Nationally renowned board-certified plastic surgeon, Dr. Jose Rodríguez-Feliz serves local and international clients at his boutique aesthetic practice in Miami, FL. Dr. Rodríguez-Feliz is one of few surgeons in the United States that after completing his Residency in Plastic and Reconstructive Surgery, pursued further training in Oculoplastic and Aesthetic Surgery under world-renowned plastic surgeon Dr. Mark Codner.

Photo Credit: ShutterstockHow much time do you spend looking down at your phone every day? This simple act—along with genetics, accumulated sun damage, and normal age-related changes—contributes to visible lines that run horizontally across the neck that eventually remain visible when you’re looking straight ahead. Miami, Florida plastic surgeon, and Haute Beauty expert Dr. Jose Rodríguez-Feliz outlines the variety of options that can help smooth those horizontal neck lines based on their cause and severity.

Superficial neck lines

As with other fine lines that are limited to the skin’s surface, there are several non-invasive, minimal-downtime treatments that can smooth the appearance of minor horizontal neck creases. The first option would be a low-viscosity hyaluronic filler that instantly plumps superficial lines from the inside out and smoothes the appearance of the skin’s surface.

Mild to moderate neck lines

Microneedling with radiofrequency is another great option for mild to moderate neck lines. This minimal-downtime energy-based treatment creates micro-injuries that prompt the skin’s natural healing process while delivering heat to the lower layers of the skin to help boost natural collagen production. This combination of skin-rejuvenating modalities works to resurface the skin, restore elasticity and minimize the depth of horizontal neck lines gradually within the first few months of initial treatment (although a series is often recommended for optimal results.)

Photo Credit: ShutterstockModerate to severe horizontal neck lines

In many cases, more prominent neck lines are associated with the skin’s attachment to underlying platysma muscles—and the decline of skin elasticity along with the accumulation of subcutaneous fat make these lines even more apparent. In some patients, simply relaxing the platysma muscles with an injectable neurotoxin like Botox or Dysport can provide enough of a “release” to smooth the look of horizontal lines as well as the visible vertical bands that contribute to the appearance of an aging neck.

However, many patients yield a more significant improvement in horizontal neck lines with the “stromal vascular technique.” Similar to fat grafting, this treatment helps fill in horizontal lines, but an additional advantage of this approach is that these growth-factor-rich injections help break down excess fat to further smooth the skin’s surface while plumping lines from within. In cases, I perform this in conjunction with neck lift surgery.

Advanced, severe neck lines

The ideal approach for improving horizontal neck lines in older patients, or those with significant sun damage, is often neck lift surgery. In addition to removing excess skin and tightening the underlying platysmal muscles, this surgical procedure separates the skin from the muscle so these two tissues can be addressed independently in order to yield the optimal line-smoothing outcome (and additional neck-rejuvenating benefits) in appropriate patients.