Caring For Your Neck: From Products to Procedures

[Intro] Hey, everyone. Welcome back to Facially Conscious with myself, Trina Renea, esthetician, Dr. Vicki Rapaport, dermatologist, Rebecca Gadberry, the cosmetic ingredient guru, and our fabulous, overly-educated consumer, Julie Falls. We are gathered here together with you to talk about this crazy world of esthetics. It's confusing out there in this big wide world. 

That's why we are here to help explain it to you all, subject by subject. We will be your go-to girls, and from our perspective without giving medical advice, we will keep things facially conscious.

Let's get started. 

00:51 Trina Renea: Hello. Good morning, ladies. How are you today?

00:55 Dr. Vicki Rapaport: Good morning.

00:58 Julie Falls: Good morning.

00:58 Rebecca Gadberry: Hello. Hi, this is Rebecca. Good morning, or afternoon or evening. For us, it's afternoon.

01:07 Trina Renea: Yes, it's a Saturday afternoon in August. You'll be listening to this in probably January or February. But I'm very excited. My name is Trina. I'm an esthetician. And we are going to talk about a subject today that is a big one for everyone that I come into contact with. It's called the neck. 

There are so many ideas about the neck out there, and everybody feels like nothing works. So what in the world can we do about this neck situation, because I feel like it's the first thing to go. It's starting to go younger and younger and it's horrifying.

It's like the thing that ages us the most and you can't hide it. I mean, we can't walk around in turtlenecks every day, right?

02:03 Julie Falls: Yeah. I don't know if I would say it's horrifying but…

02:05 Trina Renea: It is horrifying.

02:07 Julie Falls: I'd say it's a thing.

02:10 Trina Renea: Well, ‘tech neck’ is getting worse and worse.

02:13 Rebecca Gadberry: What is tech neck?

02:15 Trina Renea: You know, technology, looking down at your devices causing lines across your neck. 

02:24 Dr. Vicki Rapaport: But tech neck has posterior and anterior issues. 

02:26 Julie Falls: Posture.

02:28 Dr. Vicki Rapaport: Tech neck, officially, like, is very bad for the cervical spine, so it's pulling on the back of the neck. But cosmetically…

02:34 Trina Renea: My daughter has been complaining about her neck pain since she was seven.

02:39 Rebecca Gadberry: Really? 

02:40 Trina Renea: Yes. 

02:41 Julie Falls: I think the kids’ heads are always down looking at their phone.

02:43 Trina Renea: Yeah. She's always, like, sore, because she's looking down at the computer and COVID and having the iPads and the phones, and they're just constantly— then when their neck comes up, they're like, “Oh, my God, my neck hurts.”

02:55 Dr. Vicki Rapaport: Oh, yes. My daughter who's 17 has a friend whose dad is a chiropractor and, apparently, they make fun of this father because the father walks around the house like this.

03:06 Trina Renea: With his phone held up against his neck.

03:08 Dr. Vicki Rapaport: With his phone at eye level, because that's what you should do. He does it.

03:11 Julie Falls: Yeah, my chiropractor has big signs asking people…

03:15 Trina Renea: I even tried to do that. I try and lift my head.

03:18 Dr. Vicki Rapaport: Literally hold it up, yep. It looks really weird but it's really good for you.

03:21 Trina Renea: Arm muscles. It also looks like you're old because you can't see your phone or something, because you're holding it up here.

03:27 Rebecca Gadberry: Another reason to lift weights for your arms.

03:29 Trina Renea: Well, that is lifting a weight. You're holding your phone up over and over. It's the weight.

03:37 Rebecca Gadberry: For those of you who can't see, Trina is lifting her phone up and down and up and down and up.

03:43 Trina Renea: Like a weight.

03:45 Rebecca Gadberry: Like a weight.

03:46 Trina Renea: The weight of the world. I have the weight of the world in my hand.

Anyway, so I don't even know where to start with this neck situation. I feel like where do we start? Who starts?

04:03 Rebecca Gadberry: How about with a few statistics?

04:05 Trina Renea: Okay. 

04:09 Rebecca Gadberry: Tech neck is causing younger and younger people to have issues with their neck skin. You were calling them wrinkles. They're bands that run across our necks. If you are larger, if you have some fat in that area, you're going to start getting kind of little bubbles or pillowing, if you will, between those bands. 

04:37 Julie Falls: Is that from sweat?

04:38 Rebecca Gadberry: It can be. You can sweat there. When you look down, you're forming those bands. And then you've got the bands that run the other way. The bands I'm talking about run horizontal and then there's the bands, are they the Langer bands?

04:56 Dr. Vicki Rapaport: The platysmal bands you're talking about?

04:57 Rebecca Gadberry: The platysmal bands that run from the chin and the jaw down to the collarbone.

05:04 Dr. Vicki Rapaport: These?

05:05 Rebecca Gadberry: Yes. Vicki is now demonstrating by tightening her neck up from her jaw.

05:12 Trina Renea: But isn't that just bands that we naturally have?

05:14 Dr. Vicki Rapaport: Yeah. But when we lose— so a couple things happen as we age in our neck. We lose fat, unfortunately. Young girls with the perfect neck is because they have the most beautiful amount of evenly distributed fat and their skin hasn't fallen. So there's no looseness. I say girls, boys, girls, everybody who's young. Their skin hasn't loosened. The loss of elasticity hasn't happened. 

The turkey neck hasn't happened, which is basically a combination of both, that looseness and then the fat which falls. It isn't so tight up on the muscles anymore. 

05:53 Rebecca Gadberry: That's kind of where it pooches out underneath your chin.

