허쉬성형외과의원

Neck Wrinkle Lifting Methods: Do They Differ for Horizontal and Vertical Neck Wrinkles?

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Although many people consistently care for their facial skin, care for wrinkles on the neck is often delayed. 

One day, you may notice clearly defined horizontal lines on your neck in the mirror 

or vertical bands extending from beneath the chin down the front of the neck.

Neck wrinkles are not simply changes caused by aging. Various factors may affect them, including skin thickness and elasticity, 

habitual neck movements, and changes in the tissues beneath the skin.

Then how should neck wrinkle lifting be approached?

First, it is important to understand that horizontal and vertical neck wrinkles may differ in both their causes and the structures that make them prominent. 

Rather than choosing a method based only on the direction of the wrinkles,

it is important to assess the skin condition, muscular changes, and the degree of sagging around the neck together.

Today, we will examine in detail the causes of neck wrinkles, the differences between horizontal and vertical neck wrinkles, available lifting methods, 

and points to check before surgery.

Why Do Neck Wrinkles Develop?​​​​​​​​​​​​​​​​​

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Like facial skin, the elasticity of neck skin changes over time. 

When habitual neck movements and changes in the tissues beneath the skin are added, wrinkles may gradually become more noticeable.

Common factors that affect neck wrinkles include the following.

1. Reduced Skin Elasticity

: As the structures and elasticity supporting the skin change over time, wrinkles can form more easily on the skin's surface. 

Existing wrinkles may appear more pronounced in areas that repeatedly fold.

2. Repetitive Neck Movements and Posture

: Repeatedly lowering the head while looking at a smartphone or working at a desk for long periods can cause the neck skin to fold frequently. 

Although these movements are not the sole cause of neck wrinkles, they can affect where the skin folds and how noticeable the wrinkles become.

3. Characteristics of Skin Tissue

: Skin thickness, elasticity, and the depth at which wrinkles have formed vary from person to person. 

Horizontal neck wrinkles may appear even at a relatively young age, 

and these wrinkles do not necessarily mean that aging has progressed significantly.

4. Sagging of the Skin and Muscles Around the Neck

: Over time, the neck skin may loosen and the borders of the muscles at the front of the neck may become more prominent. 

In such cases, changes may appear not only as wrinkles on the skin's surface but also in the contour extending from beneath the chin to the neck.

Therefore, when evaluating neck wrinkles, it is necessary to assess not only the number and depth of the lines 

but also whether the skin has becomeloose and whether muscular changes are present.

Horizontal and Vertical Neck Wrinkles: What Is the Difference?​​​​​​​​​​​​​​​​​​

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Neck wrinkles can broadly be examined as horizontal lines or vertically prominent lines according to their appearance.

1. Horizontal Neck Wrinkles

Horizontal neck wrinkles appear as lines running across the front of the neck. They may appear as a single line or as several overlapping lines.

They can also be observed at a relatively young age and may be associated with several factors, 

including skin characteristics, repetitive neck movements, and lifestyle habits.

When assessing horizontal neck wrinkles, it is helpful to check the following points.

Whether the wrinkles are shallow and limited to the skin's surface

Whether deep wrinkle grooves have formed

Whether the overall elasticity of the neck skin has decreased

Whether sagging is also present beneath the chin and around the neck

If the wrinkles are shallow and skin sagging is not pronounced, skin-elasticity care or laser procedures may be considered. 

In contrast, if the wrinkles are deep and accompanied by sagging of the skin and surrounding tissues, it may be appropriate to consider whether a surgical approach is needed.

However, because horizontal neck wrinkles do not all arise from the same cause,

it is difficult to determine the appropriate method based solely on the direction of the wrinkles.

2. Vertical Neck Wrinkles

Vertical neck wrinkles appear as vertical lines or bands on the front of the neck.

Along with changes in the skin, they may be associated with more prominent borders of the platysma muscle 

at the front of the neck or with separation and sagging of the muscle.

If vertical bands extending from beneath the chin down the front of the neck are particularly noticeable,

both the skin surface and the condition of the muscles should be assessed.

When evaluating vertical neck wrinkles, the following points are checked.

Whether prominent vertical muscle bands are present at the front of the neck

Whether the skin beneath the chin is loose

Whether excess fat has accumulated around the neck

The degree of reduced elasticity in the neck skin

If muscle separation or sagging is considered the primary cause, a surgical procedure such as neck-band muscle plication may be considered.

However, not every vertical line is caused by muscular changes. The appropriate approach may differ depending on skin thickness and the form of the wrinkles.

​How Should a Neck Wrinkle Lifting Method Be Chosen?​​​​​​​​​​​​​​​​​​

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Neck wrinkle lifting does not mean improving every type of wrinkle with a single method.

Nonsurgical and surgical approaches can be considered according to the depth of the wrinkles, 

skin elasticity, muscular condition, and degree of sagging around the neck.

1. Skin-Elasticity Care and Laser Procedures

If the wrinkles are relatively shallow and skin sagging is not severe, skin-elasticity care or laser procedures may be considered according to the skin condition.

These methods are intended to manage fine lines on the skin's surface and reduced elasticity.

However, they cannot necessarily improve deeply established wrinkles, substantially loose skin, or changes in the muscles at the front of the neck in the same way.

Therefore, before choosing a procedure, it is necessary to determine whether the current neck wrinkles are primarily a surface-level skin issue or are accompanied by changes in the underlying tissues.

