Ask a doctor

Best Procedure for Firming Neck and Chin?

I'm about to turn 50. The skin on my face is relatively firm and in great condition for my age so I don't need a Facelift.

However, my neck and chin area doesn't look nearly as good as my face. What are my options for firming up the neck and chin area?

Doctor Answers (43)

Necklift

+6

Neck Lift (Cervicoplasty / Platysmaplasty): restoring elegance to the face

If a person’s neck does not appear youthful, the face – no matter how limited the aging changes are – will often not be perceived as youthful either, unless the aging neck is concealed.

Even in the absence of other signs of facial aging, a poorly-defined or sagging neck can add years to a patients overall facial appearance. When performed expertly and with great attention to detail, a necklift surgery can dramatically restore a natural and youthful neck profile, with no outward evidence that surgery has been performed. The adjective that immediately comes to mind when I review ‘before and after’ images of my necklift patients is elegant – for restoring a youthful neck contour truly makes the patient appear not just younger but also refined and elegant.

A very wise and very talented surgical mentor of mine put it very succinctly: in facial rejuvenation surgery, “Get the neck right.” A youthful and well-contoured neck, with no distortions of the surrounding tissues and anatomic structures, is the foundation of a beautiful and youthful-appearing face.

Though it is not technically part of the face, a neck with loose, sagging skin can age the face dramatically. A neck lift is a standard part of most facelift surgeries, as the neck skin is mobilized in continuity with the lower face.

Immediately under the skin of the neck is the platysma muscle, which you can easily see in a mirror when you clench your teeth and tighten your jaw. In youth, this paired muscle meets in the midline below the chin. With age, the right and left sides of the platysma often separate, producing vertical 'cords' in the anterior neck. The platysma can be divided anteriorly and tightened during neck lift cosmetic surgery to permanently eliminate these 'cords' and improve the neck contour. One tightened in the midline below the chin, lateral traction on the platysma then creates a 'sling' which elevates the soft tissues below the jawline.

Cervical / submandibular liposuction

Some individuals have 'sagging' necks primarily due to fat accumulation below the jawbone (mandible). In some cases, liposuction alone can significantly improve the neck appearance. Liposuction is also frequently combined with surgical neck rejuvenation, and in selected cases some direct excision of fat (through a hidden incision below the chin) is performed. The reduction of fat in the area below the jawline and in the anterior neck almost always makes the neck appear longer, and makes the patient's profile appear more elegant or refined.

Suture suspension neck lift

In cosmetic surgery patients that do not have a sharp transition in profile between the submental area (area below the jawline) and the anterior neck, and in patients who simply want that transition enhanced, I add a 'suture suspension necklift'. A permanent suture is passed subcutaneously across the anterior neck, at the level corresponding to depth of the angle between the submental area and anterior neck, and is then anchored to the deep soft tissues behind each earlobe. This suspension cosmetic surgery procedure can dramatically enhance the definition between the jawline and anterior neck, producing a more elegant profile.

The neck is without question the primary 'facelift' aesthetic area where subtractive (excisional) and tightening procedures restore a truly youthful contour. Once again, take a look at the fashion magazines: essentially every neck you'll see demonstrates something close to a right angle between the neck and jaw. When it comes to the neck, and only in the neck, flat is good.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 38 reviews

Best procedure for firming up the neck

+2
A facelift is very effective with firming up the neck. Consider improving the chin area with a chin implant at the same time.

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Neck and Chin Firming

+2

The neck and chin area can often times show the appearance of age with loose skin, wrinkles, or an accumulation of fat. For best results, each concern should be addressed separately and a plan devised. Often liposuction of the neck or skin tightening is a reasonable combination of procedures to improve the appearance of a loose or a fatty lower neck. Depending on the patient’s expectations, liposuction will not correct sagging or wrinkled skin. If these are the patient concerns, then a lower facelift tightening procedure may need to be considered. If there is additional fullness under the chin and within the neck, then liposuction can be utilized in conjunction with a facelift. I recommend consulting with a board certified facial plastic surgeon to access an accurate diagnosis of your particular condition. All the best—Dr. Cohen

Michael D. Cohen, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 27 reviews

You might also like...

