Abstract:
A method of toning skin on a human patient&#39;s neck. The method includes applying a beam to an exterior surface of a portion of the skin of the neck. The beam comprises at least one of infrared light waves, ultrasound waves, and low fluence radiofrequency waves. The beam is configured to tone the portion of the skin. The portion may include a posterior portion of the skin of the neck. In such embodiments, the beam tones the posterior portion causing the posterior portion to pull on and tighten an anterior portion of the skin. The portion of the skin may include a circumferential portion that extends circumferentially completely around the neck. The skin is divisible circumferentially around the neck into a plurality of sections that each extend only partway around the neck. The beam may be applied to each of the plurality of sections separately.

Description:
BACKGROUND OF THE INVENTION 
     Field of the Invention 
       [0001]    The present invention is directed generally to methods of improving the appearance of the human neck by toning or tightening the skin and/or related tissue. 
       Description of the Related Art 
       [0002]      FIG. 1A  is an illustration of a cross-section of old skin  10 , and  FIG. 1B  is an illustration of a cross-section of young skin  12 . Both the old skin  10  and the young skin  12  have the same anatomical structures. For example, the old skin  10  and the young skin  12  each have an epidermis  14 , a dermis  16 , and a hypodermis  18 . Both the old skin  10  and the young skin  12  have an exterior surface  13  that is an outermost portion of the epidermis  14 . A lower layer of the dermis  16  is referred to as a reticular dermis  17 , and a layer above the reticular dermis  17  is referred to as a papillary dermis  19 . Connective tissue  20  lies within the hypodermis  18 , and fascia  22  is under or at the base of the hypodermis  18 . The fascia  22  surrounds muscles, ligaments, and tendons and anchors the skin to bony prominences. 
         [0003]    Collagen is abundant in the reticular dermis  17 , and elastin is found mainly in the papillary dermis  19 . Collagen resists stretching and provides structure to the skin. Elastin gives skin resiliency and the ability to stretch and snap back into shape (like a rubber band). Unfortunately, collagen and elastin levels in the structures of the young skin  12  decrease with aging and photodamage. As the volume of these compounds is depleted, the skin becomes more lax, sags, and wrinkles. Thus, as illustrated in  FIGS. 1A and 1B , the old skin  10  is more lax and less toned than the young skin  12 . 
         [0004]    Many people are dissatisfied with the appearance of their neck. For example, many people believe the skin on their neck has wrinkled and/or sagged in an undesirable or unattractive manner. To address this problem, a number of surgical procedures have been developed to improve the appearance of the neck. For example, a conventional neck lift or platysmaplasty removes some skin from the neck, and repositions and/or tightens other skin. Unfortunately, such surgical interventions are painful, require recovery time, and may have undesirable complications (e.g., infections, scarring, nerve damage, tissue damage, etc.). Further, some people are simply not good surgical candidates and cannot take advantage of such procedures. Therefore, a need exists for methods of improving the appearance of the neck. Methods that do not involve surgery are particularly desirable. The present application provides these and other advantages as will be apparent from the following detailed description and accompanying figures. 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S) 
         [0005]      FIG. 1A  is an illustration of a cross-section of old skin. 
           [0006]      FIG. 1B  is an illustration of a cross-section of young skin. 
           [0007]      FIG. 2  is an illustration of a patient having the posterior portion of her neck toned by a beam emitting device operated by a healthcare provider. 
           [0008]      FIG. 3  is a cross-section of a portion of the beam emitting device illustrated treating a portion the patient&#39;s skin. 
           [0009]      FIG. 4  is an illustration of a posterior neck toning treatment grid. 
           [0010]      FIG. 5  is an illustration of a right posterior-lateral neck toning treatment grid. 
           [0011]      FIG. 6  is an illustration of a right lateral neck toning treatment grid. 
           [0012]      FIG. 7  is an illustration of a right anterior-lateral neck toning treatment grid. 
           [0013]      FIG. 8  is an illustration of an anterior neck toning treatment grid. 
