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When it comes to the question of how to age gracefully, the majority of women want an answer beyond arguments. Women are looking for ways to look and stay young and to age gracefully without showing off the signs of ageing for as long as possible. Women pay special attention to and get cosmetic treatments for their face, neck and hands, but one of the most ignored areas is the “Décolletage” region.

Décolletage is a French word, which translates to mean “exposing the neck”. The Décolletage area is comprises of the upper portion of woman’s torso; the neck, shoulders, chest and back. Visually this is the exposed area through the neckline of women’s clothing; sometimes referred to as a women’s cleavage. The Décolletage area is highly vulnerable and one of the first areas to show tell-tails signs of ageing due to its sensitive and thin skin. The Décolletage area has fewer oil glands and is more predisposed to the sun damage, skin irritations and other changes related to ageing. The skin is less elastic compared to other parts of the body due to a lack of fat in the tissues. As a result, the Décolletage skin is more likely to develop “crepe-paper” like fine lines, dryness, pigmentation and spots.

Why pay attention to the Décolletage and neck area?

Just as the skin of the face is susceptible to showing  signs of ageing, similarly the neck and Décolletage area show the common signs of ageing such as fine or deep lines (wrinkles); loss of skin elasticity, skin dryness and discolouration of skin as a result of sun damage.

The skin and muscles around the neck powerful and they provide support to the jawline and head. However, the main muscles of the neck are not connected directly to the bone structure, which makes it more prone to the elastic loss and gravity.

The female breast is composed of various types of tissue including fat, glandular and connective tissues. There are no muscles or bands in the breast to provide support with the exception of large muscle of chest wall; the pectoral muscle.

Similarly in the neck and the Décolletage area, there is little fat in its tissue along with fewer oily glands making the area more vulnerable to dryness and wrinkles. Some other causes can be the stresses on skin from movement, the weight of breast tissue and exposure to UV radiations.  People who undergo hormonal ageing (Menopause) may also notice a change in the tone and texture of skin.

Physical causes of appearance of wrinkles in cleavage

As the skin become older and dryer, the cleavage wrinkles appear to become deep vertical creases. There are numerous physical causes which can make them more prominent which includes;

  • Sleeping on just one side.
  • Wearing push up and sports bras.
  • Excessive sun exposure making it susceptible to UV damage.
  • Rapid changes in weight.
  • Hormonal changes due to menopause making women in their 40s and 50s more prone to Décolletage wrinkles

Décolletage Treatment Options

There are numerous effective Décolletage wrinkle treatments available. These simple treatments help in preventing and improving the appearance of chest wrinkles. Most of the non-surgical cosmetic treatments that are used for facial rejuvenation are also applied for Décolletage treatment. Here is an overview of the most common neck and Décolletage treatment methods available.

  • Combined CO2 resurfacing and PRP Décolletage treatment

This Décolletage treatment uses a combination of Fractional CO2 Laser and Platelet Rich Plasma (PRP) injections for treating the cleavage wrinkles. CO2 is a fractional laser therapy that is ideal to treat the sun damaged skin, age spots, fine lines and wrinkles, skin laxity, texture and scarring. This fractional laser treatment for Décolletage encourages the production of new collagen giving an immediate tightening effect while improving Décolletage wrinkles. After the CO2 laser treatment for chest wrinkles, the next step a cosmetic doctor may employ is to inject almost 50 to 60 small PRP deposits into intra-dermal layer of Décolletage. This will further help in repairing skin damage making décolletage neckline firmer, smoother, plumper and radiant.

Side effects: There are few and temporary side effects of this Décolletage treatment. The skin will remain red for almost 7-10 days and will exfoliate. 

Results: The results of this laser chest wrinkles treatment keeps on improving during the next few months as the new collagen will synthesize and cause the skin to repair and regenerate

It is advised to moisturise the Décolletage area regularly along with the use of factor 50 sun protection (SPF 50) to prevent any further sun damage. It is recommended to have a course of 3 Décolletage treatments with a gap of one to two in-between each treatment. The results of this combined treatment last for more than 3 years and in some cases the results of CO2 resurfacing are permanent.

  • Biomimetic Mesotherapy

This Décolletage treatment is aimed to stimulate mesoderm by boosting the production of collagen and elastin within Décolletage skin. It effectively treats the chest wrinkles induced by sun damage and has little or no downtime.

This Décolletage rejuvenation treatment procedure involves injecting into the Décolletage area with active ingredients that include hyaluronic acid, peptides and retinols. The aim of this treatment is to rejuvenate the skin and to soften the chest wrinkles.

Results: The results of this Décolletage treatment start to surface in a couple of weeks but for optimal results, it is recommended to have a course of 3 sessions in a week. 

Side effects: Mild and temporary side effects that include pinprick bleeding along with skin bumps which usually fades away in 6-12 hours.

  • Chemical skin peels for Décolletage treatment

For improving the texture, tone and elasticity of skin, chemical skin peels play a crucial role but their benefits are often overlooked. Glycolic acid peels are mild peels that are particularly effective in softening and smoothing the Décolletage wrinkles. These peels belong to the family of AHA peels and work on the cellular skin level causing the cells to shed rather than causing the shedding of skin sheets. This peeling process is normally slow so the patients may need 6 treatment sessions.

It is very important to pre-treat the Décolletage skin with AHA skin care products for at least 2 weeks before the treatment in order to prepare it for the glycolic acid peel and minimize the skin damage.