05:56 Dr. Vicki Rapaport: The turkey, right? Yeah, so you get the horizontal bands, which is just like a smushed skin, in a sense. Then you get the platysmal bands, which are more like the vertical bands that show when you move the platysmal muscle, which is the muscle over the neck.

06:10 Rebecca Gadberry: You can see it like when The Rock is straining to lift something. You can see those platysmal bands in his neck.

06:19 Dr. Vicki Rapaport: And bulging veins.

06:22 Julie Falls: Then with age, the whole thing can get crepe-y. It's a whole situation. 

06:25 Dr. Vicki Rapaport: And that’s a more superficial change where the skin is has been so sun damaged and there's zero elasticity and they get crepe-y or they get sort of white, little tiny balls, which is basically solar elastosis, which is like collagen that doesn't even work anymore. So sad.

06:43 Trina Renea: So people can have this perfect, beautiful face that they've been working on keeping beautiful with products and a little bit of Botox, fillers and lasers, and this and that, and then they have this neck that just shows their age. It's really hard to do things too. There's not a lot of results. 

I work on so many clients every day who are dealing with this neck situation. The creams don't work and the lasers don't work and this doesn't work. There's so many things and it's like they end up getting a little lower facelift or something.

07:22 Julie Falls: Sorry to interrupt. With our last episode, we talked about fillers. Are there fillers that can address any of these issues with the neck, Dr. Vicki?

07:30 Dr. Vicki Rapaport: Yes. If people come in with the neck issue, saying, “Help me with my neck,” we’ll do a consult, trying to figure out what it is. Is it looseness? Is it loss of volume? Is it too much volume, too much fat? If it's just the horizontal bands that you're asking me about for filler, yes, you could put filler in those little tiny horizontal bands. 

There's actually a new filler called Redensity, which is RHA 1. Tiny, tiny, tiny, tiny lines can be improved with hyaluronic acid. Some of them are deep and require something like Juvederm or Restylane, and if the little horizontal bands are really superficial, you can inject more superficially hyaluronic acid.

Can you do sculpture in there? Yeah, you can do sculpture in there. Radiesse is a little too thick.

08:15 Julie Falls: I know people do Botox in their neck too, right?

08:17 Dr. Vicki Rapaport: So Botox is for the platysmal bands, so the bands that go diagonally or vertically. Yes, you inject their cords. You hold onto the cord, inject Botox, inject Botox. It softens and flattens the neck beautifully. 

So the consult involves trying to figure out what's wrong with them. Do they just need filler? Do they need Botox, because it's the bands? Do they need a resurfacing laser, like Morpheus, because it's the crepe-y skin? Do they need threads, because it's just loose and they just need to really pull it back and they don't want surgery? Do they need surgery, because threads wouldn't do anything? Or do they need liposuction? 

There's so many possibilities to improve the neck aging. Again, it just has to be something that you really have somebody look and find out what is the problem, what bothers you and what can be given to improve it.

09:11 Rebecca Gadberry: Now, isn't there a special treatment? I know when I go to my derm I see posters of it. Is it gels or turkey neck?

09:22 Trina Renea: Kybella?

09:24 Dr. Vicki Rapaport: Oh, yes, Kybella. We have to talk about Kybella. That's for the fat, the pre-platysmal fat. The pre-platysmal fat, meaning fat between the skin and the platysmal muscle, not under the platysmal muscle because it just wouldn't work.

09:40 Trina Renea: Can you explain what the platysmal muscle is?

09:43 Dr. Vicki Rapaport: The platysmal is your neck muscle. It's not the sternocleidomastoid that helps you turn your neck. It's the muscle that allows you to do…

09:47 Rebecca Gadberry: That’s the one that’s on the side.

09:49 Trina Renea: That allows you to squeeze your face, squeeze your neck up?

09:52 Dr. Vicki Rapaport: Do you really need the platysmal muscle? You do, but the sternocleidomastoid, for sure.

09:59 Trina Renea: Probably to chew.

10:03 Dr. Vicki Rapaport: Yeah, it's used to chew a little bit. It's like the cow muscle that when you're chewing like a cow, people say don't chew like that. Yes, you're using your platysmal muscle.

So the Kybella is used to basically dissolve the fat, the pre-platysmal fat, which is really best on people who just barely have that problem. If people have a really, really large amount of fat, they need liposuction. Kybella really isn't going to be the answer.

10:27 Trina Renea: You're talking about when it kind of turkey necks down, like it starts separating from your jaw and dropping.

10:36 Dr. Vicki Rapaport: Kybella is more for like the double chin, so the extra little bulge under the chin.

10:40 Rebecca Gadberry: Oh, like this?

10:42 Dr. Vicki Rapaport: That's fat and not loose skin, because it doesn't really tighten loose skin. You can do Kybella and then follow it up with like a tightening laser.

10:48 Trina Renea: What does Kybella do?

10:50 Dr. Vicki Rapaport: Dissolves the fat.

10:51 Trina Renea: It just dissolves fat.

10:52 Dr. Vicki Rapaport: Yeah.

10:53 Rebecca Gadberry: And it's a surface treatment, right?

10:54 Dr. Vicki Rapaport: It's an injection.

10:55 Rebecca Gadberry: It's an injection. Okay. Got it.

10:58 Trina Renea: And the injection, you have to do it a few times. You don't just do it once.

11:02 Dr. Vicki Rapaport: Three times.

11:02 Trina Renea: It's three times. And how much does that cost?

11:05 Dr. Vicki Rapaport: $3,600, usually, because it's about $1,200 per session. And it takes three injections every, you do it every four to six weeks. And it does work really beautifully. That fat doesn't usually come back unless people gain weight again. You're aging, of course, over time, but that can be “semi-permanent”. It can last years, 5 to 10 years if people maintain their weight.

