A Comprehensive Review of Dermal Fillers and Biostimulators for Neck Rejuvenation

BACKGROUND: Facial revitalization has long been a prime objective for aesthetic providers and patients alike. More recently, attention has been shifting to include the neck area, driven by the desire to address visible neck lines, wrinkles, and skin laxity. OBJECTIVE: This review aims to comprehensively examine the English peer-reviewed literature of fillers, including cross-linked and non-cross-linked hyaluronic acid (HA) gels, poly-l-lactic acid (PLLA), and calcium hydroxylapatite (CaHA), for neck rejuvenation, including neck lines, skin laxity, and wrinkles. MATERIALS AND METHODS: PubMed database search was performed for interventional and observational studies for neck rejuvenation, excluding case reports with fewer than 10 patients. RESULTS: A total of 24 studies which included 887 patients were included in our clinical review. Recent studies have validated the efficacy of HA gels for reducing neck wrinkles. Poly-l-lactic acid stimulates collagen synthesis and may also improve wrinkle severity. Calcium hydroxylapatite promotes collagen production and overall neck skin rejuvenation. Studies demonstrate the efficacy of all 3 of these fillers in improving neck wrinkles and skin laxity. However, heterogeneity of outcome measures, small sample sizes, and limited long-term data constrain definitive conclusions and highlight the need for further research. CONCLUSION: This review synthesizes current approaches using HA, CaHA, and PLLA for neck rejuvenation with favorable safety profiles.