Q: What are the pros and cons of a nonsurgical neck lift?

Pros Nonsurgical neck lift procedures come with minimal downtime and pain compared to cosmetic surgery, according to Plano, Texas-based facial plastic surgeon Dr. Vu Ho . They don’t require lengthy incisions or leave noticeable scars. In most situations, a nonsurgical neck lift costs thousands of dollars less than surgery. Some of the procedures also carry a lower risk of complications than surgery. Cons None of these procedures can treat moderate to severe sagging skin in the lower face and neck. Typically, results are far more subtle than those achieved with neck lift surgery, and they don’t last nearly as long. Over time, the cost of maintenance treatments can exceed the price of surgery. Certain nonsurgical procedures, including thread lifts , biostimulatory dermal fillers (like Sculptra and Radiesse ), and deep-heating RF and ultrasound energy treatments, can create scar tissue (and, in some cases, melt fat) in the neck. While this doesn’t happen for all patients, when it does, this can make any future surgical procedures more difficult, and potentially less safe and effective.

Question 1

What is a nonsurgical neck lift?

Accepted Answer

A nonsurgical neck lift aims to smooth and tighten crepey, loose skin in the submental (under chin) and neck area via a combination of noninvasive cosmetic procedures. Depending on your goals, it can also diminish the appearance of jowls, sun damage, fine lines, and neck bands.

When the term was first introduced, it primarily referred to FDA-approved skin tightening treatments, most of which use radiofrequency (RF) or ultrasound energy to heat the lower layers of the skin and stimulate new collagen production.

As the menu of noninvasive, in-office treatment options expanded, the definition of a nonsurgical neck lift broadened. “The line between surgical and nonsurgical options is also being blurred, with some procedures using minimal entry points and threads to improve neck contours,” says Dr. Anil Shah, a plastic surgeon in Chicago.

Read on to learn more about the top options, and how they compare to neck lift surgery.

Question 2

What are the pros and cons of a nonsurgical neck lift?

Accepted Answer

Pros

Nonsurgical neck lift procedures come with minimal downtime and pain compared to cosmetic surgery, according to Plano, Texas-based facial plastic surgeon Dr. Vu Ho.
They don’t require lengthy incisions or leave noticeable scars.
In most situations, a nonsurgical neck lift costs thousands of dollars less than surgery.
Some of the procedures also carry a lower risk of complications than surgery.

Cons

None of these procedures can treat moderate to severe sagging skin in the lower face and neck.
Typically, results are far more subtle than those achieved with neck lift surgery, and they don’t last nearly as long.
Over time, the cost of maintenance treatments can exceed the price of surgery.
Certain nonsurgical procedures, including thread lifts, biostimulatory dermal fillers (like Sculptra and Radiesse), and deep-heating RF and ultrasound energy treatments, can create scar tissue (and, in some cases, melt fat) in the neck. While this doesn’t happen for all patients, when it does, this can make any future surgical procedures more difficult, and potentially less safe and effective.

Question 3

How much does a nonsurgical neck lift cost?

Accepted Answer

Your cost will depend on your provider’s level of experience, their practice location, and the details of your treatment plan.

Each provider has their own favorite treatments and devices, some more expensive than others. Having a consultation with up to three qualified providers will help you hone in on the right provider and plan for your goals and budget. Just make sure their before and after photos show a measurable difference from nonsurgical treatments.

Question 4

Nonsurgical neck lift before and after pictures

Accepted Answer

The nonsurgical neck lift photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

Who makes a good candidate for a nonsurgical neck lift?

Accepted Answer

The best candidates for a nonsurgical neck lift are “typically those with mild skin laxity who want some neck tightening or those seeking moderate fat reduction,” says Dr. Shah.

If you’re looking for a sharply defined jawline, excess skin removal, or significant fat removal, your provider will probably suggest that you consider plastic surgery. “You will probably be disappointed” in the extent and longevity of results from a noninvasive treatment, adds Dr. Shah.

Related: The Treatments and Products Dermatologists Use to Anti-Age Their Own Necks

Question 6

Nonsurgical neck lift treatment options

Accepted Answer

These are the most common nonsurgical neck lift procedures. Your dermatologist or plastic surgeon may recommend one treatment or a combination of several to address your neck concerns.

