I'm 38 and have noticed vertical, crepiness, fine lines on my neck, particularly when flexing. (Photo)

Question

I'm not sure what the cause is, although I've lost about 20 lbs over the course of 6 months, have had 2 children, and weight fluctuation of about 20 lbs over the course of 5 years. Is there a non-surgical option I have to reduce or eliminate, these lines? It was difficult to get a good photo, but the appearance is that of crepe paper. Thanks!

Sheila S. Nazarian, MD · Answer

I recommend a combination of Pelleve and Nectifirm cream to address skin laxity in the neck region. You will need 4-6 Pelleve treatments and you will need to use Nectifirm twice a day for at least 2 months.By best,Sheila Nazarian

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Jed H. Horowitz, MD, FACS · Answer

While non-invasive treatments may improve the appearance for some people, many repeated treatments may be required. Nor do the results outlive those from a surgical procedure.  It's best to begin by consulting with a surgeon in-person.  She or he will evaluate both your anatomical features and aesthetic goals to determine which procedure best suits your individual needs. In some cases your plastic surgeon may give you more than one option to choose from. A neck lift is a general term used for rejuvenating the neckline to create a more youthful attractive appearance. There are various surgical techniques for a neck lift which will be discussed during your consultation. Also, additional procedures may be suggested to complement the neck lift for optimal results.
During the examination the chin will be evaluated along with the neck and jawline.  A weak #chin means there is not adequate chin support for the skin along the neck line. In younger individuals a chin #implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local anesthesia. For individuals with signs of aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.
The contributing factors to the #cost of a #neck lift include the surgeon’s fee, facility fee, medication cost and the anesthesia fee. Estimated fees may also be found here on Real Self, and the American Society of Aesthetic Plastic Surgery website, Surgery.org, or PlasticSurgery.org.  However, many #payments plans exist for cosmetic procedures. Ask your surgeon's office about finance programs and lenders they may recommend as well as personal loans available through financial institutions. It is important to choose a board-certified plastic surgeon who specializes in #neck lift procedures is important to ensure you are receiving the best advice, care, and surgical experience possible.

Michael Constantin Gartner, DO · Answer

It appears that your neck is still quite youthful and the lines you're concerned about appear to be mild. Botox can relax the platysma bands and a laser skin tightening technology may help firm up loose skin to some extent.

John Mesa, MD · Answer

Neck-bands are usually the initial sign of neck aging. These
physical findings are secondary of loosening of the neck muscle (plastysma
muscle). Non-surgical options of for neck improvement (laser, radiofrequency)
usually address just the skin and the fat layer of the neck, but not the
muscle.  Neck-bands requires tightening
of the platysma muscle through minimally invasive surgery (performed through
very small incisions behind the ear and sometimes underneath the chin). At our
practice, neck lift procedures are performed under strict local anesthesia with
minimal discomfort or pain (= no IV sedation nor general anesthesia) which means
faster recovery while maximizing safety). 
Patients with neck-bands should undergo evaluation by a board certified
plastic surgeon specialized in neck-lifts.

Frank P. Fechner, MD · Answer

Certainly, I would not recommend neck lift surgery given the rather mild nature of your complaint. Starting with non-invasive skin tightening (Ultherapy is best) possibly in combination with Dysport or Botox may provide you with meaningful benefit. Of course, the physical examination and appropriate planning and execution are paramount.

Camille Cash, MD · Answer

From your description a good option for you may be Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  Three sessions are recommended for optimal results.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Lisa Vuich, MD · Answer

Thanks for your question. There are several very effective treatment options for treating neck skin laxity. In non-surgical aesthetics, skin tightening is going to be "all about heat delivery". This is because the microinjury of heat is needed to stimulate collagen and elastin production in the skin, which happens during the healing response to the treatment. Results from any of these procedures are not instant but rather develop gradually over the course of 3 to 6 months:
1.	Sofwave- utilizing microfocused ultrasound to deliver heat to the deep dermis at a depth of 1.5mm, generating new collagen and elastin in the skin. The number of pulses delivered is important- the more laxity there is, the more important it is to do the ‘advanced protocol’ with 4 full passes. Most will need 1 to 2 sessions spaced 4 or more weeks apart. You should have either ‘full face and neck’ or at least ‘lower face and neck’ to get the best result for the jawline. Sofwave has no effect on fat cells as the energy cannot reach that level. Numbing for he procedure is primarily topical. 
2.	Morpheus8- utilizing RF energy delivered at the tips of micropins. With this approach you get the collagen stimulation of the heat PLUS the collagen stimulation of the microneedling, so you can potentially get more result per session, but at the expense of 'some downtime'- puffiness, faint redness for a day or two, potential bruising. The needles can also be set deeper in certain regions so that they will destroy unwanted fat cells- such as in the jowls and the “double chin” zone. Most will need 3 sessions- can be spaced 4 or more weeks apart. ‘Full Face and Neck’ is the ideal approach. Numbing for this procedure is primarily topical but nerve blocks (injection numbing) is very helpful also.
3.	FaceTite- this procedure involves placement of a probe just under the skin to achieve full thickness heating. The probe is introduced  through some simple needle pokes- considered ‘minimally invasive’. Most require a single session. Results typically last 5 years. Numbing for this procedure requires lidocaine injection.

Edward E. Dickerson, IV, MD · Answer

Surgery is unnecessary at this stage, topical radio frequency treatments are your best bet. ThermiSmooth can be used on the surface of the skin to, as the name implies, "smooth" wrinkles and encourage collagen production. Having microdermabrasion treatments regularly can also help retain youthful skin in this area.

I'm 38 and have noticed vertical, crepiness, fine lines on my neck, particularly when flexing. (Photo)

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Answers (14)

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