11:32 Rebecca Gadberry: So, if you're getting injections into the bands, into the deeper wrinkles, deeper set wrinkles, is it possible for what you inject to travel? Should we keep our necks still for a while?

11:45 Dr. Vicki Rapaport: If you're injecting hyaluronic acid, it does not travel. And also you're injecting it so superficially.

11:48 Rebecca Gadberry: Okay, or it doesn't lump.

11:51 Dr. Vicki Rapaport: It doesn’t lump, usually. I mean, it can, but usually that will reapproximate itself and dissolve or incorporate itself into your own hyaluronic acid. But you're injecting such little tiny droplets that it usually doesn't. And choosing the right filler, right something really nice and smooth that does move with your body. And when you inject Botox, of course, that definitely doesn't dissolve. It just goes right into the muscle and stays there. 

12:15 Trina Renea: Or it doesn't move.

12:15 Dr. Vicki Rapaport: Travel, yeah.

12:18 Julie Falls: There's also a new procedure called Profound, which I know Dr. Talei is doing it. 

12:22 Dr. Vicki Rapaport: The laser.

12:24 Julie Falls: It's a laser. It's a lot more invasive. He likes to do it along with facelifts. 

12:29 Rebecca Gadberry: We're having him on, aren't we, pretty soon?

12:33 Julie Falls: Yeah. I'm looking at before-and-afters with Profound and a lot of these women look like they had their necks lifted. But it's definitely a lot more invasive and a lot more downtime, but it's supposed to be good. What do you know about that, Dr. Vicki?

12:45 Dr. Vicki Rapaport: I don't know a lot about that particular laser, although all those lasers that tighten do help, depending on the person, 20 to 80% improvement. Ultherapy, or I should say Thermage was the first one that came out, that's still very effective but it's painful. Ultherapy, which is the ultrasound therapy for the neck. This is for neck tightening, is also very effective. 

And then Morpheus, which is radiofrequency microneedling. Effective, profound. There are a lot of options out there laser-wise to tighten the skin. Is it as good as threads? Is it as good as surgery? Not always.

13:25 Julie Falls: I have spoken to many doctors who said that they were never really thrilled with Ultherapy. But I've heard people really very happy with the Profound. It's like kind of a new generation.

13:38 Dr. Vicki Rapaport: Yes, the lasers get better. 

13:41 Trina Renea: I've had many clients who've gotten Thermage and Ultherapy who, like, the results weren't enough to see over time. It didn't make that big of a difference for the price point and the pain that they went through, so they wouldn't do it again. Just it takes too long for the skin to tighten for them to see that it did much. Then by that time, they've aged more and it's like…

14:08 Dr. Vicki Rapaport: They need something else. 

14:09 Rebecca Gadberry: That’s a good point.

14:10 Dr. Vicki Rapaport: I had a patient that did Ultherapy and her results were like a facelift.

14:16 Trina Renea: But she must have had tighter skin.

14:20 Dr. Vicki Rapaport: She must have been a better candidate. I didn't do the Ultherapy on her. I sent her out for that, but I was so impressed. Of course, after that, I started sending everybody to Ultherapy. Some people are great candidates and some people aren’t. But I was incredibly impressed, and so was she. She would have done it again. It lasted, for her, almost 3 years, actually.

14:37 Rebecca Gadberry: What about neck lifts that a plastic surgeon would do?

14:42 Dr. Vicki Rapaport: Those will certainly be the ultimate.

14:44 Rebecca Gadberry: They're the ultimate, okay.

14:45 Dr. Vicki Rapaport: Which is what we're going to have— I’ve never actually even watched a neck lift, but I know that the patients who end up saying Botox was great, the filler was fine, the lasers helped a little bit, but I'm ready. I can't stand my profile anymore. I can't stand it, so of course then that's the big decision that you make. 

I think that they do look great, but I would say a large percentage of people who do neck lifts, they're never 100% satisfied, because I think they're really expecting to look like when they were 20. I think going into the surgeries, you also have to be really well consulted, that it's going to be much improved but it's not going to be perfect.

15:21 Julie Falls: I think a lot of plastic surgeons will tell you they don't do neck lifts. They do a lower facelift.

15:29 Rebecca Gadberry: That’s what it's called.

15:31 Julie Falls: Because just doing your neck is not going to address, you have to address the jowls, the laxity, and the lower, the whole thing. 

I know I've had consultations with plastic surgeons who said, “I don't do neck lifts.” If a doctor tells you they do, leave. It's interesting.

15:53 Dr. Vicki Rapaport: Or they're saying I'll do your neck lift, but they're saying this is part of it.

15:56 Trina Renea: They mean lower face.

15:59 Dr. Vicki Rapaport: Lower face is part of it.

15:59 Julie Falls: Exactly, but I'm saying people just say, “I just want my neck done,” and it's kind of not really…

16:05 Trina Renea: How much is a lower facelift these days? Does anyone know?

16:10 Julie Falls: if you're in New York or Los Angeles, you're probably looking at, depending upon the doctor, anywhere from $40,000 to $100,000. But if you're in a different— not in New York and not in LA, it's going to be a lot less.

16:25 Rebecca Gadberry: I think practicing self-acceptance in the way you are might be a healthy way to go.

16:31 Trina Renea: Sure, if you don't live in New York or LA. 

16:35 Rebecca Gadberry: Beverly Hills.

