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Abstract Background: Aesthetic improvement of the neck and cervicomental angle remains one of the most challenging aspects of rejuvenation. Changes in skin quality, submental fat, and muscle tone or position related to aging, photo damage and other factors are among the causes. Fractional radiofrequency microneedling demonstrated significant wrinkle reduction, skin tightening and lifting of lower third of the face, as well as the advantage of its long-lasting high efficacy and safety for treating the aging neck. Autologous platelet rich plasma also has been used in skin rejuvenation of face and neck with promising results. Combining (fr-RF) microneedling and autologous (PRP) might provide synergistic benefit in neck rejuvenation and minimize downtime plus possible side effects.Aim: To evaluate and compare the efficacy and safety of fr-RF microneedling alone and combined with PRP in neck rejuvenation. Methods: Twenty female patients with aging signs of the neck were enrolled in this study and randomly assigned to one of two treatment groups (group A: fr-RF microneedling + PRP, group B: fr-RF microneedling). Patients received a total of 3 sessions one month apart. Evaluation of results was done using optical coherence tomography (OCT) to detect changes in epidermal and dermal thickness, measurements of cervicomental angle and clinical photographs before and after treatment by two blinded investigators as well as patient{u2019}s satisfaction level |