularly effective for neck and decolletage rejuvenation, delivering intense hydration and stimulating collagen and elastin in skin that is often too thin for traditional fillers. Two sessions four weeks apart typically produce significant improvement in skin quality, crepiness, and hydration lasting 6-9 months.
Energy-Based Devices
Radiofrequency microneedling (Morpheus8) delivers controlled thermal energy for skin tightening and collagen stimulation. HIFU (Ultherapy) targets the SMAS layer for deeper lifting. IPL and vascular lasers address redness and pigmentation on the decolletage. Multiple sessions produce cumulative improvement.
Chemical Peels and Laser Resurfacing
Superficial to medium-depth peels improve texture, pigmentation, and skin quality. Fractional laser (non-ablative or ablative at conservative settings) addresses photodamage and crepiness. The neck and decolletage heal more slowly than the face, so conservative treatment with longer recovery intervals is essential to avoid complications.
Surgical Options
For significant laxity, surgical neck lift (platysmaplasty) addresses excess skin and muscle laxity that non-surgical treatments cannot resolve. This involves tightening the platysma muscle, removing excess skin, and potentially liposuction of submental fat. Recovery is 2-3 weeks with results lasting 7-10 years.
Prevention and Maintenance
Daily SPF application to the neck and chest (often neglected), extending facial skincare routine to the neck and decolletage, using retinoids on these areas (starting at lower concentrations), sleeping on the back or using a specialised pillow to prevent sleep wrinkles, and wearing sun-protective clothing are all essential for maintaining results and preventing further damage.
Frequently Asked Questions
Why does my neck look older than my face?
The neck receives less skincare attention, has thinner skin with fewer oil glands, and is subject to constant mechanical stress. Most people apply SPF and anti-ageing products to their face but neglect the neck and chest, creating a visible discrepancy over time. Starting neck-specific care can help close this gap.
Is Profhilo good for the neck?
Profhilo is one of the most effective treatments specifically for neck rejuvenation. Its high concentration of hyaluronic acid provides intense hydration and biostimulation in thin neck skin that is often unsuitable for traditional fillers. Two sessions produce noticeable improvement in skin quality, firmness, and crepiness.
Can exercise fix my turkey neck?
While neck exercises can modestly improve platysma muscle tone, they cannot address excess skin or significant laxity. For mild concerns, non-surgical treatments such as RF and HIFU can help. For significant turkey neck with redundant skin, surgical intervention is likely the most effective solution.
How do I treat chest wrinkles from side sleeping?
Prevention (back sleeping or specialised pillows) is most effective. For existing damage, combination treatment with biostimulators (Profhilo), fractional laser or RF microneedling for collagen stimulation, and consistent topical retinoid use produces the best improvement. Results take 3-6 months to fully develop.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Individual results vary. Always consult a qualified medical or aesthetic professional for personalised advice.
This content is provided for informational purposes only and does not constitute medical advice. Individual results may vary. Always consult with a qualified medical professional before undergoing any treatment. All treatments carry potential risks and side effects which will be fully discussed during your consultation.
Medical Disclaimer: This content is provided for informational purposes only and does not constitute medical advice. Individual results may vary. Always consult with a qualified medical professional before undergoing any treatment. All treatments carry potential risks and side effects which will be fully discussed during your consultation.