This story first appeared in the Jan. 16 issue of The Hollywood Reporter magazine.
If the late Nora Ephron had written her best-selling memoir I Feel Bad About My Neck now instead of in 2006, she'd have a few things to feel better about — like options.
The neck and cleavage area always has been a sure tell of aging, even among the most maintained Hollywood women. After all, no one but a wax figure is immune to genetics and gravity's pull. And no amount of makeup or exercise can affect neck cords and deep cleavage lines (though sunblock, of course, can help prevent fine lines and pigmentation damage). But in 2015, there are a multitude of ways to improve the skin from the chin down — called the decolletage — ranging from less invasive topicals and microdermabrasion to chemical peels, lasers and even surgery. That's good news for all those wearers of strapless and low-cut gowns at the Golden Globes and SAG Awards — because no one but Diane Keaton can pull off a black-tie turtleneck.
Beverly Hills facialist Ronit Falevitch likes exfoliation for the decolletage: "When you remove dead skin, you get new healthy skin." To get rid of lines and pigmentation in the area, he advises weekly glycolic peels, microdermabrasion and vitamin C, followed by hydrating honey masks and "light therapy that stimulates collagen." An alternative is "a mix of hydraquinone and Retin-A, a cocktail I mix up as a topical" (neck-only treatment is $150; face, neck and chest, $500). Olga Lorencin Northrup, owner and top facialist at Kinara Spa on Robertson Boulevard, adds a special secret ingredient to her microdermabrasion machine, an oxygen-sodium bicarbonate serum ($300): "We call this a 'poreless neck and chest facial.'"
For deeper lines, Falevitch recommends a chemical peel, while Northrup opts to add a 20-minute microcurrent: "It's a fine electrical current that lifts the muscles underneath, a nonsurgical face-lift" for the decolletage. She says clients "really see a difference" after three treatments ($900).
To combat visible loss of collagen and elastic fiber — i.e., the sags, less desirable than the SAGs by far — Beverly Hills dermatologist Peter Kopelson recommends photodynamic therapy, which combines the use of an intense pulsed light (IPL) machine with a substance called Levulan to remove brown spots ($800). "The light energy, when applied in a series, also activates collagen and tightens loose skin," says Kopelson. Beverly Hills plastic surgeon Lawrence Koplin, another proponent of IPLs, explains that they "injure and make the skin heal itself. For the girl who's been too long at the beach, the top layer of the neck and chest can be addressed by the IPL." Plus, there's no downtime. Procrastinators — or last-minute switchers to low-cut gowns — can undergo the treatment on Golden Globes day (and many do) for a quick tightening effect.
Now, what about those two deep cords in the neck that often start to appear on women around age 45? Kopelson applies Botox every two or three months to relax them ($800 to $1,200, depending on the severity of the cords), a very popular treatment among women and gay men, he notes. But Kopelson adds that there's a reason why fillers aren't injected into those valleys caused by cords in the neck and chest area: "You don't want to cause bumpiness; the neck and chest area have very thin skin." (Other doctors, such as plastic surgeon Leif Rogers, are not averse to using ultra-fine and thin fillers, such as Belotero, for decolletage wrinkles; $850 per syringe.)
Lasers have varying degrees of intensity, with stronger therapies includ- ing the Pearl and the Erbium, Kopelson's favorites. Beverly Hills dermatologist Harold Lancer is an advocate of laser peels for serious grooves, from fractional Erbium, Venus or Diva lasers (all three are great for peeling and tightening) to an EndyMed 3DEEP laser, which uses little gold pins to create tiny wounds that rev collagen output for healing, ironing out crepey texture and chest lines along the way.
An advanced turkey neck can benefit from the newly FDA-cleared ultrasound technology called Ultherapy ($4,500 for face and neck), which tightens the area around the jawline with more energy than lasers, says Rogers. It treats deeper layers of skin with little visible healing, and can take three months for best results. "It even has a breast-lifting component," he says.
For deeper neck and chest wrinkles, Koplin believes in using the stem cells of one's own body fat as an injectable to plump skin ($8,000 to $14,000). "Stem cell nanostem serum improves the skin rather than injuring the skin," he says. The fat is extracted by liposuction from the thighs or belly and injected with the serum into cleavage lines, for an almost permanent filler effect.
An even more invasive treatment is ThermiTight ($4,500), which delivers radio frequency under the skin with a probe, heating tissue to the point where it increases collagen. "After that, it's only surgery," says Rogers, "a little incision under the chin, cut the muscle a little, tie it together, and you have a new neck by platysmaplasty," or neck lift. It seems that for some pronounced neck bands, only a good old-fashioned lift will do ($6,000 to $8,000).
Yet the laser-, voltage- and needle-averse need not despair. Lifestyle changes, such as cutting out sun exposure, smoking and alcohol, can help (although nothing can prevent lines in the breast area caused simply from sleeping). A low-fi tip from Northrup that anyone can try — and women over 50 should — is massaging in nutritive serums or oils (coconut oil "is fantastic for the chest").
Lancer also recommends a high-protein, low-carb and no-added-salt diet to improve skin texture, and Pilates to keep the musculature under the skin firm, making it tighter. And please note, ladies, that according to Lancer, push-up bras can cause cleavage lines, and breast implants make them even worse! Lancer adds that, whatever you do, "the skin has to match from the dinner table up" — meaning, if women are having facial treatments, they would be wise to also treat the neck and chest or their skin tones won't jibe: "It's a dead giveaway."