           [0014]      FIG. 9  is an illustration of a left anterior-lateral neck toning treatment grid. 
           [0015]      FIG. 10  is an illustration of a left lateral neck toning treatment grid. 
           [0016]      FIG. 11  is an illustration of a left posterior-lateral neck toning treatment grid. 
           [0017]      FIG. 12  is an illustration of the healthcare provider using the beam emitting device to apply a beam to the anterior neck toning treatment grid. 
           [0018]      FIG. 13  is an illustration of the healthcare provider applying gel to the anterior neck toning treatment grid. 
           [0019]      FIG. 14  is an illustration of the healthcare provider using the beam emitting device to apply the beam to the anterior neck toning treatment grid through the gel. 
           [0020]      FIG. 15A  is a photograph depicting an anterior portion of a patient&#39;s neck before treatment. 
           [0021]      FIG. 15B  is a photograph depicting the anterior portion of the same patient&#39;s neck after treatment. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0022]      FIG. 2  depicts a patient  100  with a neck  110 . A healthcare provider  112  (e.g., a physician, nurse, technician, and the like) operates a beam emitting device  120  and positions it to deliver a beam  122  (e.g., light, ultrasound, or radiofrequency) to at least a portion of a treatment area  124 . The treatment area  124  may include the entire neck  110  or a portion thereof. For example, the treatment area  124  may include a circumferentially extending portion of the neck  110 . The treatment area  124  may also include portions of the shoulders, lower jaw (e.g., under the chin), upper chest, and/or upper back of the patient. 
         [0023]    The beam  122  is applied to the exterior surface  13  (see  FIGS. 1A and 1B ) of skin  130  in the treatment area  124 . Referring to  FIGS. 1A and 1B , like the old skin  10  and the young skin  12 , the skin  130  (see  FIG. 2 ) includes the epidermis  14 , the dermis  16 , and the hypodermis  18 . Further, the connective tissue  20  lies within the hypodermis  18 , and the fascia  22  is located under (or at the base of) the hypodermis  18 . In particular, the beam  122  may be delivered to structures composed of various subtypes of collagen (types I-XII) and subtypes of elastin (I-VI) depending on depth and function. For example, the beam  122  may be delivered to the dermis  14 , the connective tissue  20 , and the fascia  22  within the treatment area  124 . 
         [0024]    As illustrated in  FIG. 3 , the device  120  may include a treatment window  140  through which the beam  122  is emitted from a source  142 . The treatment window  140  may be configured to be placed near or against the exterior surface  13  of the skin  130  in at least a portion of the treatment area  124 . If the treatment window  140  is smaller than the treatment area  124 , the beam  122  will be applied to only a portion of the treatment area  124 . For ease of illustration, the beam  122  will be described as being applied to a target region  144 . As is apparent to those of ordinary skill in the art, the treatment area  124  may include one or more target regions. If necessary to treat the entire treatment area  124 , the treatment window  140  may be repositioned within the treatment area  124  to apply the beam  122  on different target regions until the entire treatment area  124  has been treated. The different target regions may be non-overlapping, or partially overlapping. By way of a non-limiting example, the beam  122  may be applied to one or more target regions located circumferentially around the neck  110  by positioning and/or repositioning the treatment window  140  to apply the beam  122  to those target regions within the treatment area  124 . 
         [0025]    The beam  122  may be delivered in a continuous pulsed delivery or intermittent pulsed delivery. The beam  122  may include light, ultrasound, and/or low fluence radiofrequency (“RF”). Low fluence RF may be delivered at a low level that does not cause pain and at the same time penetrates the skin to a satisfactory depth (e.g., up to about 20 mm). In contrast, higher fluence radiofrequency treatments can penetrate beyond 20 mm into the skin and deliver more heat and are frequently described by patients as being painful. By way of another non-limiting example, the source  142  may be implemented using any source suitable for delivering low fluence RF (e.g., suitable devices may be purchased from Cynosure, Inc., which acquired Palomar Medical Technologies, Inc., Alma Lasers, Ltd., and the like). Non-limiting examples of suitable devices include the Peneve S5 RF System manufactured by Cynosure, Inc., the Accent Family of RF based platforms manufactured by Alma Lasers, Ltd., and the like. 
