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Ask The Surgeon, Cleveland Magazine, 7/1/2012

Start Date: Sunday, July 1, 2012
Last Modified: Monday, March 26, 2018
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Question: I have some fine wrinkles and a few creases on my upper chest (just between and above my breasts). I'm really self-conscious of this, especially when I wear V-neck tops or dresses with straps. Is there anything that can be done to treat that area?

 

Answer: The area you're describing, known as the décolletage, is a concern to many women who opt for fashions that highlight the cleavage and collarbone. The main cause of this problem is excessive sun exposure and aging. Just like on the face, sun damage will eventually cause wrinkles. The other contributing factor and perhaps the reason you have deeper creases has to do with your sleeping position. When you lay on your side the breast tissue (of the top breast) tends to shift down causing a fold between the breasts and over time this becomes a permanent crease.

 

Treatments for this, in the past, have included chemical peels and lasers, both of these options can cause burns, scarring, and pigmentation changes that can be very difficult to correct. I have found that the best treatment for mild to moderate lines of the décolletage to be injection of a hyaluronicacid (HA) product such as JUVÉDERM® XC. HA is a naturally occurring substance in the skin that sun damage can deplete. This causes your skin to lose volume and wrinkles to occur. The injection of the HA filler helps to replenish the skin and return natural structure. I start with conservative injections in the area and gradually increase the amount over several weeks for the best result. This treatment has worked very well with my patients and generally lasts over a year, as long as the patient limits further sun damage.

 

Just as many women are using a daily sunscreen product on their face, (many makeup lines now boast an SPF of 15 to 30) they should also be applying it to the neck and décolletage to prevent further damage. Sleeping on the back, versus the sides, should also help to prevent further wrinkles and creases from developing.