New Diamond Technique Introduced for Neck and Décolleté Rejuvenation

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A novel manuscript introduced the Diamond technique, a minimally invasive procedure that rejuvenates the neck and décolleté in older patients.¹ The method uses a diamond-shaped acetate device to guide the injected solutions, which contain calcium hydroxyapatite (CaHA), hyaluronic acid (HA), and incobotulinumtoxinA (INCO). This combination can create a more youthful appearance by restoring firmness, smoothness, and hydration while reducing platysmal bands.

Thanks to UV exposure and environmental stressors, these areas are prone to early signs of aging such as saggy skin, muscle laxity, wrinkles, spots, and loss of elasticity.² The current methods for rejuvenating the skin and maximizing aesthetic improvement are biostimulators, hyaluronic acid, laser therapy, micro-focused ultrasound, and neurotoxins.³

The utilized device is a pentagonal acetate plate (18 × 14 cm = 200 cm²) with 71 orifices, cleaned with 70% alcohol-based antiseptic before each use. It creates markings on the skin vectors/vertexes and outlines the injection points. The placement of the diamond-shaped device varies slightly depending on whether the neck or décolleté is being treated.

Clinicians use a combination of solutions; the first one involves 1.5 mL of CaHA, 1 mL of HA, 4 mL of saline, and 1 mL of 2% lidocaine, while the second utilizes 1.2 mL of INCO diluted with 4 mL of saline. The highly diluted mixture of CaHA and HA is applied first and immediately after, 0.1–0.2 mL of hyperdiluted INCO toxin is added using a 22G × 70 mm cannula.

This particular report followed 4 female patients aged between 55 and 63, who had no previous treatments on the neck and décolleté regions. Based on the Merz scale of neck laxity at rest, 2 participants were categorized as grade II while the remaining were categorized as grade III. Each was asked to rate their results using a 5-point subjective satisfaction scale. Clinical photographs were taken before and after treatment.

All 4 patients showed improvements in skin quality, laxity, and wrinkle appearance 90 days after treatment. More specifically, 2 participants had “good results” while 2 reported results were “beyond expectations.”

Overall, the procedure was well tolerated with few adverse events. Minor pain, transient edema, and bruising were observed but this was minimal. None of the patients needed touch-ups or retreatment and expressed that they would undergo the procedure again if needed.

“The ‘diamond’ device brings agility to the marking process and technical reasoning, without compromising the individualization of each treatment. In addition, the simple and well-standardized technique eases medical training and increases reproducibility,” the authors wrote. “Moreover, the technique can be tailored as the composition of CaHA and/or HA can be changed according to the needs and customization of each treatment and patient. Consequently, highly predictable clinical results and patient satisfaction are possible when the Diamond technique is strictly followed.”

Although this report showed initial success, controlled, blinded, and prospective studies are necessary to confirm its efficacy, safety, and cost-effectiveness, especially when compared to existing protocols. According to the authors, this research should be rigorous, comprehensive, and long-term with objective measurements so investigators and clinicians can maximize treatment outcomes.

References

1. Dos Santos Teodoro M, da Fonseca Armada Barros JH, da Cunha ALG. Diamond Technique: A Triple Treatment for Neck and Décolletage Rejuvenation. J Cosmet Dermatol. Published online December 4, 2024. doi:10.1111/jocd.16667

2. Shadfar S, Perkins SW. Anatomy and physiology of the aging neck. Facial Plast Surg Clin North Am. 2014;22(2):161-170. doi:10.1016/j.fsc.2014.01.009

3. Engerer N, Frank K, Moellhoff N, et al. Aging of the Neck Decoded: New Insights for Minimally Invasive Treatments. Aesthetic Plast Surg. 2022;46(4):1698-1705. doi:10.1007/s00266-022-02961-0