         [0026]    In embodiments in which the beam  122  delivers ultrasound waves, the source  142  may be implemented using a micro pinpoint ultrasound device. By way of another non-limiting example, the source  142  may be implementing using any source suitable for delivering ultherapy. 
         [0027]    In embodiments in which the beam  122  delivers light, the light may be near infrared light (700 nanometers (“nm”)-1200 nm), mid infrared light (900 nm-1400 nm) or far infrared light (1300 nm-1800 nm), or broadband light (e.g., having wavelengths of approximately 695 nm to greater than approximately 800 nm). By way of a non-limiting example, the light may include only infrared light. By way of another non-limiting example, the light may have wavelengths of about 700 nm (near infrared) to about 1,800 nm (far infrared). The source  142  may be implemented using an infrared light source, a broadband spectrum light source, and the like. 
         [0028]    The beam  122  may penetrate a predetermined distance into the target region  144 . For example, the beam  122  may penetrate into or through the skin  130  only about 1 mm to about 3 mm. In contrast, radiofrequency treatments can penetrate beyond 20 mm in the skin and are frequently described by patients as being painful. 
         [0029]    While the beam  122  may include light, the beam  122  is not a laser of the type commonly used for facial resurfacing. Collagen fibers are abundant in the reticular dermis  17 , which is a lower layer of the dermis  16 . On the other hand, the epidermis  14  (see  FIGS. 1A and 1B ), which is above the dermis  16 , is nearly devoid of collagen fibers. A laser of the type used for facial resurfacing cannot reach the reticular dermis  17  (to shrink collagen therein) without damaging or denaturing collagen. 
         [0030]    The source  142  may be capable of controlling skin temperature. Collagen fibers shrink when heated. Thermal shrinkage of collagen occurs between about 55° C. and about 58° C. Thus, the source  142  may be used to heat the skin  130  to between about 55° C. and about 58° C. to help tone the skin  130 . Treatments utilizing the source  142  may not be painful or require anesthesia. 
         [0031]    Without being limited by theory, it is believed that the beam  122  (e.g., infrared light, ultrasound, or broad band light) may tone skin through a process referred to as biostimulation, which is defined as the use of light or ultrasound to direct the body to repair damaged skin and tissue components. Fibroblasts produce collagen and elastin, which are structural components of skin, muscle, and connective tissue. Fibroblast cells can repair elastin and collagen in skin, muscle, ligaments, and tendons. When skin is lacerated, fibroblasts repair the damage by making a scar. Fibroblasts can also be stimulated by the beam  122  to repair damaged skin and tissue in the absence of a laceration or wound. For example, when stimulated by the beam  122 , fibroblasts may repair damaged collagen fibers in the reticular dermis and/or synthesize new collagen fibers (neocollagenesis). Collagen fibers give structural support to skin. When stimulated by the beam  122 , fibroblasts may repair damaged elastin fibers in the papillary dermis and/or synthesize new elastin fibers (neoelastigenesis). Elastin fibers give stretchability to the skin. Thus, referring to  FIG. 2 , the beam  122  may be used to help tone the skin  130  (and improve the appearance the skin  130 ) by stimulating fibroblasts to repair and/or synthesize collagen fibers and/or elastin fibers. 
         [0032]    Referring to  FIG. 2 , by way of non-limiting examples, the beam emitting device  120  may be implemented as a deep dermal heating device, such as a TITAN device, which can deliver light having a wavelength within a range of about 1100 nm-to about 1800 nm (available from Cutera, Inc.), or a broadband light device, such as a BBL™ SkinTyte (“ST”) BroadBand Light device, which can deliver light having wavelengths of about 700 nm to about 1300 nm) (available from Sciton, Inc). Other non-limiting examples of devices that may be used to implement the beam emitting device  120  are described in U.S. patent application publication No. 2005/0049658, titled “Method and System for Treatment of PostPartum Abdominal Skin Redundancy or Laxity,” and U.S. patent application publication No. 2006/0052847, titled “System and Method for Heating Skin Using Light to Provide Tissue Treatment.” 
