Need Advice for Treatment Worsening Neck Cords? (photo)

You need a mini neck lift. A small incision is made under the chin. Fat and soft tissue will be removed (but no skin removal). Your platysmal bands will be cut or removed. This should give you a nice result.

  A lower face and neck lift would improve the neck, the jowls, and sharpen the jawline.Kenneth Hughes, MDLos Angeles, CA

It is not surprising that Ultherapy  did not improve your muscle cords as it only penetrates the skin and subcutaneous fat and should not be expected to improve your underlying neck muscles. Botox can help but is temporary and has to be repeated 3-4X/ year. Direct approach is best - minifacelift for jowl and jawline improvement, and platysmaplasty to correct platysma banding.

 

The most important thing is to  get a good explanation from your surgeon about the cause of your neck webbing.  There can be several factors, and each might require a slightly different approach.  My opinion is that Ultherapy or other IPL or ultrasound type treatments just create a very minimal improvement in skin tightening. Most patients desire more of a change.  Depending on what your consultation showed, you might benefit from liposuction of any extra fat under the chin and along the jawline and/or tightening of the platysma muscles on the front of the neck, both of which can be done through a small incision under the chin.  If you have loose skin on the neck, then you might require an actual neck lift to tighten the skin, which is performed through an incision behind the ear.  So the first step is to define the problem, and then your surgeon can recommend the best option for you.

As you have found out Thermage and treatments that "contract" the skin are quite not worth it. To improve your cords, jowls and excess skin you need a facelift.  That is why I and other plastic surgeons have facelifts themselves!