16:36 Julie Falls: We were talking about this earlier when we were talking about the fillers, Rebecca. I do think that someone who has taken really, really good care of their skin for years and then, suddenly, just has a genetic jowl, a double chin or something, and they feel like, hey, this could take 10, 20 years off and I'll still look like myself and I won't look freaky. I advocate for that. 

17:04 Trina Renea: I mean, if you have the money.

17:06 Julie Falls: I guess, yeah.

17:07 Trina Renea: Or if you don't, I guess you could go to the middle of the country or another country and get it less expensive.

17:15 Julie Falls: I don't think this show is about us telling people, “Oh, you have to go and do things to yourself.”

17:22 Rebecca Gadberry: No, it isn’t.

17:22 Julie Falls: That's not what we're here for. I think that everybody has their own version of growing older gracefully and I applaud that. But I also applaud somebody saying, “Hey, I want to do a little something.” That's what we're here to provide, the education and how to make wise choices. Education and…

17:44 Trina Renea: And know your options and pricing and how long it lasts and if it's worth it, because most people out there don't have experience or they don't know doctors. They don't know where to go. They have one doctor in their town who does it. They don't know how to get this information so they go to see a doctor and the doctor is like, “This is what you should do,” and they've never heard of anything they're talking about. 

And they're like, “Should I? Do I trust this person? Like, am I going to look crazy? Is this worth the money?” So that's the purpose of this show, is just so people can get the information. We're here to spread the information of your options and their costs and so you can make better choices.

18:32 Dr. Vicki Rapaport: Just to touch on the cost thing, I have some incredible colleagues in Beverly Hills. It's not $40,000. I think if they're just doing lower face, I've seen it as low as like $15,000, and they do a great job. They're not schlock operators. I had a patient who…

18:47 Julie Falls: I don't know those doctors.

18:49 Dr. Vicki Rapaport: They're great. They like to combine it with other things too, like face and lower face. Like that might be $30,000. But, yes, the prices can definitely range. And if you go to a different country, it can be much less expensive. I'm not advocating for that. I just don't know any of those doctors. I don't know those procedures. I don't know their laws. I don't know their complication cases, so that would be a little scary for me to advocate for.

19:19 Trina Renea: I definitely know people who do that. I mean, I don't know the doctors. I know people who go out of the country. There are certain places that they're known for certain body part surgeries that they go and do that for. But I mean it is risky, unless you really know somebody who's done it and they know the doctor. I wouldn't just like venture down to another country. It's scary.

19:42 Rebecca Gadberry: Like Julie was saying, if you've taken good care of yourself and then suddenly it starts, the genetics starts in. And I don't know about you, but I've noticed that necks age the way your parents’ neck age, the one that you look the most like. When I was a little girl, I think I was 8 years old, and I looked at my grandmother, my aunt and my mother. They all had jowls. I thought, “I'm going to have jowls when I grow up,” and I do have jowls.

20:17 Dr. Vicki Rapaport: So the cosmetic chemist in the making was already looking at her grandparents at seven or eight. “I'm going to look like that.” I'm going to say use that retinol. 

Do you want to tell us about some products that they can at least consider trying?

20:27 Rebecca Gadberry: Yeah, that’s kind of where I was leading to, is the younger you start, especially on the neck, the less likely you are to need these treatments especially earlier in life. I know we were talking, before we sat down and started today, about people who are getting procedures, neck procedures, are going younger and younger and younger. It's predominantly because of the looking down at the computer or your phone or your iPad or whatever it is that you're using, the tech neck issue.

There's some interesting products that you can use. And before I start talking about interesting products, I want to talk a little bit about the type of cream, not a lotion, because lotions don't do as well on the neck. Most of the products that are out there are creams. But I've noticed that when I'm coming up with a new formula for a cream, I need to stay away from creams that are sticky. Because you look down and then your skin sticks together when you look up.

21:34 Trina Renea: That's the worst feeling.

21:35 Julie Falls: Rebecca, it's so interesting. I ordered a neck gel, I guess. It's kind of a well-known company. It's not SKM but it's something Skin Medic or something like that. It's a gel and I broke out from it.

21:53 Rebecca Gadberry: You did?

21:55 Julie Falls: Yeah.

21:54 Rebecca Gadberry: Interesting. Did it have fragrance?

21:56 Julie Falls: I don't think so. It's like really widely recommended.

22:00 Dr. Vicki Rapaport: Skin Medica? I love Skin Medica. Are you sure?

22:03 Julie Falls: I'm going to look at…

22:05 Rebecca Gadberry: Did it have peptides in it?

22:07 Julie Falls: I don't know. I'm going to look at all these things. But are gels sometimes, can people be allergic?

22:11 Rebecca Gadberry: Gels can penetrate more easily.

22:14 Julie Falls: But can you be allergic to?

22:16 Rebecca Gadberry: Well, here is a little thing we haven't talked about yet, but there's a preservative called phenoxyethanol. Phenoxyethanol in a gel can cause some people to break out or form a rash. 

22:30 Julie Falls: Interesting.

22:32 Rebecca Gadberry: So if it's a gel and it has phenoxyethanol, it'll be on the website. But if it has phenoxyethanol in it, that could add to the situation. If it has citrus fragrance in it, especially lime fragrance or grapefruit, that can cause itching or breaking out and can also cause discoloration when you go into the sun. So you want to avoid…

23:02 Julie Falls: Like Trina with her limes.

23:04 Rebecca Gadberry: Yeah, the limes have a particular— funny story. I was with a friend who we were having something that had lime in the drink. She squirted the lime and the juice went down the side of her face and her neck, on the right side. 

23:23 Dr. Vicki Rapaport: Like Trina's legs.

23:26 Julie Falls: That's what happened to Trina.