The glycolic acid peel for chest wrinkles treatment is individually tailored to suit the skin type of a patient. When it is applied on the Décolletage area, it is left for about 10 minutes after which it is rinsed off. Moisturising cream along with SPF 50 sun screen is applied on the skin. 

Results: For best results a course of 6 peels once a week is recommended. This treatment promotes cellular activity in the dermal skin layer thereby improving the texture and tone of skin. The results of this peel treatment lasts for up to a year but for lasting results, AHA maintenance regime and skin conditioning is recommended.

  • Micro needling

This treatment involves the use of a micro-needling device that is rolled over the skin of chest region. This leads to the creation of thousands of “pinpoint punctures” in the dermis of skin. The body perceive this as damage and activates the body’s natural wound healing process boosting collagen levels. As a result the production of collagen thickens skin and improves the fine lines, wrinkles, scars and uneven skin tone.

Peptide and antioxidant serums are gently massaged to penetrate into the skin whilst micro-needling is still occurring to optimise treatment. 

Results: This treatment stimulates the natural healing process of the body with effects lasting for several months. During this period, the results will keep on improving. 

Possible side effects: The common side effects of micro-needling décolletage treatment include temporary skin reddening for some time.  It is recommended to have a course of six treatments after every 4-6 weeks.

  • Dermal filler and Botox for Décolletage wrinkles treatment

The efficacy of Dermal fillers and Botox is already established in treating fine lines and wrinkles in the facial. Similarly they can be effectively used for Décolletage treatment.

The tiny microinjections of hyaluronic acid dermal fillers can be injected into the Décolletage area, which helps in reducing the fine lines and wrinkles while giving a plumping effect to the area smoothening bumps. 

Results: The tiny doses of natural filler are injected into the entire chest area to avoid bumps and unevenness.  The use of permanent fillers like silicone should be avoided as it may result in the formation of nodules. The results of hyaluronic acid can last for up 9 to 12 months. 


Small doses of Botulinum Toxin A (Botox) are injected into the dermis layer of Décolletage with a distance of 1-2cm, which has the same effect when treating facial wrinkles. The injections cause the relaxing of muscles underneath the skin and improving superficial wrinkles. This treatment is safe with minimal side effects and gives results lasting for about 3-6 months.

Radio Frequency for Décolletage treatment

  • Non-Ablative

This treatment helps by tightening the crinkly chest skin and stimulating the production of collagen. Before the treatment, a conductive gel is applied to the area and the radiofrequency device is used to deliver constant and gradual energy which causes the Décolletage skin to heat up. This stimulates collagen production over the time. The tightening in Décolletage skin can be instantly experienced with the results improving over the following 4-6 months with the formation of new collagen. For achieving best results a course of 6 treatments is recommended with gap of 2 weeks in between. This procedure should offer long lasting results.

  • Ablative

Another treatment that can give effective results is the use of ablative radiofrequency devices using coated or uncoated pins that make holes in the skin and cause tissue coagulation. However, this chest wrinkles treatment needs extensive experience, expertise and caution as very high energy levels can cause damage to the thin chest skin. 3 sessions with a 6 weeks gap are recommended for good results.

  • Photodynamic therapy (PDT)

It’s a simple but time consuming treatment that is highly effective for skin rejuvenation, treating skin pigmentation and sun damaged chest skin.

The treatment starts with the use of an exfoliating mask which is applied over the Décolletage skin to remove dead skin cells. A light sensitising cream along with 5-aminolaevulinic acid (ALA ) is applied over the sun damaged skin. After the application of creams, the treatment area is covered for almost 3 hours to allow a deep penetration of cream into sun-damaged chest skin. The area is exposed to the red LED laser that targets the photosensitised damaged skin cells for 10 minutes. The body then naturally replaces and repairs the damaged skin cells with healthy ones.

Side effects: This treatment can cause redness, burning sensation, blistering, peeling and milia formation in the treated area for about 2 weeks.

  • Intense Pulse Light (IPL)

IPL is the time tested treatment that is used for improving sun damaged skin, reducing skin discolouration, age spots and broken thread veins or blood capillaries. In an IPL treatment, specific photo-filter wavelengths are used for targeting the pigmented and damaged area. The release of low energy levels on skin cause stimulation of collagen and promotes cells regeneration making skin tighter and plumper. High levels of energy absorption by pigmentation cause photo-coagulation of skin tissues which are repaired and replaced naturally by the body. 

Side effects: The treatment area can become red for some time. But can also become noticeably darker for few days. The patients may need up to 6 treatment sessions and the results of the treatment lasts for about 18 months.

Combination of Polydioxanone(PDO) sutures and dermaroller for Décolletage treatment

One of the latest, advanced and innovative weapons to fight against signs of ageing and Décolletage damage is the use of PDO sutures.  These sutures are known for their dual effect; they stimulate collagen and elastin along with lifting and tightening the skin. 30 G knotless PDO sutures are inserted sub-dermally within the skin to create a structural matrix that is followed by the rolling of 3mm dermaroller all over the surface along with PRP application. This treatment requires local anaesthesia. As mentioned previously, the use of dermaroller induces damage to the skin stimulating the body’s natural healing process and increase in cellular activity. This combined treatment gives brilliant skin rejuvenating results that can last for more than 2 years. This treatment can also help in improving the stretch marks formed around the Décolletage and breasts.

In addition to the above stated treatments, it is highly recommended to use good skin care products that are packed with antioxidants such as peptides and vitamins which help in repairing, protecting and revitalising the décolletage area as well as promotes the stimulation of collagen and elastin.

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