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How to Get Rid of Excess Neck Skin

I am an active, fit, thin 49yr old woman. However I have one issue that is making me uncomfortable about my appearance. I have a fold of excess skin running lengthwise under my chin. I don't have the sloping chin with excess fat. It seems to be just skin. My friends tell me that it's not noticable, but then I pull the skin back manually behind my ears and they are amazed. I quite litterally look 10 yrs younger! Are there any non surgical ways to get rid of this excess skin or are they a waste of time and money. Should I just go with a chin lift?

Doctor Answers (35)

Improving the Neck

+10
The neck is the one area in facial rejuvenation where a tighter and more toned surgical result looks natural and aesthetically ideal (as opposed to the face where ‘tight’ and ‘tighter’ just looks like surgery). Neck skin removal is accomplished through incisions around the ears which can be extended a short distance into the scalp if necessary. If the incisions are created and closed correctly and without undue tension, a very natural looking result can be obtained with no obvious signs that a necklift has been performed. A great deal of experience and expertise is required to avoid distortion of the ear and surrounding skin.
A number of ‘limited incision’ and ‘quick recovery’ facelift procedures are currently marketed to patients with names like “The Quicklift”, “The Lifestyle Lift”, “The Weekend Facelift”, “The S Lift”, “The MACS Lift”, etc. As with most things in life, if it sounds too good to be true, it usually is. In my opinion, the results of surgery are in direct proportion to the time and effort that the surgeon has put into the procedure. Most of the procedures I have listed above cut corners to arrive at a shorter surgical time and quicker recovery (which, by the way, isn’t always quicker), and most of them undertreat or do not at all improve the neck. Additionally, cutting corners in the neck almost always leads to distortion of the neck area skin, which often is quite readily apparent in ‘before and after’ images of these procedures with gimmicky names. Look for abnormal and unnatural-appearing skin tension lines in the lateral neck as well as below and behind the ears.
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.
The neck is the one area in facial rejuvenation where a tighter and more toned surgical result looks natural and aesthetically ideal (as opposed to the face where ‘tight’ and ‘tighter’ just looks like surgery). Neck skin removal is accomplished through incisions around the ears which can be extended a short distance into the scalp if necessary. If the incisions are created and closed correctly and without undue tension, a very natural looking result can be obtained with no obvious signs that a necklift has been performed. A great deal of experience and expertise is required to avoid distortion of the ear and surrounding skin.

Web reference: http://www.michaellawmd.com/necklift.html

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 31 reviews

Neck issues are simple!

+5

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.
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

How To Get Rid of Excess Neck Skin

+4

Thank you for your question.

When you use your hands to pull the neck skin behind your ears you are creating the appearance of a Neck Lift. If that is the appearance that you want you should have a Neck Lift.

There are many advertisements for a Non-surgical Neck Lift out there. My advice is not to believe them.

Thermage, Titan, Ulthera etc. can only tighten skin about 10-20% and they do less well on the neck. Neck skin is thicker and gravity pulls it down. Non surgical techniques are just not effective enough to lift neck skin

Web reference: http://drseckel.com/surgical-procedures/face-lift/

Boston Plastic Surgeon
5.0 out of 5 stars 24 reviews

No nonsurgical ways to get rid of excess skin in the neck

+4
There are no non-surgical ways to get rid of excess skin in the neck. Neck liposuction only addresses extra fat removal. A neck lift addresses fat removal both above and below the platysma as well as tightening the platysma anteriorly. When excess skin is present in the neck, a lower face/neck lift must be performed in order to tighten loose excess skin. The muscles have to be tightened underneath the neck in both the front of the neck at the level of the jawline and then skin tightened to give a comprehensive facial and neck rejuvenation. For many examples, please see  the link below to our facelift photo  gallery

Web reference: http://www.seattlefacial.com/photogallery/facelift_photos.html

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

You probably need an isolated neck lift without a facelift.

+4

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.

Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

A necklift would be a nice, durable option

+3

Your question is a very common one, and while most patients want to have the procedure with the least amount of downtime, I think an important question to ask yourself is if these nonsurgical procedures will create natural, durable results. With a necklift, the surgeon can control the variables that are contributing to the aged appearance of the neck, including relaxation and loosening of the muscles of your neck, not to mention excess skin and fat. The procedure is straightforward and produces exceptional results in experienced hands. For an investment of 2 weeks (which is the typical amount of time my patients take off from work for recovery from this procedure) you can expect the results to last around 10 years or so.

I would recommend seeking out a Board Certified Plastic Surgeon in your area for a formal consult, and he or she can review with you your options.

Best of luck,

Dr. S

Seattle Plastic Surgeon
5.0 out of 5 stars 85 reviews

It sounds like you need a minilift.

+3

From your description, it sounds like you have excess skin of your neck which is best handled by a minilift with the excision of skin with the incisions around the ear. The incisions can be hidden inside the ear. This is different than the small incision lifts with catchy titles. This is a facelift, but not as extensive as a full facelift.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Excessive neck skin

+2

Excessive neck skin can also include underlying muscle as well.  If pulling your neck skin toward your ears gives you the dramatic look you desire, then likely a minifacelift or full facelift is necessary to achieve this look for you.  If however the skin is limited to a small crepy area under the chin, then simply a minor neck muscle lift under chin with removal of the extra skin is all that is needed.  Hope that helps!

Web reference: http://www.bwfacialplasticsurgery.com/

Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Non surgical neck lift options

+2

The skin can be treated in one of two ways:  Excision of excess skin or redraping the skin over the course of the neck.  The former requires an incision around the ears and the latter can be done without removing skin but by using sutures (there are several different methods) to redrape the excess skin over the length of your jawline.

Saint Louis Plastic Surgeon
5.0 out of 5 stars 1 review

Non-surgical methods will not improve your profile much

+2

I also think that non-surgical methods, whether laser resurfacing, liposuction, laser liposuction, radiofrequency tightening of the skin will only help so much.

Shrink a shirt/Tailor a shirt analogy

 I think my colleagues have all made excellent points regarding surgery versus the non-surgical methods.  I will use an analogy to help make my point.  

The non-surgical method is like trying to shrink an oversized shirt which you are trying to make fit skin tight.  You can wash it and dry it in the dryer to try to shrink that shirt, but it may only shrink so much and you really don't have control how much it will shrink.  Yet the goal is to make the shirt fit skin tight.

Surgery is really tailoring.  By tailoring the fat, muscle of the neck, and redraping the neck skin, will you ultimately get the "tailored" result that you are looking for.  The tailor would need to open the seams of the shirt and remove the extra fabric, then sew the seams back together in the same places that you would expect for a shirt.

The analogy may seem a bit hokey, but I hope it makes some sense when you are thinking about your options.

Best,

Dr. Yang

New York Facial Plastic Surgeon
5.0 out of 5 stars 17 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.

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