23:28 Rebecca Gadberry: And she spotted all the way down her face and her neck just from the squirt of one lime. Did you do that with your legs?

23:34 Trina Renea: I did. Oh, my God. I'm glad nobody else can see this.

23:39 Rebecca Gadberry: Was this on vacation?

23:41 Trina Renea: Yes, so what happens is I squeeze lime into my margarita and then the lime is on my fingers and I go like this. I wipe it on my body. I'm not thinking because I'm like wet.

23:51 Rebecca Gadberry: She's wiping it on her leg.

23:52 Trina Renea: Yeah, and I'm like wet from the pool or whatever and I'm sitting there and I just wipe, I just brush it across my leg. Then I get a citrus burn.

24:03 Julie Falls: Is it common, Vicki?

24:05 Dr. Vicki Rapaport: Very common, citrus burn.

24:07 Rebecca Gadberry: Oh, my goodness. It's not on her leg. It's higher up.

24:11 Dr. Vicki Rapaport: It's called phytophotodermatitis. 

24:13 Trina Renea: It's called photodermatitis. It's my bathing suit line. I went like, you know, wiped my hand across my butt.

24:22 Rebecca Gadberry: Yeah, photosensitivity or photodermatitis.

24:25 Trina Renea: And I did it, I get them on my leg and I know that…

24:27 Rebecca Gadberry: It's a brown discoloration.

24:30 Trina Renea: Yeah, it's basically a burn wherever my fingers, the limes touched my leg. It turns into a burn. It's horrendous.

24:38 Rebecca Gadberry: Yeah. So you want to avoid that type of thing on the side of…

24:41 Trina Renea: Yeah, don't touch your face, your neck.

24:43 Rebecca Gadberry: Don't touch your face or your neck if you're handling limes. But if you're wearing fragrance, don't put it on the side of your neck. 

24:50 Trina Renea: Which everyone does.

24:52 Rebecca Gadberry: We've all been taught to do that because that's a pulse point. So you might find yourself turning brown in that area. 

There's an old, old fragrance named Shalimar. 

25:04 Trina Renea: I remember that.

25:05 Rebecca Gadberry: It's a lovely fragrance that was very expensive. I think it's still sold.

25:09 Dr. Vicki Rapaport: Balsam of Peru, right?

25:11 Rebecca Gadberry: It was Balsam of Peru and something else was in there. I used to sell it when I worked at a store called May Company out here in California.

25:20 Trina Renea: May Company. We didn’t know.

25:23 Rebecca Gadberry: Yeah, when I was 19. And I was selling it to everybody. They loved it. And then I started seeing women coming back and I could see where the brown spots were on the side of their neck. I figured out really quickly.

25:37 Trina Renea: Oh, my God.

25:38 Rebecca Gadberry: They put it there.

25:39 Dr. Vicki Rapaport: Well, the company should be mortified, because that's where people spray it.

25:42 Rebecca Gadberry: Well, then they started talking about it at the company. The company is Guerlain. They’re in Paris.

25:48 Trina Renea: Is it a certain ingredient in the perfume?

25:51 Rebecca Gadberry: Yeah, there was Balsam of Peru. There was also another.

25:55 Julie Falls: Balsam of Peru?

25:56 Rebecca Gadberry: It's a fragrance component and it gives a deep, what I call almost like a caramel or a balsamy base note to it. It's not a lift note that you smell originally. It's the base note that lasts forever. That can be a problem. We don't use Balsam of Peru in products anymore. We're not supposed to.

26:25 Trina Renea: Because of the pigmentation problem.

26:28 Rebecca Gadberry: Yeah. And it's really common.

26:29 Dr. Vicki Rapaport: Can we talk about amazing ingredients for the neck?

26:34 Rebecca Gadberry: Yes, we can.

26:35 Dr. Vicki Rapaport: Because I'm taking notes. I'm ready.

26:38 Rebecca Gadberry: Well, I love peptides for the neck, but some people react to peptides. The stratum corneum on the neck is a little bit thicker than the face, but it also…

26:55 Trina Renea: Can you please explain to our audience what the stratum corneum is?

26:59 Rebecca Gadberry: It's that barrier that we talked about a long time ago on the podcast, like around May or June.

27:05 Trina Renea: But they may have not listened to that one.

27:07 Rebecca Gadberry: Yes, but they can go back and listen.

27:07 Julie Falls: It's the surface of your skin.

27:09 Rebecca Gadberry: Yeah, it's the surface. It's the barrier of your skin. It's what keeps things out or allows certain things to get in. It also keeps moisture in. It keeps transepidermal water loss or TEWL, what we pronounce ‘tool’, at a minimum. The barrier on the neck is super effective at reducing water loss compared to the cheeks. 

The dermis, which is your underlying part of your skin that helps to keep away sagging and wrinkles, it is thinner than on the face. So you're going to lose some of its components, like Dr. V was just talking about collagen. You're more likely to lose certain types of collagen there that help to keep the neck from forming those bands or forming the lines that go from the chin to the collarbone.

In order to stimulate the collagens and elastin, which is in the dermis and it provides stretchability to the neck, and the neck is much more elastic than on the face because you're turning your neck all the time.

28:25 Trina Renea: So it has to be stretchy skin.

28:27 Rebecca Gadberry: Yeah, and it's your swivel point for your head.

28:30 Trina Renea: Swivel bobblehead.

28:33 Rebecca Gadberry: I like peptides for that, and the best peptide that I like for that is called, and we're going to put this in the show notes, Acetyl Dipeptide-1 Cetyl Ester. 