         [0033]    As explained above, the beam  122  may be applied to the skin  130  and used to improve both its structure (by repairing and making new collagen fibers) and its elasticity (by repairing and making new elastin fibers). Thus, if the beam  122  is used to treat a front portion of the neck  110 , one would expect the structure and elasticity of that portion to improve. The inventor found that using the beam  122  to treat the back (or posterior) of the neck  110  (see  FIGS. 2 and 4 ) may also improve the appearance of the front (or anterior) of the neck  110  (see  FIGS. 8, 12-14, and 15A-15B ). In particular, treating the back of the neck  110  was found to improve the appearance of the front of the neck  110  in thin, athletic women. In these patients, about 50% to about 75% (and sometimes even 100%) of the forward sagging skin and soft tissue on the front of the neck  110  was improved after the beam  122  was used to tone the back of the neck. Essentially, the skin  130  on the rear of the neck  110  was tightened (or pulled taut), which pulled the skin on other parts of the neck rearwardly and immediately improved the appearance of the front of the neck. 
         [0034]    The back of the neck  110  is very delicate because it contains nerves, arteries, and muscles that are so close to the surface that it is impossible to dissect out those structures and perform a surgical “lift” or toning. The inventor determined that the back of the neck  110  may be treated safely with the beam  122 . Thus, the beam  122  may be used to treat portions of the neck  110  that may not be treated surgically. 
         [0035]    Referring to  FIGS. 4-11 , the neck  110  may be divided circumferentially into eight grids each including three sections. When one of the grids is treated, the beam  122  (see  FIG. 3 ) is applied to each of the sections in the grid. For example,  FIG. 4  depicts sections P 1 -P 3  defined on the back or posterior of the neck  110 . Together, the sections P 1 -P 3  form a posterior neck toning treatment grid. In  FIG. 2 , the healthcare provider  112  is using the device  120  to treat the posterior neck toning treatment grid. Returning to  FIG. 4 , when treating the posterior neck toning treatment grid, the beam  122  (see  FIG. 3 ) is applied to each of the sections P 1 -P 3 . 
         [0036]      FIG. 5  depicts sections P 2 -P 4  defined on right posterior-lateral portion of the neck  110 . Together, the sections P 2 -P 4  form a right posterior-lateral neck toning treatment grid.  FIG. 6  depicts sections P 3 -P 5  defined on right lateral portion of the neck  110 . Together, the sections P 3 -P 5  form a right lateral neck toning treatment grid.  FIG. 7  depicts sections P 4 -P 6  defined on right anterior-lateral portion of the neck  110 . Together, the sections P 4 -P 6  form a right anterior-lateral neck toning treatment grid. 
         [0037]      FIG. 8  depicts sections P 5 -P 7  defined on an anterior portion of the neck  110 . Together, the sections P 5 -P 7  form an anterior neck toning treatment grid. In  FIG. 12 , the healthcare provider  112  is using the device  120  to treat the anterior neck toning treatment grid. Returning to  FIG. 8 , when treating the anterior neck toning treatment grid, the beam  122  (see  FIG. 3 ) is applied to each of the sections P 5 -P 7 . 
         [0038]      FIG. 9  depicts sections P 6 -P 8  defined on a left anterior-lateral portion of the neck  110 . Together, the sections P 6 -P 8  form a left anterior-lateral neck toning treatment grid.  FIG. 10  depicts sections P 7 , P 8 , and P 1  defined on left lateral portion of the neck  110 . Together, the sections P 7 , P 8 , and P 1  form a left lateral neck toning treatment grid.  FIG. 11  depicts sections P 8 , P 1 , and P 2  defined on left posterior-lateral portion of the neck  110 . Together, the sections P 8 , P 1 , and P 2  form a left posterior-lateral neck toning treatment grid. 
