Synergic effect of plasma exeresis and non–cross‐linked low and high molecular weight hyaluronic acid to improve neck skin laxities

Background: Many therapeutic options are today available for neck aging, but little evidence exists about the efficacy of combining such procedures. Nonsurgical treatment of neck laxities and wrinkles is often preferred by patients, and combined strategies are nowadays emerging as the standard of care. Both plasma exeresis and hyaluronic acid (HA) injection are two emerging techniques in this setting. Aims: To investigate the synergic effect of plasma exeresis and non-cross-linked HA injection, in stabilized hybrid complex of low and high molecular weight, in terms of both tolerability (assessed using VAS scale of pain) and improvement of neck skin laxities, according to the GAIS score assigned by patients and clinicians. Patients/methods: Ten consecutive patients with signs of neck skin laxities (≥ type 3 according to the Glogau wrinkle scale) aged between 35 and 65 years were enrolled in our study. Two treatment sessions were performed. During the first session, both plasma exeresis and HA injection were performed. Patients were re-evauated after 30 days, and HA injection in the wrinkles of the neck was repeated. After 30 days from the second treatment session, a follow-up visit was performed to assess global efficacy of the two-step combined treatment and to monitor eventual long-term side effects. Results: A GAIS score of 1 or 2 was present in 90% of the treated cases, according to both patients and clinicians. Mean VAS value for pain was 2.4/10. Minor side effects such as erythema and/or edema were transient and completely resolved. No major adverse events were observed. Conclusions: We strongly encourage the combined treatment with plasma exeresis and non-cross-linked HA injection for its promising remodeling effects in the field of neck rejuvenation.