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Crepey, Saggy Neck at 39, What Are My Options?

I am 39 years old, generally slim and youthful in appearance. I am 5'5 and 124 pounds, and have two children. I gained and lost about 50 pounds in each pregnancy. My neck skin is extremely wrinkly, crepey, and saggy. My face and body look 35, but my neck looks like it belongs to a 55-year old. I KNOW I have some sun damage there from some severe burns I got in my teens. I am also wondering if the weight gains and losses of pregnancy contributed to the sagging. What can I do?

Doctor Answers 13

Neck Lift Will Correct Crepy Saggy Neck Skin

Thank you for your question.

Certainly weight gain and loss will cause loose skin under the neck.

From your photo you appear to have loose skin, some residual fat and lax neck muscle.

A Neck Lift with repair of the muscle through a small incision under your chin, and tightening of the muscle and removal of loose skin through incisions behind the ears should give you a very nice result.

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Laser Assisted Weekend Necklift

It is possible that you may be a candidate for what I have termed, "The Laser Assisted Weekend Necklift:" It is a minimally invasive procedure and the downtown is generally 2-3 days.

Cervicofacial Liposculpture is first employed to contour the unfavorable fatty changes seen in the face and neck as time passes by, such as the ‘Turkey neck’ and ‘double chin’.

Careful attention is then turned to tightening the neck muscles and eliminating neck bands. Finally, I employ laser technology to ‘resurface’ the underside of the neck skin, thereby ‘shrinkwrapping’ the skin of the neck restoring a youthful contour.

A consultation with a board certified facial plastic surgeon will help determine which procedures will provide the best results for you.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.5 out of 5 stars 41 reviews

Loose skin at 39 looking at Face Lift and Neck Lift

 I have performed Face Lifts and Neck Lifts for over 20 years and at 39 you have more loose skin that typical.  This, IMHO, is most likely due to the substantial weight gain and loss as you described.  Your choices, to remove, this amount of skin are limited and would include a formal Neck Lift or some smaller variation of excess skin excision under the chin.  The limited surgery would not make the neck completely smooth like the full neck lift, so the decision, of how smooth, you'd like your neck would dictate what procedure is best for you.

 IMHO, you should not rely on sutures, threads or suture suspension procedures to tighten and lift your loose neck skin.  These procedures, IMO, are all limited by the fact the threads are more stiff then the tissue within which they are placed.  This creates a "wire through cheese" type effect that will cause the threads (sutures) to move towards the surface, of the skin, or loosen which allows the skin to once again sag.  This degree of loose skin will require an incision, tissue dissection and skin removal.  RF or Laser treatrments, IMO, tighten the skin a couple of mm's and would not be able to remove 2 inches of skin, like the Neck Lift.

You should have a few consultations with Face Lift surgeons with good reputations to discuss your best options.  Hope this helps and good luck.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Crepey, loose neck skin needs a facelift

While your photos aren't perfect, even at your age, your weight gains and losses have taken away your skin elasticity and it will never return.  No non-surgical treatments are worthwhile in my opinion to make any real difference for you.  The only way I know to dramatically improve what you have is to do,a facelift (cheek and neck lift).  On rare occasions these are needed even in folks under 40 if they have the right anatomy.

Neck lift

Although I would need to see you inperson to determine the best option, I think a neck lift would be the most suitable treatment for you to address your concerns. 

Yes, weight fluctuations and sun damage can definitely contribute to sagging skin.

face and neck lift versus neck lift only

The photograph shows a significant amount of excess skin and laxity in the neck area. This most likely due to weight gain and loss, genetics, and sun exposure. The best treatment for this is either a face/ neck lift  or a neck lift  with skin removal. From many examples, please see the link below to our photo Gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Necklift or Ulthera Ultrasound Skin Tightening

A necklift or Ulthera ultrasound skin tightening would help your neck.  A neckift is much more invasive but the results are more dramatic.  Ulthera is an easy outpatient procedure with no downtime.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Solution: Neck Lift

As you know, age is only a number - on that genetically your body doesn't necessarily coincide with. And, yes, the weight gain and loss may be a factor. Loosey, creepy skin is best treated with a neck lift. This procedure can restore the neckline, jawline and your self confidence!

John W. Bass, MD
Phoenix Plastic Surgeon
4.0 out of 5 stars 8 reviews

Corset platysmaplasty

You have two visible problems;

1- Sagging skin from weight loss

2- Platysmal bands - a separation of the platysma muscle with age.

The best way to correct these problems is with a neck lift. In my hands, the most durable and aesthetically natural lift is the Corset Platysmaplasty. You do not need a facelift if your jowls and cheeks are OK.

Other things you can do to maximize the benefit of surgery would be to eat and live well. 

Robert M. Freund, MD
New York Plastic Surgeon
5.0 out of 5 stars 22 reviews

Necklift with Platysmaplasty Will Provide Excellent Longevity

Your "best" option is a neck lift with dedicated tightening of the platysma (=neck) muscle. If done well, this will provide you with superb results and last a long time. Otherwise, non-invasive facial tightening (i.e. Ultherapy) is an non-surgical alternative; the overall improvement will not rival that of a necklift, though.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.5 out of 5 stars 31 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.