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The neck, decolletage and hands used to be the forgotten areas but with advancements in technology and homecare we can now treat these areas with little downtime and efficacious results.

Most patients who visit me for a neck consultation will be over the age of 45, although I will always assess a patient’s physiological skin age rather than solely looking at their chronological age. We commonly treat the lower face and neck for skin laxity and my favoured procedure would be a combination of Profound and homecare.

Profound is a radiofrequency (RF) micro-needling device that is Food & Drug Administration (FDA) cleared for both the face and the body. It is clinically proven to produce three fundamental components for youthful skin – elastin, collagen and hyaluronic acid. Instead of adding these elements to skin, it activates the body’s own production – up to five times more elastin, two times more collagen and an increase in hyaluronic acid. A noticeable difference should be recorded after six weeks, and at six months the results are at their best. These optimal results last up to three years. At that point the visible results will start to decrease, and another treatment may be recommended.

The Profound device uses 32G insulated needles to penetrate the skin and deliver long pulse radiofrequency to either the dermis or the subcutaneous layers of tissue. Using this method will spare the epidermis, meaning the barrier of the skin is less compromised, while delivering the radiofrequency energy.

It can be safely used on Fitzpatrick skin types I to IV, and potentially in higher Fitzpatrick skin types with caution, by experienced doctors.

The treatment time is around 45-60 minutes, followed by LED to help with inflammation. Patients will be in the clinic for about two hours in total. We then apply Clinisept+ Aftercare to help with inflammation and Oxygenetix Oxygenating Foundation to cover any redness or bruising.


Figure 1: Pre and post treatment with Profound.


Figure 2: Pre and post treatment with Nectifirm®.

After eight weeks. Nectifirm® used twice daily, morning and evening.
No other products or treatments were used.
Photos courtesy of Revision Skincare® and Victoria Cirillo-Hyland, MD, and Colleen Witmer,
Spa Director, Cirillo Cosmetic Dermatology Spa, Bryn Mawr, PA.
Results may vary.


After the skin has fully healed at home, I complement the treatment with a medical-grade skincare product such as Revision Skincare Nectifirm Advanced for the client to use as part of their daily regimen. Nectifirm Advanced uses a proprietary blend of peptides, proteins and ingredients to stimulate biological processes to reduce the visible signs of ageing on the neck. It helps the skin appear brighter, firmer and lifted and reduces the appearance of adipose tissue and rough, crepey skin – therefore working in harmony with the Profound treatment. Once fully healed a patient can expect to see a reduction in wrinkles and a lifted, tighter contour to the lower face and neck (Figure 1 and 2).


Dr Sophie’s Tri-Lift Protocol
  • Step 1 – Virtual or in-clinic consultation to ascertain suitability.
  • Step 2 – Profound treatment – one to two hours for the local anaesthetic and the facial treatment. Actual treatment time – 45-60 minutes.
  • Step 3 – Healing time. This takes approximately seven days followed by targeted skincare.
  • Step 4 – Filler two to four weeks post Profound treatment – 30-minute appointment. Filler is administered where needed for volume and lift.


Declaration of competing interests: The author has received a fee for speaking at a press event for Revision Skincare.



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Sophie Shotter (Dr)

Illuminate Skin and Wellness Clinics, Kent, UK.

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