You probably need an isolated neck lift without a facelift.

To amourei,

Hi!   It is very hard to give you specific advice without seeing you because every thing depends on the individual anatomy.  There are literally 8 different causes for a "bad neck".

Based on your description, a neck lift would help you. This is done through a short scar under the chin.  If you have a weak chin, a small chin implant placed through the same incision can do wonders in redraping the skin of the neck.

We do Thermage as a non invasive procedure to tighten skin, but I think this probably would not help you enough.

The problems of the neck can be broken down into anatomic structures and there findings as you age:

1. Sagging skin due to loss of elasticity

Non-surgical treatment options -

• Laser
• Thermage
• IPL (Intense pulsed light)
• Chemical peels

All have very little effect on the excess skin of the neck. Some believe their value borders on worthless.

Surgical treatment options -

• Submental skin excision- either through a vertical or horizontal incision, skin can be removed from under the neck. The vertical scar technique can remove a large amount of skin, but the scar can be visible (healing time is very small). The horizontal scar technique removes less skin but no scar is visible.
• Post-auricular scar excision - a fancy term to remove the skin of the neck from behind the ears. The best way, if possible is to bunch the skin right behind the ear, so that the hairline is not affected and a woman can wear her hair in a ponytail without concerns of visible scars.

2. Excess fat under the neck

Non surgical treatment options -

• Mesotherapy - stay away!

Surgical treatment options -

• Liposuction - an excellent technique with good results regardless of the type of machine used. You don't need smartlipo or slimlipo - conventional lipo works just fine.

3.  Sagging of the Platysma muscle of the neck

Non-surgical treatment options -

• Botox - can work for mild bands of muscle
• Segmental transection of the muscle - small incisions are made on the edge of the platysmal muscle where it sags and relaxes the muscle - done under local anesthesia.

Surgical treatment options -

• Tightening of the muscle should include a release of some muscle at the angle of the neck. This procedure should be done in almost all other neck procedures described above.

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Some patients receive a good response with tightening devices such as Thermage and Titan. Others do not receive the good result. There is no guarantee and it is a costly treatment.

Liposuction is a surgery but can improve the looseness as well.

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