Correction of horizontal neck lines: Our preliminary experience with hyaluronic acid fillers

There is an increasing trend shifting the esthetic focus downward from the face with a significant number of new treatments aimed at the aging neck. Hyaluronic acid (HA) filler injection is widely performed into the horizontal neck lines in Korea, but there are few reports assessing its effectiveness.

We aimed to evaluate the efficacy and safety of HA filler injection in the treatment of horizontal neck lines.

A retrospective chart review was performed on cases of horizontal neck lines treated with HA fillers. A total of 28 neck halves from 14 patients with Fitzpatrick skin types IV-V were included. All participants underwent a single treatment session with a 0.3 cc insulin syringe (31G×8 mm needle). Wrinkle assessment was conducted at baseline and 2 months after treatment. Two blinded physicians evaluated the improvement using a 5-point Global Aesthetic Improvement Scale (GAIS) (5-very much improved, 4-much improved, 3-improved, 2-no change, 1-worse) by comparing the pretreatment and post-treatment photographs. A questionnaire was used to evaluate patient satisfaction and the incidence of adverse reactions.

Among the 28 neck halves, 35.7% were treated with the linear threading technique (LTT) and 64.3% were treated with the vertical technique (VT). The average amount of filler injection per side was 1.01±0.13 cc. The GAIS score of the horizontal neck lines measured at the 2-month follow-up after filler injection was 4.04±0.79 (overall); the GAIS score of the horizontal neck lines was 3.60±0.70 with the LTT and 4.27±0.75 with the VT (P=.027). Complications, such as skin irregularity and accentuation of neck lines, were observed, but they were transient.

Our preliminary study results indicate that HA filler injection with a 0.3 cc insulin syringe could be a safe and effective treatment option for horizontal neck lines.