Diamond Technique: A Triple Treatment for Neck and Décolletage Rejuvenation

Abstract

Background: In the pursuit of integral beauty and a harmonious overall appearance, individuals are increasingly seeking cosmetic treatments for both facial and extrafacial regions. Among these areas, the neck and décolleté have become focal points for care due to their visibility and susceptibility to postsurgical scarring and dyschromia compared with the face. Environmental stressors and sun exposure contribute to aging signs in these areas, prompting a demand for effective, minimally invasive procedures with reduced downtime and minimal risks. Biostimulators, hyaluronic acid, laser therapy, microfocused ultrasound and neurotoxins have become key players in addressing these concerns.

Aims: This manuscript introduces the Diamond technique, which uses a diamond-shaped acetate device to perform a minimally invasive protocol combining calcium hydroxyapatite, hyaluronic acid, and incobotulinumtoxinA for neck and décolleté rejuvenation.

Patients/methods: The technique involves two steps: solution preparation and device-guided injections. The diamond-shaped device was developed to guide the injections, enhancing precision and reproducibility and facilitating medical training. The device's strategic markings aid in solution application, ensuring a multidimensional approach to rejuvenation. Four female patients, aged between 55 and 63 years were used to demonstrate the technique, with two categorized as grade II and two as grade III according to the Merz scale of neck laxity at rest.

Results: The four examples demonstrate improvements in skin laxity, wrinkles, and overall skin quality. Two participants reported "good results," and two reported results "beyond expectations." The Diamond technique's potential lies in its ability to provide predictable outcomes, individualized treatments, and patient satisfaction.

Conclusion: While the authors assert the technique's safety and efficacy, the need for controlled studies is crucial. Rigorous, long-term studies are warranted to validate its effectiveness and safety compared with the existing approaches.

Keywords: biostimulatory treatment; calcium hydroxylapatite; collagen; dermis; neck; neocollagenesis; rejuvenation.

FIGURE 1

(A) Schematic representation of the mixing solution containing diluted CaHA and HA for the “fan mode” application of subdermal retroinjections (0.3 mL per vector) guided by the five vector groups (orange, red, green, purple, and blue), starting from the five vertices of the “diamond” on the neck (upside down/mirror image) and the décolleté. (B) Representation of the solution volumes for subdermal retroinjection from the five vertices of the “diamond” in five vectors: 0.3 mL each.

FIGURE 2

(A) Schematic representation of the preparation of the hyperdiluted neurotoxin for the treatment. The injections of 1–2 UI should be administered intradermally at the markings, 1–2 cm apart, set by the perforations of the “diamond” device. (B) Detailed characteristics of the marking diamond‐shaped device.

FIGURE 3

Demonstration of the skin markings on the skin vectors (HA and CaHA) and the injection points for the hyperdiluted INCO. For the neck, the upper vertex of the diamond‐shaped device, used in a mirrored manner, is positioned at the level of the mental spine, while its two lower vertices are directed toward the upper edge of the clavicles. For the décolleté, the two upper vertices of the diamond are positioned at the level of the upper edge of the clavicles, while its lower vertex is directed toward the intermammary sulcus.

FIGURE 4

Diamond technique for the neck and décolleté. (A) Before treatment. (B) 90 days after treatment. There was an overall improvement in skin laxity, static wrinkles, and skin quality. In the center‐medial region (lower portion), there is a noticeable smoothing of perpendicular wrinkles and a revitalized appearance of the skin.

FIGURE 5

Diamond technique for the neck. (A) Before treatment. (B) 90 days after treatment. There was dermal densification, cutaneous restructuring with improvement in quality and hydration, as well as tissue repositioning, resulting in neck rejuvenation and beautification.

FIGURE 6

Diamond technique for the décolleté. (A) Before treatment. (B) 85 days after treatment. Smoothing of static wrinkles as well as overall improvement in skin quality. Dermal densification and cutaneous restructuring, promoting local rejuvenation.

FIGURE 7

Diamond technique for the décolleté. (A) Before treatment. (B) 95 days after treatment. Global improvement of the skin with rejuvenation and beautification, including the smoothing of static wrinkles, dermal densification, and tissue restructuring.