INTRODUCTION
Skin, like most organs, undergoes deleterious changes with the passage of time. A primary component of skin aging is the degradation of the extracellular matrix, which is marked by a decrease in fibroblast quantity and activity; this degradation clinically manifests as wrinkling, fat loss, and worsening skin quality.1 Maintaining good skin quality requires sufficient skin firmness, surface evenness, tone evenness, and glow. All of these characteristics are affected by multiple tissue layers, which are influenced by aging.2
Additionally, in contrast to other organs, skin is also directly affected by exposure to the environment, especially chronic ultraviolet radiation from the sun, which results in photoaging. As a result, areas of the body frequently exposed to the sun, such as the face, neck, decollete, forearms, and dorsal hands, show visible signs of aging more rapidly than other areas of the body.3-5
Addressing these variable conditions can be challenging for the aesthetic physician. While facial rejuvenation is well-established, interest in rejuvenation procedures for more intricate areas, such as the decollete, has recently increased. Current modalities used to treat signs of aging in the décolleté region include neurotoxins, fillers, chemical peels, intense pulsed light, non-ablative and ablative lasers, and microfocused ultrasound with visualization.7,8
Additionally, in contrast to other organs, skin is also directly affected by exposure to the environment, especially chronic ultraviolet radiation from the sun, which results in photoaging. As a result, areas of the body frequently exposed to the sun, such as the face, neck, decollete, forearms, and dorsal hands, show visible signs of aging more rapidly than other areas of the body.3-5
Furthermore, in females, the decollete is vulnerable to the mechanical stresses associated with the weight and movement of the breasts. Females are also more prone to decollete aging due to hormonal changes from menopause and estrogen deficiency. These changes result in an accelerated breakdown of collagen and elastin, leading to skin thinning and laxity, and worsening of lines and wrinkles.6
Addressing these variable conditions can be challenging for the aesthetic physician. While facial rejuvenation is well-established, interest in rejuvenation procedures for more intricate areas, such as the decollete, has recently increased. Current modalities used to treat signs of aging in the décolleté region include neurotoxins, fillers, chemical peels, intense pulsed light, non-ablative and ablative lasers, and microfocused ultrasound with visualization.7,8
