41 crepey neck- tried everything - what are my options? (Photo)

Question

What is the answer to this? I've tried scarlet, Morpheus8, pixel, Fraxel, diluted sculptra (nightmare don't do it), etc I'm skinny with thin skin. My facial skin looks 10 years younger. No one wants to do a neck lift without doing a facelift, and because of my age no one wants to do a facelift. But this is not acceptable to me and I've wasted too much time and money as it is. Seems strange that there isn't a real solution, yet, I've been sold a half dozen different treatments...

Jason Emer, MD · Answer

With significant neck sagging you would need a neck lift / facelift with muscle tightening (platysmaplasty). At the same time, lasers treatments (Fraxel, CO2, Erbium, Halo) or microneedling RF (Fractora, Intensif, Morpheus, PiXel8) can be performed to improve crepey skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach:​ - Microneedling and laser treatments for texture - Botox, Dysport, Xeomin, or Jeuveau to help the Platysmal bands - Intensif, PiXel8, Morpheus or Fractora RF microneedling for crepey skin and lifting - Injectable fillers like Belotero, Restylane Silk, and/or Juvederm Volbella to improve lines and folds - Renuvion, ThermiRF, and/or InMode FaceTite for internal tightening - Ultherapy and Thermage for external tightening - regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness - PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production See an expert for a full evaluation and treatment plan based on your individual situation and goals.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. You may be a candidate for a PDO threadlift to reduce crepey neck skin and provide a lifted, refreshed appearance while encouraging your body’s natural collagen production.
In this procedure, dissolvable polydioxanone threads are inserted under the skin for a subtle lift that is less invasive than a face or neck lift. Results from this treatment option can last for up to one year. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can help you decide on the best option for you.

Peter Lee, MD, FACS · Answer

I agree with your realization that if you continue to pursue energy based treatments and fillers, continue to be disappointed with their results.  They are not the solution to your problem, as you have discovered.  However, I disagree with your premise that “no one wants to do a neck lift without doing a facelift.”  On the contrary, why wouldn’t you want to do a discrete, targeted neck lift to address this problem, and improve the overall aesthetics of your neck and submental region, if it would allow you to put off doing a full facelift for ten years or longer, while allowing you to be quite pleased with your appearance in the interim?

Richard G. Schwartz, MD · Answer

The real question is what is causing the lines on your neck.  An examination should reveal whether it is loose, poorly elastic skin, or whether it is due to your not having enough subcutaneous fat between neck skin and the platysma muscle, which allows the vertical muscle fibers to be visible.  If you have loose skin, then a standard necklift can be done to tighten and smooth the area.  If the problem is visibility of underlying muscle fibers too close to the skin surface, you might be helped by fat grafting to thicken that layer and camouflage the muscle fibers.  However, there is no guarantee that the grafted fat would heal really smoothly.  Since the usual non-surgical technologies that help smooth crepey skin haven't worked, I suggest you speak with your plastic surgeon again about a necklift.

Jeffrey Lisiecki, MD · Answer

Crepey skin like that can be a challenge. First off, if you need a necklift (hard to tell from your one photograph), keep looking around because there are certainly plastic surgeons who will do a necklift without a facelift in the correct patient (I count myself as one of them). If you don't need a necklift, I would need more info about your skincare regimen and prior treatments. I usually treat skin like this with Morpheus8 and have seen great improvements. The settings matter a lot, as well as the care and attention to ensuring that every area is treated (which takes some time to do properly), as does the aftercare. Certain topicals after treatment make a big difference. Morpheus usually takes a few treatments to get the best results, so if you just got a one-off Morpheus, I wouldn't expect a huge improvement. Layering Morpheus with laser or light treatments helps. Nothing works immediately, everything must be done over time to steer your skin in the right direction. Of course, also using medical grade skincare and religious sunscreen use (on your neck also not just your face) are crucial.

Gurkan Kayabasoglu, MD · Answer

I would say try chemical peeling. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile. You can also book an online consultation and discuss your problems with me. With all respect.

Kristopher Day, MD, FACS · Answer

If you have exhausted these other options, then a neck lift may be your best options. Facelift and neck lift are usually combined, because they share the same incision, contribute to the efficacy of each other's results, and generally are applied on patients with excess skin in both the face and the neck simultaneously. But not in all cases. The skin may be made more taught by removal laterally behind the ear and toward the hairline, and the underlying muscle can be made less lax with a platysmoplasty, which is sewing the underlying broad muscle of the neck together like a corset under the skin. These, in addition to topical skin care options, may be something to consider, as your frustration with non-invasive techniques is not uncommon. They are sometimes more costly than the effect they are able to deliver in some patients.

William Portuese, MD · Answer

In our practice, the only way to tighten loose and inelastic neck skin in the neck is to perform a lower face and neck lift. A full set of facial photographs from all angles are required to make a determination about how best to proceed

Darryl J. Blinski, MD · Answer

Thanks for the limited view 1 posted photo. Inmost cities there are boarded PSs willing to do neck lifting. I know I do this operation w/o an anterior facelift many times. Fee from $8,000+ Best to virtual consult with....

Gerald Wittenberg, MSc, DMD (retired) · Answer

I am not sure why they won't do a necklift in isolation since target procedures are more natural looking. That is 
, a necklift appears to be appropriate from what is presented. Perhaps further consults will help

41 crepey neck- tried everything - what are my options? (Photo)

Answers (10)

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