Mechanical Micronization of Lipoaspirates for the Treatment of Horizontal Neck Lines.

[BACKGROUND] Horizontal neck wrinkles develop as a result of the aging process. Stromal vascular fraction (SVF) gel, which is rich in extracellular matrix and functional cells, can be produced by a series of simple mechanical processes, including intersyringe shifting and centrifugation. This study aimed to assess stromal vascular fraction gel in the treatment of horizontal neck wrinkles.

[METHODS] This single-center study included female patients with horizontal neck wrinkles (Fitzpatrick types II to IV) treated with either SVF gel or botulinum toxin type A (BTX A) injection. SVF gel was first diffusely distributed subcutaneously along the neck line and then injected in a diluted way intracutaneously at points 0.5 cm apart along the horizontal lines. BTX A was injected at points 1.5 cm apart (2 U in each injection site). Satisfaction and improvement scores were compared between the two groups, and the collagen content of the neck wrinkle was compared by histologic evaluation before and after treatment.

[RESULTS] Twenty-eight patients received SVF gel and 22 received BTX A. In patients with type II neck wrinkles, BTX A and SVF gel treatment resulted in similar improvement scores and patient satisfaction in the first 3 months. In patients with type III and IV neck wrinkles, SVF gel resulted in significantly higher improvement scores and better patient satisfaction. A longer duration of adverse events was seen in the SVF gel treatment group. Histologic assessment suggested that SVF gel increased the collagen density of neck wrinkles.

[CONCLUSION] SVF gel is an effective treatment for horizontal neck wrinkles, particularly in patients with type III and IV wrinkles.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, II.