39 Years Old Loose Neck Skin? (photo)

I am a 98 lb woman, I am almost 40. i have always liked my profile and still do. However I have noticed when I look in a mirror, from below looking up I see loose skin. I do not really think it is noticeable unless looking up under my neck but would neck exercises or skin tyte help?

Doctor Answers 16

Loose neck skin in 39 year old

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There are no neck exercises or skin tightening procedures that will help when there is excess skin in the neck.  The 2 cords that are present are actually the anterior most platysmal cords.    They are beginning to herniate downward, tenting the lower neck skin outwards.  When there is excess skin present in the neck along with anterior platysmal bands, the only solution is to perform a lower face/neck lift that includes the tightening of the platysmal muscle in both the anterior and posterior portion of the muscle to give a comprehensive neck rejuvenation.


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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.

ThermiTight Can Make All The Difference

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ThermiTight is a micro-invasive procedure that can help tighten the skin of the neck or under the chin by applying radio frequency with a thin wand just below the surface of the skin. Your platysmal bands are really not very prominent, so at this point surgery doesn't seem necessary.

Platsyma Banding

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    As the platysmal bands become more prominent with age and skin integrity is compromised a neck lift may become necessary.  It is reasonable to start with Botox to the platysmal bands.

Improving neck contour

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Thanks for the photos. It's a bit hard to assess the quality of neck skin based on photos alone. Just from the photos, it appears that you have medial platysmal banding resulting in two, near parallel, vertically oriented banding from chin to lower neck. If you have good skin quality and not much loose skin, then I would think that just correcting the muscle position will be suffice to improve your neck contour. I would first try Botox to see if the muscle will relax enough and fall back along your natural contour of the neck. If Botox is unsuccessful, then a surgical platysmalplasty can improve your condition. It's done with a short incision below your chin. Unless you also have significant loose skin, you may not need incision behind your ears to pull the skin. Given all these options, you really should get a consultation with a qualified plastic surgeon to help decide the best course of action.

Best Wishes,

Neck lift will remove platysma bands.

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You certainly do not look bad at all.  But your problem is platysma muscle bands, not just a little loose skin.  Do not waste your money on gimmicks.  When you cannot stand your neck, have a neck lift (safe and simple, with a short scar under the chin).  That is the only thing that corrects these bands, and it is very long lasting.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Loose Neck Skin

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I would agree that your main issue is related to banding of the platysma muscle.  I have not personally had much success in improving these bands using Botox.  With your young age I would suspect that this banded appearance is going to get worse as you age.  I would recommend approaching the neck through incisions behind the ears and under the chin.  I would then divide the platysma muscle very low in the neck and then suture it together in the midline.

Michael Sundine, MD
Orange County Plastic Surgeon

Your problem is prominent platysma bands, not loose skin

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The platysma is a very thin muscle beneath the skin that covers the other major muscles in your neck. The two anterior edges of the platysma come together in the middle, but not always. What you're saying is the edge of the platysma muscle. There are surgical procedures to suture the muscle edge together, cut the muscle inferiorly to let it slide, or pulled the muscles from incision around the ear. Some patients have success with injecting the muscle age with about 25 units of Botox per muscle, and this will last about 3-4 months.

Loose skin on neck

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It appears from you photos that your issue is more with bands from the muscle underneath the skin of your neck and not with the skin itself.  There are surgical techniques that can be done to deal with this issue alone and not tighten the skin of the neck.  I would recommend an in person consultation to determine if you are a candidate for this type of surgery or not.  As was mentioned previously, Botox injections would be another option but the results would not last as long as the surgical option.

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews


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You need to see a certified PS to go over your options. From your pictures you can’t really get a clear view on what it is that you would benefit from. If you are concerned about loose skin in your neck a neck lift and Liposuction of the neck would give you great results.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

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.