With an increasing understanding of the aging process and the rapidly growing interest in minimally invasive treatments, injectable facial fillers have changed the perspective for the treatment and rejuvenation of the aging face. Other than autologous fat and certain preformed implants, the collagen family products were the only Food and Drug Administration approved soft tissue fillers. But the overwhelming interest in soft tissue fillers had led to the increase in research and development of other products including bioengineered nonpermanent implants and permanent alloplastic implants. As multiple injectable soft tissue fillers and biostimulators are continuously becoming available, it is important to understand the biophysical properties inherent in each, as these constitute the clinical characteristics of the product. This article will review the materials and properties of the currently available soft tissue fillers: hyaluronic acid, calcium hydroxylapatite, poly-l-lactic acid, polymethylmethacrylate, and autologous fat (and aspirated tissue including stem cells).

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There are many treatments for neck laxity and fullness, both invasive and noninvasive. The purpose of this study was to evaluate the effectiveness of combined infrared, radiofrequency, mechanical massage, and suction therapy in performing contour changes in the submental and lateral neck regions. This was a single-center, prospective cohort study in which 30 patients were treated with a session of combined infrared, radiofrequency, mechanical massage, and suction therapy once a week for 4 weeks. Follow-up was performed at posttreatment months 1, 3, and 6. Both subjects and investigators completed submental fat grading scales and lateral neck and jowl linear analog scales. Exclusion criteria included history of soft tissue augmentation, cosmetic injections, ablative or nonablative skin resurfacing, or surgical procedures in the lower facial region, as well as weight gain or loss exceeding 10 pounds during the study period. There was a significant difference between mean ± SD neck and jowl investigator scores at day 0 and month 6, which were 5.6 ± 0.9 and 4.4 ± 1.0, respectively ( P < .05). Mean investigator submental fat score at day 0 was 1.9 ± 0.7 vs 1.5 ± 0.6 ( P = .04) at month 6. Differences between mean patient neck and jowl and submental fat scores were also statistically significant between day 0 and month 6. At day 0, the mean patient neck and jowl score was 4.7 ± 0.8 vs 3.2 ± 1.1 at month 6 ( P < .05), and at day 0, the mean patient submental fat score was 2.2 ± 0.5 vs 1.8 ± 0.6 at month 6 ( P < .05). Combined infrared, radiofrequency, mechanical massage, and suction therapy provides an effective, noninvasive treatment modality for improving contour of the lateral neck and submentum.