Find an experienced, reputable provider who can recommend the best options for you. “Results are heavily dependent on the person performing the procedure,” says Dr. Ho. The neck requires careful handling: not only is the skin extremely delicate, but the thin fat layer on its underside must be preserved to maintain a soft, youthful look.

Energy-based skin tightening

Ultrasound and RF energy can be applied to the surface of the skin or just below it, to help rejuvenate lax tissues, firm skin, and smooth fine lines.

Ultrasound-based Ultherapy and RF-driven Thermage FLX have been the go-tos for treating the neck noninvasively. Their deep heat stimulates collagen production and causes existing collagen fibers to constrict, which gives an immediate tightening effect and leads to firmer skin over time. However, in recent years, many practitioners have moved away from these technologies after finding them too intense for the delicate neck tissues.

Sofwave is a more modern approach to noninvasive energy-based tissue firming in the neck. The device restricts its ultrasound energy to the dermal layer of the skin (just below the top layer), to ramp up collagen production while safeguarding fat cells and deeper structures.

The treatment can be done with or without numbing cream. In either case, you’ll feel a mild to moderate pinching sensation that peaks and then quickly subsides.
Sofwave can be done in under an hour and requires no downtime or aftercare.
You may see some immediate skin tightening, but final results usually aren’t visible for six months to a year, once new collagen and elastin have formed.
Doctors typically recommend a single session annually or every other year.

FaceTite is considered a minimally invasive procedure rather than noninvasive: its radiofrequency energy is delivered via a probe that’s placed underneath the skin, for more pronounced tightening coupled with fat-melting. It’s often paired with liposuction, to treat a double chin and sharpen the transition between the neck and jawline.

Most patients require local anesthesia and oral pain medication.
Plan for about a week of recovery time (swelling, bruising, tenderness).
Discomfort can be addressed with ice packs and over-the-counter pain medication.
As collagen production ramps up over the course of three to six months, you’ll see gradual firming and rejuvenation results.
Because FaceTite melts fat, it should be used cautiously in and around the neck, in only appropriate patients.

Radiofrequency microneedling

Some providers also like RF microneedling devices, like Secret RF and Morpheus8, for restoring the neck. Used conservatively and at an appropriate depth, they can firm the skin and improve the appearance of horizontal neck lines. Certain devices, like the Profound RF, have been shown to stimulate elastin production as well as collagen growth to restore elasticity.

Anesthetics vary, depending on the device used. Some call for numbing cream, while others require injections of local anesthetic.
Treating the lower face and neck takes about an hour.
Expect to look red and puffy afterward, with areas of pinpoint bleeding and potential bruising. Stronger treatments, like the Profound, require more downtime than milder RF needling treatments.
Skin may start to appear smoother within a week or two. Final results can take months to materialize.
While these tools can help to firm and thicken the skin, they cannot lift sagging tissue, or eliminate moderate to severe jowls, excess skin, or neck bands.

Laser treatments

Laser resurfacing heats up the lower layers of the skin, causing microdamage that triggers the body’s healing response to address signs of sun damage.

As the skin regenerates, you will see improved texture and tone—especially in hyperpigmentation and crepey neck skin—but sagging will likely remain. Aggressive lasers, like the fractionated CO2, can deliver modest skin tightening, but they’re not a first-line treatment for the neck because they come with a higher risk of scarring.

Most laser treatments for the neck use nonablative fractional lasers. Patients usually opt for numbing cream; some request additional oral pain medication.
Once the area is numb, your doctor will apply a water-based gel to protect your skin and glide the laser across the neck for about 15 to 30 minutes.
Downtime varies by laser. Expect some combination of redness, bronzing, swelling, flaking, and sensitivity, lasting a couple days to a couple of weeks.
Laser resurfacing results appear gradually, over the course of several months.
With gentler nonablative or fractional lasers, most people require a series of three to six sessions, every four to six weeks, so you may not see full results until 9–10 months after your first laser treatment.
If you’re considering laser resurfacing for your neck, trust only a board-certified dermatologist or plastic surgeon who specializes in lasers.

Injectables

Botox, Dysport, and other injectable neuromodulators can relax the platysmal bands—the thick, vertical pleats of the platysma muscle, which can become more prominent over time and give the neck a ropey appearance.