         [0039]    The beam  122  (see  FIG. 3 ) may be applied to each of the sections P 1 -P 8  to thereby apply circumferential treatment ( 360  degrees) around the neck  110 . Such circumferential treatment tones neck muscles (e.g., the platysma muscle and posterior neck muscles) and connective tissue associated with (or attached to) these muscles together as a unit. This toning provides a circumferential reduction, which clinically translates into a more toned, lifted, and/or “pedestal” neck with reduced or eliminated forward sag. 
         [0040]    Referring to  FIG. 3 , a layer of gel  150  (e.g., refrigerated or cooled water soluble ultrasound gel) may be applied to the exterior surface  13  (see  FIG. 3 ) of the skin  130  in the target region  144  before the target region  144  is treated with the device  120 .  FIG. 13  illustrates the healthcare provider  112  applying the gel  150  to the anterior neck toning treatment grid, and  FIG. 14  illustrates the healthcare provider  112  using the device  120  to apply the beam  122  (see  FIG. 3 ) to the anterior neck toning treatment grid through the gel  150 . 
         [0041]    As will be readily appreciated by those of ordinary skill in the art, any number of gels may be used in connection with applying the beam  122  to the outer surface of the target region  144 . After the gel  150  is applied, the treatment window  140  may be placed against the outer surface of the target region  144  and used to deliver the beam  122  to the outer surface of the target region  144  through the gel  150 . Then, the gel  150  may be wiped away. The process of applying the gel  150 , using the device  120 , and wiping away the gel  150  may be repeated one or more times. 
         [0042]    Optionally, referring to  FIG. 3 , a layer of a composition  152  may be applied to the exterior surface  13  (see  FIG. 3 ) of the skin  130  of the target region  144  before the target region  144  is treated with the device  120 . For example, the composition  152  may be applied to the outer surface of the target region  144  first. Then, the gel  150  may be applied over the composition  152 . In such embodiments, the composition  152  lies substantially between the outer surface of the target region  144  and the gel  150 . After the composition  152  and the gel  150  are applied to the outer surface of the target region  144 , the treatment window  140  may be placed against the outer surface of the target region  144  and used to deliver beam  122  to the outer surface of the target region  144  through the composition  152  and the gel  150 . Then, the composition  152  and the gel  150  may be wiped away. The process of applying the composition  152 , applying the gel  150 , using the device  120 , and wiping away the composition  152  and the gel  150  may be repeated one or more times. 
         [0043]    The composition  152  may be inert and may not be absorbable by the skin. By way of a non-limiting example, the composition  152  may be in the form of a powder that includes one or more of the following ingredients in varying amounts: micronized zinc oxide, micronized titanium dioxide, pigmenting titanium dioxide, iron oxide, oat, rice, mica, silicone powder, marine algae and/or talc. As used herein, the term “micronized” describes a relatively small particle size (especially with regard to the particle size of like compounds used in traditional sunscreen products), which may be, for instance, in the range of about 30 μm to about 50 μm, and in certain embodiments, of about 40 μm. As used herein, “pigmenting titanium dioxide” is a form of titanium dioxide with a relatively large particle size, which may be, for instance, at least 850 μm, at least 900 μm, at least 950 μm and/or up to about 1,000 μm. The composition  152  may be formulated to include particles of varying size so as to reflect, refract, and/or scatter light exposed to the composition  152  in a generally predetermined manner. The composition  152  may include one or more compositions that may be obtained from Colorescience (Dana Point, Calif.). For example, the composition  152  may include Sunforgettable Mineral Powder Sun Protection SPF 50 and/or Pressed Illuminating Pearl Powder. 
         [0044]    The composition  152  may also include a quantity of salicylic acid, which may itself be in powder form. Such salicylic acid powder includes a predetermined concentration of powered salicylic acid, such as 0.01%, 0.05%, 0.1%, 0.5%, 1.0%, 1.5%, 2.0%, 2.5%, or 3.0%. In an embodiment of the present invention, the salicylic acid powder includes 1% powdered salicylic acid. 
