What can you do to improve prominent horizontal neck creases?

With more people working from home and utilizing ZOOM, we are seeing an influx of younger patients, beginning in their 30’s and up, come to us to address the horizontal creases, also known as Venus rings, that they see on their necks during their ZOOM meetings. 

While most wrinkles on the face and neck develop as we age, Venus rings can appear in younger individuals because they are not “true” wrinkles. Instead, attachments of the skin to the underlying musculature form these horizontal neck creases. Moreover, genetics significantly affects how prominent these creases are in different individuals. In some people, these lines can be barely visible, and in others, these creases are pronounced and demonstrate a branching pattern. 

Venus rings are just as susceptible to aging as the rest of the neck. Perhaps most relevant to the times today is the concept of “Tech neck,” where prolonged neck flexion from using the computer and smartphones increases neck wrinkle formation. Additionally, factors that compromise skin health, such as excessive sun exposure, smoking, poor diet, and significant weight swings, can make Venus rings more prominent. Lastly, as we age, we lose fat, collagen, and elastin, so the skin surrounding the muscle attachments becomes laxer and makes the Venus rings more noticeable.

Now that we’re familiar with what Venus rings are, how do we treat them? 

Skincare: Starting in your 20s, regular use use of sunblock, retinol, and vitamin c containing products on the neck could help slow down skin photoaging, thereby preserving skin elasticity and thickness.

Micro-Botox: For mild Venus rings, injection of dilute Botulinum toxin along the course of the crease can weaken the underlying muscle just enough to soften the appearance of the crease. This is a simple treatment with no downtime, and the results last 3-4 months and can be performed at the same time as when you come in for your facial Botox.

Hyaluronic Acid Fillers: This type of filler can be used to “fill” in the crease to make it less noticeable. However, because the attachments between the skin and underlying muscle form the creases, HA filler cannot correct them entirely. Furthermore, too much filler can make the area around the creases appear heavy. The fillers typically last 1 to 1.5 years.

Dilute Radiesse - Neck Wash: Diluted Radiesse Calcium Hydroxyapatite injected under the neck creases stimulates new collagen and elastin formation that lasts up to 2 years without the potentially unnatural fullness that could appear with too much HA fillers. Depending on the prominence of one’s horizontal creases, the initial treatment may require 2-3 sessions, then a maintenance treatment every 2 years. 

Surgery - Surgery could be a treatment option for those with prominent neck creases who want longer-lasting results. With surgery, the attachments that form the horizontal creases can be released. The choice of which surgical procedure to have depends on how much fat and skin laxity there is and whether one has vertical neck bands. For those with some fat and mild to moderate skin laxity, neck liposuction with FaceTite radiofrequency skin tightening is a great option. During liposuction, the attachments that form the horizontal crease are released to make them less visible. For those with vertical bands or more significant skin laxity, a central neck lift or a conventional neck lift would be the way to go.