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Deep Neck Lines and Folds

I have these really deep lines that go in a circle around my neck. They are hereditary. My father has them and his father had them. I am trying to reduce their number or get rid of them all. Whenever I talk to people this is what they stare at first. I have tried using a product called rejuveneck but I am seeing no results. As I age the folds get deeper. I have tried exercise and everything but they just won't disappear. Please help.

Doctor Answers 14

Horizontal neck folds

The lines that are present in your neck are simply congenital horizontal neck folds that everyone has. Yours are just more prominent. They will not go away with a facelift. They cannot be surgically excised and removed. It is best to just leave them alone and no facial creams are going to help with this problem either. for many examples of what a neck lift can accomplish in our practice, please see the link below.

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

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Options for Neck Folds: Liposuction, Neck Lift, Fat Injections

                  This probably represents a congenital abnormality of the skin and subcutaneous tissue. The cause of the problem isn’t clear and the best treatment is even less clear. Options might include fat injections, liposuction and possibly a neck lift. Although your pictures are helpful a physical exam will be necessary for a more definitive treatment plan. 

Deep Neck Lines treatments

Deep neck lines are a common problem and complaint by many.  Nonsurgical options are available for surgical options may offer better outcomes but still with limitations.  

Horizontal neck lines occur as a result of flexing the neck and occurs in almost every skin type.  Once they get etched in, they are difficult to eliminate but they can be improved. 

Nonsurgical options include using thin fillers such as Belotero and combining this with a resurfacing technique such as fractionated CO2 laser.  There are limitations to this but is an option.

Surgical options usually deliver a better outcome.  The lines will improve but will still remain.  Options include a horizontal necklift where 2 deep lines can be converted into a single deep line.  Alternatively, and a better option usually, is a necklift that tightens the skin upward softening the deep neck lines.  The advantage of this latter procedure is it can be combined with filling the lines with Belotero and the skin can still be resurfaced with a laser to maximize the result.

I would advise you find someone who specializes in facial plastic surgery and performs a high volume of neck surgeries to maximize your result as one can only expect improvement, not elimination of the lines.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Treatment of neck lines

Congenital disorders of the subcutaneous fat are rare, but by no means unheard of. There are several types of disorders in the subcutaneous fat, some congenital and some acquired. Your dermatologist will probably be the most likely to recognize the subtleties of your condition and help make a diagnosis.

Once an underlying etiology is elucidated, you can start looking ahead towards treatment options. These may include either adding or decreasing volume on your neck. There is a new product on the horizon from a company called Kythera that should be approved by the FDA soon. It is currently called ATX–101. The clinical trials for this product looked at its ability to dissolve submental fat, under the chin, and it may provide a future option and some hope as far as treatment for you.

To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Cameron Chesnut, MD, FAAD
Spokane Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Laser Assisted Weekend Facelift

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.

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

Deep Neck Folds

You appear to have a rather unusual problem; the lines are very deep. There are several options you could try from fat injections, fillers, liposuction or even a neck lift but without a thorough exam it is difficult to determine the best option. At my practice, Cape Fear Aesthetics, we always recommend a patient comes in for a thorough consultation, which at my cosmetic practice, are always complimentary. “Dr. D”

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.5 out of 5 stars 61 reviews

Treatment of horizontal neck lines

Fillers may benefit you but you would want to consider a semi permanent filler or fat injections, but you would be best off having a necklift and liposuction to your neck first to reduce the depth of the folds as much as possible. Hyaluronic acids like Restylane will cost you a lot of money and would require treatment every 6 months at least. 

Jason B. Diamond, MD
Beverly Hills Facial Plastic Surgeon
4.0 out of 5 stars 5 reviews

Treatment of deep creases around the neck

This is not a common problem and these creases almost look like joint creases on the palm side of the fingers. Therefore the crease is likely a result of a combination of tissue under the skin and skin itself factors. That is to say these creases are missing some of the deep layers of the skin as well as some of the normally present fat under the skin and may have anomalous connections between the undersurface of the skin and the deeper tissues. All 3 need to be addressed in treating the creases.

Injecting fillers will be expensive over time and probably not give you a uniform result. These creases are below the level of the adam's apple (which is lower than the normal extent of dissection for a face/neck lift procedure) and extend around to the back of the neck (beyond the reaches of a normal face/neck lift). Also from the photos you appear to be darker skinned so any approach employed needs to account for your skin's greater tendency to scar than the average lighter skin colored caucasian.

The treatment would then be an extended face/neck lift placing incisions around the ear and in the crease under the chin. This would lift the skin off the underlying soft tissue and disrupt any anomalous connective tissue between the undersurface of the skin and the deeper tissues. After removing some skin from the bottom edge of the incision and closing that will also flatten the peaks of skin between the creases. Direct manipulation of the creases from the undersurface with grafts and or sutures may further help to reduce the depth of the crease. Because the creases extend around the side of the neck towards the back the incision on the side of the head would have to extend much further than with the usual face/neck lift. The incision around the ear would have to be omega shaped so it is less visible with short hair. I am not sure any safe plastic surgeon would be willing to extend his/her incisions that far back on the side of the head.

I had a similar case years ago of a patient who had fillers injected into the neck in Asia. After some time the normal neck motions caused the filler to collect in specific bands around the neck. The difference was that the deeper areas were not creases like you have and the process did not extend around the side to the back of the neck. Liposuction of the filler and face/neck lift improved the condition significantly but did not completely get rid of the banding.

In short if you just do fillers, just do a regular face/neck lift or even if you do both of these I do not think it will fix the problem. The worst thing to do would be to directly cut out the creases as that would leave you with visible scars that look less natural than a crease.

Your case is very interesting. Thank you for submitting it with a photo.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Deep neck lines can be helped with surgery or fillers.

You can have fillers done to help, but the cost over time is quite a bit. A better choice would be liposuction with or without a neck lift. That would depend on how the tissue feels. You would still need some form of grafting for the residual lines which can be done at he same time.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Deep vertical neck wrinkles

This is a very unusual problem.

An examination would be very necessary. Perhaps a combination of a face and necklift with liposuction might help you, followed by grafting of fat into the depressed areas at a second stage.

Filler can be done on a temporary basis but will quite expensive to maintain.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 103 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.