Multimodal Approach for Treating Horizontal Neck Wrinkles Using Intensity Focused Ultrasound, Cohesive Polydensified Matrix Hyaluronic Acid, and IncobotulinumtoxinA

BACKGROUNDFor the restoration of horizontal neck wrinkles, multimodal approaches using neuromodulators, intensity focused ultrasound (IFU), and fine line fillers are recommended. OBJECTIVETo evaluate the efficacy and safety of a 1-day, multimodal approach for horizontal neck wrinkles. METHODSTwelve female patients with horizontal neck wrinkles were treated with a combined treatment of IFU, cohesive polydensified matrix hyaluronic acid (CPMHA), and incobotulinumtoxinA. Therapeutic outcomes were assessed on Day 0 and 1, 2, 3, and 6 months thereafter. RESULTSHorizontal neck wrinkles decreased significantly in length from a median at baseline of 269.75 mm (interquatile range [IQR], 235.35–302.94 mm) to 91.5 mm (IQR, 51.4–108.61 mm) at 1 month, 92.3 mm (IQR, 69.66–132.07 mm) at 2 months, 101.88 mm (IQR, 86–146.77 mm) at 3 months, and 109.48 mm (IQR, 85.06–148.17 mm) at 6 months after the combined treatment. The median global aesthetic improvement scale scores were 3.5 (IQR, 2–4) at 1 month, 3 (IQR, 3–3.5) at 2 months, 3 (IQR, 2–4) at 3 months, and 3 (IQR, 3–3) at 6 months. Post-treatment petechiae resolved completely within 7 days, and CPMHA-induced lumps disappeared within 1 month. CONCLUSIONThe present data demonstrated that the multimodal, combined treatment used in the present study provides satisfactory and long-lasting therapeutic outcomes by targeting different pathogenetic factors of horizontal neck wrinkles.