28:47 Trina Renea: Forget it, I'm not going to write it. I was just trying to write it and I'm like…

28:52 Rebecca Gadberry: Okay, don't worry about it. It'll be on the Show Notes.

28:54 Julie Falls: How in the world are people supposed to find that?

28:56 Rebecca Gadberry: Well, you go to Google, and you enter the name of the ingredient and then you hit ‘Image’. All the products that have that ingredient in them will pop up on Google.

29:13 Trina Renea: All the products that have their ingredients. 

29:14 Dr. Vicki Rapaport: Do you have a product that you make in your lab with that amazing peptide in it?

29:19 Rebecca Gadberry: I do. 

29:19 Dr. Vicki Rapaport: Can you tell me the name of it?

29:20 Rebecca Gadberry: I can't, because I don't know.

29:24 Dr. Vicki Rapaport: Oh, it's in formulation.

29:25 Rebecca Gadberry: It's in a formulation. I use it in…

29:27 Trina Renea: You can call her later.

29:29 Dr. Vicki Rapaport: It's coming.

29:31 Rebecca Gadberry: It's there.

29:31 Dr. Vicki Rapaport: Oh, I see, I see.

29:32 Trina Renea: The formulation is there and you can get a hold of it if you call her lab.

29:38 Dr. Vicki Rapaport: Okay.

29:39 Rebecca Gadberry: But you can't call my lab if you're a consumer. Only brands. I believe it's called neck and throat cream, but I'm not sure. I put some silicones in there to make sure that it's not going to be sticky.

29:58 Dr. Vicki Rapaport: Is there glycerin in there?

29:59 Rebecca Gadberry: I don't know. I developed it 12 years ago. 

30:02 Dr. Vicki Rapaport: Okay. Amazing.

30:03 Rebecca Gadberry: I'm redeveloping it next year, because there's some new ingredients and some of those I'm talking about. There's also an ingredient that is from the plant edelweiss. Edelweiss…

30:16 Trina Renea: I love that song.

30:17 Rebecca Gadberry: Edelweiss, it comes from Switzerland.

30:21 Julie Falls: I feel like I read something about that.

30:24 Rebecca Gadberry: It helps to tighten sagging in jowls. It works with that part of your dermis where it keeps the sagging away. And as you get older with all that movement, the sagging starts in and this ingredient, the edelweiss ingredient, it's actually an edelweiss stem cell ingredient. So it's got ‘callus culture’ in the name, which is an indicator that it's from stem cells.

And then we also have monk fruit, which has a firming and filling effect. That's specifically for the bands on the neck and it does remarkably well.

31:09 Trina Renea: We're going to have to talk about neck cream later, making a neck cream. Anyway, go on.

31:12 Rebecca Gadberry: I love neck creams. What I like to do with a good neck cream, and I again I like it thicker but not sticky, is I like to take certain essential oils and do a lymphatic drainage massage along with it. You can take the oils that are really good for lymphatic drainage massage, like lemongrass and sandalwood and myrtle and Cyprus. There's also one called bourbon geranium. It's a specific kind of geranium, but you can get all of these online. Just put a drop or two into your neck cream, rub it together and heat up the neck cream between your palms. And then put it on your fingers, your fingertips, and then you can do the lymphatic drainage massage.

There are several ways to do it. There's a way to start at the back behind your jawline, behind your jawbone and kind of press with your fingertips in almost like pulsing motions towards, in front of that muscle that you were calling the…

32:31 Dr. Vicki Rapaport: The sternocleidomastoid?

32:32 Rebecca Gadberry: Right, it's that long muscle that runs from the back of your jaw to your collarbone, the center of your collarbone and you can massage directly in front of there. Or you can do single nodes where you start behind with one finger on each side and you just kind of press and rotate towards the center of your neck or your jaw. 

Then you go down to that muscle we were just mentioning. I can never remember the name of it. And you go down towards the clavicle or the collarbone. 

Now, I know you do lymphatic drainage massage too, so do you have any tips to add to that?

33:21 Trina Renea: I mean, if you want to do it yourself and you're putting cream and you want to get rid of puffiness in your neck, you can definitely do a little lymphatic drainage. It's barely touching your skin, so it's a very super light, light touch. You do it in a heartbeat, with your heartbeat and you just slowly move down your lymph. 

Because lymph doesn't move on its own so it doesn't have a pump, so you need to pump it. You want to go from the top of your jaw down your neck. You go down to the clavicle bone. And then the trash cans where they empty are right at the edge of the two clavicle bones right underneath. You just pump it down and out and that'll help with the little inflammation.

34:02 Dr. Vicki Rapaport: Do you ever use any instruments when you do that? 

34:06 Trina Renea: You can use a Gua Sha. 

34:08 Dr. Vicki Rapaport: Yeah? Do you use that when you do this? 

34:10 Trina Renea: I do in my facials.

34:12 Rebecca Gadberry: What is that?

34:12 Dr. Vicki Rapaport: I bet it feels so good.

34:13 Trina Renea: A Gua Sha is just a stone.

34:15 Julie Falls: Stone.

34:16 Trina Renea: The Gua Sha is actually a movement that they call Gua Sha. It's bringing blood circulation with the edge of something that helps to move things down and bring blood circulation to the face.

Back in old, ancient Chinese times, they used to use the edge of a baby bottle lid or some kind of edge of a lid on any kind of jar that has a soft, rounded edge. You can just use that. 

34:50 Julie Falls: Now, they're like rose quartz and jade.

34:52 Trina Renea: Now, they use jade and rose quartz. It's a stone that's cold. It feels good. It has a smooth edge. And when you put a little oil or cream on the face, you can use that. It's just more of a marketing fun-shaped tool.