         [0045]    Referring to  FIG. 3 , preparing the outer surface of the target region  144  with the composition  152  and the gel  150 , as described above, augments the skin tightening effect, while advantageously cooling the exterior surface  13  of the skin  130  of the target region  144  through the inherent properties of minerals and mineral pigments, which are known to have a surface cooling effect. The device  120  delivers the beam  122  (e.g., infrared light) that heats the dermal layer of the skin  130 . Sustained heating of the dermal layer of the skin  130  (see  FIG. 2 ) over several seconds (e.g., up to six seconds) contracts the collagen and elastin components of the dermis and/or causes long-term stimulation of collagen and elastin remodeling through fibroblast activity, resulting in tightening of the skin  130 , reduction of the skin  130 , and/or improved skin tone. Additionally, the connective tissue  20  and/or the fascia  22  may be reduced, tightened, and/or toned. 
         [0046]    By way of a non-limiting example, the composition  152  (e.g., including micronized zinc oxide, micronized titanium dioxide, mica, and 1% salicylic acid powder) may be applied to the outer surface of the target region  144 . Then, the gel  150  may applied atop the composition  152 . Next, the treatment window  140  is placed firmly onto the skin  130  in the target region  144 , and the beam  122  is applied to the target region  144 . Then, the beam  122  is discontinued and the treatment window  140  is moved away from the target region  144 . Within the span of several seconds, the skin  130  has been pre-cooled (by the gel  150 ), and heated with the beam  122 . Optionally, the skin  130  may be post-cooled (e.g., by a new layer of the gel  150 ). This process (referred as a “pulse”) may be repeated for different target regions in the treatment area  124  with minimal overlap until the entire treatment area  124  has been treated. As used herein, a series of pulses required to substantially cover the treatment area  124  is referred to as a “pass.” Upon completion of a first pass, additional passes may be performed until a desirable number of passes have been performed. The desirable number of passes may be readily determined in each instance by a skilled artisan, based on a variety of factors, such as, but not limited to, the condition of the treatment area before treatment and the response of the treatment area to one or more passes. 
         [0047]    Once the desired number of passes are completed, treatment of the treatment area  124  is completed. Treatment of the treatment area  124  may result in some immediate reduction in skin and ongoing reduction of skin over several weeks thereafter. 
         [0048]      FIGS. 15A-15B  are photographs depicting exemplary results achieved by a patient.  FIG. 15A  depicts an anterior portion of the patient&#39;s neck before treatment, and  FIG. 15B  depicts the anterior portion of the patient&#39;s neck after treatment. As may be viewed in  FIGS. 15A-15B , the treatment improved the tone of the patient&#39;s neck. 
         [0049]    The methods described above are non-invasive, require no anesthesia, and require no recovery time. These methods may be used tone skin having mild, moderate, or severe laxity, wrinkling, and/or sagging. Additionally, these methods may be useful for women and men regardless of their age or skin color. 
         [0050]    The foregoing described embodiments depict different components contained within, or connected with, different other components. It is to be understood that such depicted architectures are merely exemplary, and that in fact many other architectures can be implemented which achieve the same functionality. In a conceptual sense, any arrangement of components to achieve the same functionality is effectively “associated” such that the desired functionality is achieved. Hence, any two components herein combined to achieve a particular functionality can be seen as “associated with” each other such that the desired functionality is achieved, irrespective of architectures or intermedial components. Likewise, any two components so associated can also be viewed as being “operably connected,” or “operably coupled,” to each other to achieve the desired functionality. 
         [0051]    While particular embodiments of the present invention have been shown and described, it will be obvious to those skilled in the art that, based upon the teachings herein, changes and modifications may be made without departing from this invention and its broader aspects and, therefore, the appended claims are to encompass within their scope all such changes and modifications as are within the true spirit and scope of this invention. Furthermore, it is to be understood that the invention is solely defined by the appended claims. It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to inventions containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations. In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). 
         [0052]    Accordingly, the invention is not limited except as by the appended claims.