2. Neck Lift for Horizontal Wrinkles

A neck lift may be considered when horizontal neck wrinkles have deepened and are accompanied by reduced skin elasticity and sagging around the neck.

The HERSHE Plastic Surgery website lists deep horizontal wrinkles accompanied 

by sagging of the skin and surrounding tissues as one situation in which a neck lift may be considered.

The surgical method presented on the website involves making an incision near the hairline behind the ear and dissecting the skin layer, 

SMAS layer, and surrounding tissues, 

then pulling and securing the sagging tissues, removing excess skin, and closing the incision.

The specific extent and method of surgery may vary depending on the individual's skin condition and degree of sagging.

When considering a neck lift, it is helpful to review the following points rather than thinking only about tightening the wrinkles.

Depth and distribution of the wrinkles

Extent of loose skin

Degree to which the boundary between the neck and jawline has become less defined

Incision location and scar-management plan

Postoperative recovery and possible complications

Because a neck lift is a surgical treatment, possible risks such as scarring, bleeding, infection, 

and nerve injury should be discussed thoroughly with the medical team.

3. Neck-Band Muscle Plication for Vertical Wrinkles

Neck-band muscle plication may be considered when vertical muscle bands at the front of the neck are prominent or the muscles have separated and sagged to either side.

According to the HERSHE Plastic Surgery website, the procedure involves an incision beneath the chin, 

dissection of the skin and muscles, removal of some excess fat when necessary, and bringing together and securing the separated muscles.

This procedure does not target only wrinkles on the skin's surface. 

It is an operation considered after determining whether changes in the muscles at the front of the neck are the primary cause.

However, muscle plication is not necessary for every case of vertical neck wrinkles. Skin elasticity, muscular condition, and fat distribution should all be assessed together.

Before surgery, it is important to review the incision location and extent, anesthesia method, recovery process, and the possibility of scars and complications.

4. Considering Neck and Facial Sagging Together

In some cases, neck wrinkles are accompanied by loose skin beneath the chin or sagging in the lower face.

In these situations, the overall contour from the face and jawline to the neck should be evaluated rather than examining the neck alone.

The HERSHE Plastic Surgery website states that correction through a facelift may also be considered when extensive neck and facial sagging occur together.

However, a facelift may involve a broader area of dissection and surgery and requires caution regarding complications such as nerve injury.

Therefore, the presence of both neck wrinkles and facial sagging does not necessarily mean that a facelift must be selected. 

The decision should be based on a comprehensive consideration of the individual's condition, treatment goals, and surgical risks.

​Can Horizontal and Vertical Neck Wrinkles Be Improved at the Same Time?​​​​​​​​​​​​​​​​​​

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Horizontal and vertical neck wrinkles may occur at the same time.

For example, deep horizontal wrinkles may be present at the front of the neck while the skin is also loose and the muscular borders appear as prominent vertical bands.

In such cases, it is important to assess the following factors comprehensively rather than choosing a method based on a single wrinkle.

1. Check how deep the wrinkles on the skin's surface are.

2. Assess how much skin elasticity has decreased and the degree of loose skin.

3. Check whether separation or sagging of the muscles at the front of the neck is present.

4. Evaluate whether fat beneath the chin or sagging of the lower face is affecting the neck contour.

Depending on these factors, skin-elasticity care or laser procedures may be considered, or surgical methods such as a neck lift or neck-band muscle plication may be reviewed.

Whether multiple methods can be combined depends on the individual's condition. Combining every method is not necessarily required, 

so the purpose, expected changes, and risks of each option should be fully understood before making a decision.

Points to Check Before Neck Wrinkle Lifting​​​​​​​​​​​​​​​​​

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If you are planning neck wrinkle lifting, accurately assessing your current condition should come before simply comparing the names of procedures or operations.

1. Identify the Cause of the Wrinkles.

In addition to determining whether the wrinkles are horizontal or vertical, check whether reduced skin elasticity, muscular changes, and skin sagging are also present.

2. Understand the Difference Between Nonsurgical and Surgical Methods.

Skin-elasticity care and laser procedures may be considered according to the skin condition, 

whereas a neck lift and neck-band muscle plication are surgical methods targeting sagging of the skin and surrounding tissues or muscles. 

Because their purposes differ, it is difficult to compare them simply by asking which method is better.

3. Check the Recovery Period and Plan for Returning to Daily Activities.

The recovery period varies depending on the type and extent of the procedure or surgery and the individual's recovery condition. 

If surgery is planned, it is advisable to receive information in advance about swelling, bruising, wound care, and activity restrictions.

4. Review the Risks and Limitations of Surgery.

Various complications may occur after surgery, including bleeding, infection, scarring, and changes in sensation. 

Both the expected changes and the possible risks and follow-up care plan should be reviewed.

How Should You Care for Your Neck After Neck Wrinkle Lifting?​​​​​​​​​​​​​​​​​​

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Care after neck wrinkle lifting differs according to the procedure or surgery selected.

If you have undergone surgery, follow the wound-care instructions and appointment schedule provided by the medical team, 

and avoid actions that place excessive strain on the neck during the early recovery period.

Until the wound has stabilized, avoid strong massage performed at your own discretion and repeated stimulation of the wrinkled area.

The following practices may be incorporated into routine neck-skin care.

1. Apply sunscreen thoroughly to the neck as well

2. Use