35:05 Julie Falls: Somebody just asked me in my emails that I get, a listener, using a Gua Sha, can it move filler around? If you've had filler put in your face, can it move it around?

35:20 Trina Renea: If you just got the filler done, sure. 

35:21 Dr. Vicki Rapaport: Yep. I think it's a timing thing. So when you get filler for one to two weeks, you really should just leave your face alone. After that, it's perfectly fine.

35:27 Julie Falls: That makes sense.

35:28 Dr. Vicki Rapaport: You're really not moving filler around with the Gua Sha after that.

35:30 Trina Renea: You don't want to get a facial right after you get Botox or filler either, because you don't want us moving it around. Same with Gua Sha, once the filler is settled…

35:41 Julie Falls: Then you can do anything.

35:42 Julie Falls: But that's a great tip, Julie. I'm going to put that on my post-care instructions at my office. Because people are using more and more of those Gua Shas.

35:48 Julie Falls: Yes, they are.

35:51 Trina Renea: And the little rollers.

35:52 Dr. Vicki Rapaport: That's great. I'm going to include that.

35:54 Julie Falls: I found the product that was making me break out.

35:55 Rebecca Gadberry: Right. I got it and it's not Skin Medica. 

35:58 Julie Falls: No, it's iS Clinical.

36:00 Trina Renea: iS Clinical.

36:01 Rebecca Gadberry: iS Clinical NeckPerfect Complex. It has natural AHAs in it, and it also has the phenoxyethanol I was talking about, and it is a gel.

36:12 Julie Falls: So I used it on my neck and my chest and broke out from it.

36:16 Rebecca Gadberry: I can imagine.

36:16 Julie Falls: What's in there that would do that?

36:17 Rebecca Gadberry: The phenoxyethanol. And it also has fragrance, so I don't know what kind of fragrance. It also has citrus, lemon and orange.

36:26 Julie Falls: But don't you think that I should be able to return that?

36:31 Trina Renea: Yes. If you tell them you had an allergic reaction.

36:31 Rebecca Gadberry: If you broke out, you should be able to return it. Absolutely.

36:35 Dr. Vicki Rapaport: Did you take pictures of your breakout?

36:37 Rebecca Gadberry: Oh, Julie.

36:37 Trina Renea: Hey, everybody.

36:37 Rebecca Gadberry: Now, the Gua Sha you can get online, can't you?

36:43 Trina Renea: Yes. It's a movement. If you look online, you’ll find how you use a Gua Sha. You can use anything with a soft edge. You don't have to buy a Gua Sha stone that they're selling but it's an easy tool to hold and it's easy to clean, so you can.

37:00 Rebecca Gadberry: I just wanted to add some tips.

37:03 Trina Renea: Okay. I just wanted to let you guys know, as an audience, we're going to wrap this episode up in just a little bit, but we will do a deep dive into neck ingredients on an episode soon. And coming up in about a couple more episodes, we're going to have a couple plastic surgeons on that we will also touch on some neck situations with them as well. 

So we will be talking more about the neck. It is a big subject. 

37:31 Julie Falls: We're going to dive deeper.

37:32 Trina Renea: Yeah, we're going to definitely dive deeper. This was like a little teaser for that.

37:32 Rebecca Gadberry: Right, because we haven't talked about niacinamide, which is one of my favorite ingredients for the neck, and also retinol.

37:42 Trina Renea: Which we've talked about in the past summer. 

37:44 Rebecca Gadberry: So when we do the deep dive on the neck ingredients, I'll talk about those a little bit more deeply.

37:49 Trina Renea: Perfect. Okay.

37:50 Dr. Vicki Rapaport: So, this is just a teaser to the deep dive. I love it.

37:54 Trina Renea: Teaser to deep dive, and to our plastic surgeon talks too.

37:58 Rebecca Gadberry: So I wanted to talk about single pillows for the neck, because if you have doubled up on your pillows, you're going to be promoting creases in your neck.

38:09 Trina Renea: Unless you're using a neck pillow, which helps to straighten the neck.

38:11 Rebecca Gadberry: I was going to say there's also neck pillows that you can get online.

38:14 Trina Renea: There's a company I love called Spry. I use it in my facial room. It's a neck pillow that I use for people to help them get— it just helps you straighten out your neck. You can use it when you sleep behind your pillow too. People scrunch up when they sleep and it actually holds your neck into a position where you can back sleep without turning from being uncomfortable because it supports the neck and it keeps you from wrinkling up your neck, which is really nice.

38:45 Rebecca Gadberry: Which is great.

38:46 Trina Renea: A neck pillow. But you're right, doubling up on pillows where you're scrunched up even more.

38:52 Rebecca Gadberry: Yeah. My husband sleeps on three pillows, you sleep on five.

38:55 Trina Renea: I sleep on five but I'm sleeping like I just should get an angled bed.

39:00 Rebecca Gadberry: Yeah, because you’re sleeping like that.

39:02 Trina Renea: So my neck is still in a good position. I'm just sleeping.

39:06 Rebecca Gadberry: And you get up straight so you don't bend your neck.

39:10 Trina Renea: I feel like if you back sleep, gravity pulls your face back. It's like an instant face lift, eight hours a day, 365 days a year all your life. You'll wrinkle less if you're not smashing your face if you're on the side sleepers or the face sleepers.

39:27 Rebecca Gadberry: That’s an interesting story.

39:28 Julie Falls: How do you make yourself do that, though?

39:30 Rebecca Gadberry: There's a good reason to sleep on your side, especially your right side, but we can talk about that another time. It's an interesting story.

