Background and Objectives
Aging of the neck is characterized by skin laxity, rhytides, loss of the mandibular contour, widening of the cervicomental angle, accumulation of submental fat, and an increased prominence of platysmal bands, in addition to others, for which many treatment options are available. In the present report, we describe a 1-day combined treatment for neck rejuvenation that addresses these signs of aging without the need for radiofrequency, highintensity focused ultrasound, laser, or other devices.
Materials and Methods
To improve skin laxity, calcium hydroxylapatite in a 1:1 dilution with normal saline or lidocaine (with or without epinephrine) was applied to the neck with a 25-gauge cannula. For horizontal neck lines, hyaluronic acid filler at a total concentration of 20 mg/ml containing 0.3% lidocaine was injected subdermally along the horizontal neck wrinkles using a 33-gauge needle and a superficial serial puncture technique. To treat hyperkinetic activity of the platysma, a total dose of 60-70 U of incobotulinumtoxinA was divided into 60-70 injections. GAIS scores and photos were assessed at 30, 90, and 180 days after treatment.
Results
A 33-year-old female patient presented with horizontal neck wrinkles and mild aging changes with minimal fat accumulation. At 6 months after treatment, she achieved a GAIS score of 2. No serious side-effects associated with the treatment were reported.
Conclusion
In this report, we found combined treatment with CaHA, hyaluronic acid filler, and incobotulinumtoxinA to be effective at treating signs of aging of the neck. Further studies of similar treatments for neck rejuvenation may prove beneficial.

Keywords: Calcium hydroxylapatite, Hyaluronic acid filler, IncobotulinumtoxinA, Neck rejuvenation