This treatment involves quick, relatively painless pricks.
After the injections, patients are typically given ice packs to apply to the injection sites, to minimize bruising and swelling.
Botox results are usually visible within a week and last between three and six months.
When a neuromodulator is injected along the border of the jawline, as well as into the neck bands, the treatment is known as the "Nefertiti lift.” It’s been shown to be most beneficial in young patients with good skin elasticity.

Hyaluronic acid-based dermal fillers with a very fine viscosity, such as Juvéderm Silk, Belotero Balance, or Restylane Refyne, may be injected into fine, horizontal “necklace bands” (using a fine-gauge needle or a microcannula), to help soften and smooth their appearance. They must be injected sparingly, at the proper depth, to avoid a lumpy look, so only trust a highly experienced injector.

Like Botox, this procedure is relatively painless and quick.
After each injection, they will gently massage the area to help spread out the filler and create a natural look.
Most treatments take between 15 and 30 minutes.
Results are visible right away, though it may take a few days (or even a week or more) to see the final result, once minor swelling subsides.
Thinner fillers tend not to last as long as thicker volumizing gels. Belotero, for instance, usually lasts about six months.

Biostimulatory injectable fillers, such as Sculptra, Bellafill, and Radiesse, can also address crepey skin by stimulating collagen production. In recent years, some plastic surgeons have expressed concerns about these products creating scar tissue in the neck and complicating future surgery. Others are using diluted Radiesse to reduce crepiness and tighten skin on the neck and décolletage, and one small study has documented these benefits.

Related: RealSelf Members Reveal Their Favorite Neck-Tightening Treatments—From Products to Procedures

Question 7

How nonsurgical options compare to surgery

Accepted Answer

If you want longer-lasting, more dramatic results or have moderate to severe sagging skin, consider a surgical neck lift and/or facelift.

New York City board-certified facial plastic surgeon Dr. George Yang uses this metaphor: “The nonsurgical [neck lift] is like trying to shrink an oversized shirt. You can wash it and dry it in the dryer to try to shrink that shirt, but it will only shrink so much.” In contrast, he says, “Surgery is more like tailoring. By tailoring the fat and muscle of the neck and redraping the neck skin, you can get the perfect fit.”

If fullness under the chin—a distinct pocket of fat—is blunting your jawline, your provider may recommend liposuction. This quick surgical procedure can permanently remove fat cells and give the neck a streamlined look.

However, it’s not a one-fits-all treatment. Sometimes what’s causing a neck to look full or saggy has more to do with the platysma muscle, a low-hanging hyoid bone, or deep fat located below the platysma—none of which can be solved with liposuction. See a plastic surgeon or facial plastic surgeon for an in-person exam before committing to neck lipo.

Question 8

Sources and studies

Accepted Answer

Sturm A, Shokri T, Ducic Y. Nonsurgical Rejuvenation of the Neck. Clin Plast Surg. 2023 July.

Siperstein R, Nestor E, Meran S, Grunebaum L, Cotofana S. One-Year Data on the Longevity and Safety of Hyaluronic Acid Filler for Static Horizontal Neck Rhytids. Dermatol Surg. 2023 Sep 18.

Jabbour SF, Kechichian EG, Awaida CJ, Tomb RR, Nasr MW. Botulinum Toxin for Neck Rejuvenation: Assessing Efficacy and Redefining Patient Selection. Plast Reconstr Surg. 2017 Jul.

Bencini PL, Tourlaki A, Galimberti M, Pellacani G. Non-ablative fractionated laser skin resurfacing for the treatment of aged neck skin. J Dermatolog Treat. 2015 Jun.

Oram Y, Akkaya AD. Neck Rejuvenation with Fractional CO2 Laser: Long-term Results. J Clin Aesthet Dermatol. 2014 Aug.

NONSURGICAL NECK LIFT

Vu Ho, MD

Jolene Edgar

Vu Ho, MD

Jolene Edgar

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Vu Ho, MD

Jolene Edgar

Vu Ho, MD

Jolene Edgar

NONSURGICAL NECK LIFT QUESTIONS

Late 30's, horizontal pigmented neck lines - how can I treat this? (Photo)

Late 30's - Neck sagging and creping starting. How can I help it? (Photos)

What treatments can help slim and define my jawline and face? (Photos)

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