39:38 Trina Renea: I haven't had any filler.

39:40 Rebecca Gadberry: So the reason, by the way, we want to do lymphatic drainage massage is because the neck starts to puff up. Then we can get more wrinkles that way. 

39:50 Trina Renea: I do it a lot in facials. When I notice people's necks need it, I just do it without even telling them. I just kind of do it in the facial. 

40:00 Dr. Vicki Rapaport: What about any exercises to strengthen the musculature?

40:03 Trina Renea: People say neck yoga and tightening. I don't know how much that actually works.

40:05 Rebecca Gadberry: I don’t like that because it makes your muscles move and that causes the lines to form. So I've never been a big one on facial exercises.

40:15 Trina Renea: People ask me that and I say I have no idea. It's out of my…

40:18 Rebecca Gadberry: What are some of the most used muscles of your body, besides your heart? Your face muscles…

40:22 Julie Falls: Your jaw.

40:22 Rebecca Gadberry: Your neck muscles, your jaw muscles. 

40:25 Trina Renea: What do you say to people, Vicki, about that?

40:28 Dr. Vicki Rapaport: Nobody ever asks me about that. The facial exercises, nobody ever asks me. I don't know anything about them either. I don't think that they probably do much, but again, if people kind of think it's fun…

40:37 Trina Renea: Like, if people did this all the time, I'm going to do a facial exercise.

40:44 Rebecca Gadberry: She's pulling the lower part of her mouth down.

40:45 Trina Renea: Is that going to do anything?

40:46 Dr. Vicki Rapaport: No. Make your platysmal muscles stronger, thicker, fatter, less elegant, less sexy. 

One other cute thing I will just add a tidbit for the neck with Botox, you know, we'll do those bands, those platysmal bands which will flatten really nicely, but sometimes we'll also thin the neck line out a little bit if people have very, very, very thick, high traps. You can sort of flatten the trap down, trapezius muscle, with Botox so that the neck looks longer, elongated, more elegant versus a trap and then a short neck. You can make the trap flatter and thinner and the neck looks beautiful, like a swan.

41:26 Rebecca Gadberry: In Pilates we do that. We practice with that in Pilates. 

41:30 Trina Renea: That sounds lovely.

41:31 Rebecca Gadberry: So, in ranking what we've talked about, because we've talked about everything right now, we want to start at a young age, especially if you're letting your kids use the phone at 10. You want to start at a young age with a neck cream. Always wear sunscreen on the front and the back of your neck. Then when you get older, you kind of graduate to a stronger neck cream but it's never going to be what you're going to get with a procedure for corrective or for plastic surgery for corrective.

And after you've had those procedures, use a neck cream to prolong the procedure and maintain the effects as long as you can.

42:15 Trina Renea: And don't just think a neck cream is going to fix your neck. It takes some other things along with it.

42:20 Rebecca Gadberry: It could take 12 months.

42:23 Trina Renea: I mean, you can use neck cream as a preventative when you're in your late 20s, 30s and start using it as preventive, but you can't start in your 40s and 50s thinking that a neck cream is going to fix, completely take the wrinkles away in your neck. That’s not going to happen.

42:38 Rebecca Gadberry: It never will. That's when you visit Dr. Vicki or her peers.

42:43 Trina Renea: Yeah. Cool. I think we've touched on everything today and we're going to continue to talk about the neck, so come back and see us for a deep dive into the neck. And when we have a couple of our doctors on coming up, we’ll also put it in the title so that you know we're talking about the neck again. You can look for those in our descriptions, in our titles as well.

43:06 Rebecca Gadberry: And I want to make it clear that the jowls, the neck and the décolletage or the upper chest are usually covered all at the same time, but they are three distinct areas of the body. And so we are going to do a show on each one of them. We’ll talk about the jowls.

43:24 Julie Falls: One thing we didn't mention, really fast before we sign off, is to stay away from retinols on your neck. Right, Dr. Vicki? Didn’t you say that?

43:32 Dr. Vicki Rapaport: The neck can be much more sensitive than the face. The face just has a lot more sebaceous glands, so you can usually tolerate things like retinol, Retin-A better on your face. But you can use it. You just got to go slow. 

When I start people on Retin-A, I say, “Please avoid your neck completely.” But retinol, which is the weak over-the-counter cousin, you could go slow.

43:48 Julie Falls: You can use on your neck. Okay. 

43:49 Dr. Vicki Rapaport: Once or twice a week to start that. 

43:52 Rebecca Gadberry: Like half-a-percent retinol or something, maybe it's in a liposome to slow the delivery or something like that.

43:58 Julie Falls: Okay. 

43:59 Trina Renea: In facials, I tell people to avoid their neck with exfoliation and things like that, because they do tend to, when they're using it on their neck, they come back and they're like, “Why is my neck all crepe-y and dry and weird?” It's usually because they've been using some aggressive exfoliator that they're using on their face, their glycolics, their Retin-A’s, the things like that. 

So I'll just be like, “You know what? Treat this with cream and serums and peptides and growth factors, but just try and avoid exfoliating that area.” Across the board, you don't know what people are using for their exfoliation so you can't say it's safe, unless you're giving it to them and you're like, “This one is very mild.” That's what I tell people.

So, we are going to leave you all now, but we will be back soon with another episode on next. Thanks for joining us today. Everybody, have a beautiful rest of your day.

45:04 Dr. Vicki Rapaport: Thank you. Enjoy your weekend.

45:05 Rebecca Gadberry: And your life, yes. 

45:07 Julie Falls: Goodbye everybody.

45:08 Trina Renea: Bye.

45:10 Rebecca Gadberry: Bye. 

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