Neck lift for comprehensive neck rejuvenation

+2
There are three components in the neck that must be addressed for a comprehensive neck rejuvenation. These components are excess skin, fat above and below the muscle, and the  platysma muscle itself. The anterior platysmal bands are tightened with sutures placed in the  platysma muscle. Fatty  deposits are  removed above and below the platysma muscle, and excess skin is tightened through incisions behind the ears. A lower face/neck lift is the most appropriate operation since a neck lift alone will not address the skin laxity. For many examples of neck lifts and faces/neck lifts, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Best options for tightening the neck and chin

+2

This is probably not the answer you want to hear but, in my opinion, the best option for firming up the neck and chin is a facelift. That having been said, it is not a popular option and many individuals seek non-surgical treatments such as Thermage. The problem with many of these treatments is that they may be capapble of tightening the skin. However, they may deliver a 1-2 on a scale of 10 when what you need is a 7-8. IF you select a less agressive approach, be prepared to accept a less agressive result.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 43 reviews

Options for tightening neck - surgical vs. nonsurgical

+2

Patients are often faced with two choices: to do what gives you the best result, or do what is convenient, inexpensive and gives you some result, just not the best result.

In our practice, we encourage patients to seek a course of action that gives the best result. It saves that middle, money and hope-wasting step of a minimally invasive procedure such as laser lipolysis, liposuction alone, necklift alone etc.

Many 50-year old woman who notice changes of aging in the chin and jawline area would get their best result from a facelift. A properly done facelift will restructure the deep tissues, reestablishing the youthful cheekbone vs. jawline dimension, and tighten skin as necessary. If cleverly done by an experienced facelift specialist, the incisions are usually undetectable.

We have not been enamored with laser procedures because of the risk for burning the skin, superficial skin irregularities, and discoloration of the skin. I have personally seen a patient in whom the laser burned completely through the skin during a submental procedure, an unimaginable complication from.

Proper tightening of the neck skin usually requires a facelift, at least a lower facelift. If patients know the difference between a lower only facelift and facelift, few choose the neck only procedure because of the subtle disharmony that can result from rejuvenation in one portion of the face and not in another.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

How to tighten the neck without a facelift

+2

Many patients come to us asking for their neck to be improved when, in fact, it is actually the face that needs improvement and that procedure also improves the neck. However, some patients truly have very little sagging skin in the face but have some excess fat in the neck along with mildly sagging skin in this region.

The "neck" really refers to jawline down to the clavicle. If the excess skin is near the jaw line (jowls), then the only real treatment is a facelift. If the excess skin an fat is below that, then it is possible to use alternative treatments. One of these is ultrasonic-assisted liposuction. This can remove some of the excess fat in the neck, and at the same time cause some tightening of the skin.

The best way to determine your options is truly with a consultation. Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon

Can neck skin be firmed without a facelift?

+2

As the other replies to your question have noted, there are no nonsurgical treatments that do what a facelift does. Many people do not realize that a facelift includes the neck. Having said that, I have treated many patients in your age group with a combination of liposuction and Thermage. With this combination, there is more tightening than with Thermage alone. It can all be done under local anesthesia with very little recovery time. Your best bet is to see a specialist who can offer a range of surgical and nonsurgical options so that you can get an honest opinion about what is best for you.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

There are different options

+1
Thank you for your question. 

There are a host of noninvasive modalities that would possibly improve those areas, such as Ultherapy.

Whether any of them brings a worthwhile improvement over surgery, I do have my doubts.

If I were to choose, I might delay anything until such time for a less invasive surgical procedure such as a lower and limited neck lift.

I hope this helps....

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

Neck Lift addressed by Lower Face Lift

+1
An exam is always needed to determine how the specific causes of your undesired neck appearance. In particular there are 4 main factors that need to be evaluated:
1. the amount of redundant skin, excess fat below the chin, (requires neck or lower facelift (mini - lift)
2. banding of your neck mid-line neck muscles (platysmal bands) - requires platysmal plication (neck tightening)
3. elasticity of your skin. - requires laser or peels, thermage, ultherapy
4. a weak chin (supports the skin structure) - requires chin augmentation
Each of these components are dealt with in a different manner. For example, excess fat requires direct removal or liposuction (more common), widely spread playtsmal bands are brought together (neck tightening), and excess skin is removed with a lower facelift or neck lift (this can be done with minimal scars). Certain lasers and peels can help with elasticity problems and your photo seems to indicate adequate chin projection

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 40 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.