Which procedure should be done - CO2 or neck lift? (Photo)

Thank you for your question. I understand you have concerns about your skin texture, fine lines, and scars, and wonder if you should have a neck lift or CO2 laser treatment. You also state that you do not want a facelift. Many people often have conflicting ideas about neck lifts and CO2 laser, so I’m not surprised you feel the same way. I think I can clear up some of these conflicting thoughts for you as I have been using CO2 laser, as well as many other types of lasers, for over 20 years, and have performed many face and neck lifts in my practice. I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic surgeon. When I have consultations with people like yourself, I try to make the distinction between face and neck lifts, and CO2 lasers clear. When it comes to face and neck lifts—whether it is a facelift alone, a neck lift alone, or a combination of both—we are addressing redundancy and malposition due to sagging of the soft tissue from natural facial aging. There is also sagging and weakening of the SMAS (superficial muscular aponeurotic system), which is the muscle or tissue underneath the skin, and the platysma, which is the layer of muscle in the neck. That said, it is reasonable to conclude that loss of definition in your jawline and neck could partially be attributed to the sagging on your face as well. You can do a simple check by means of a “mirror lift” wherein you can just go to a mirror, lift your face with your fingers gently, and see what happens to your neck. I think you will see some improvement.Fractional CO2 laser improves skin quality and texture defined by fine lines, wrinkles, and discoloration. In the mid-90s, doctors who didn’t perform facelifts would advocate aggressive lasering to their patients, and for a time, many patients believed they could avoid facelifts altogether, and just tighten their skin with these laser heat devices. Today’s thermal devices are basically the same thing with a new coat of paint, and the truth is these devices cannot tighten skin as effectively as a proper facelift.What I do in my practice is combine both the lift and the laser treatment. We’ll perform the surgery and then the laser, which is adjusted to suit the type of lift that is done. Both issues can be resolved, but it must be understood that one treatment does not displace the other because they address different things. If the texture bothers you, and the sagging doesn’t, then you can opt for the laser treatment only, however I don’t know how satisfied you would be with the outcome, especially if you do not get the dramatic tightening that you’d like.I recommend that you meet with experienced and qualified cosmetic surgeons, as they can do both surgical procedures and laser treatments, rather than non-surgeons who are more limited in terms of the scope of their practice. Learn about your options and get opinions so you can make a more informed decision and get better results.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Texture of the neck skin is treated very different than lifting of the neck skin.  I suggest you get a formal consultaiton to go over all the options for the neck including fat, texture, laxity/sagging.  They are all treated with different procedure. You can do neck lift with co2 to get ultimate results.  Best, Dr. Emer.

You may consider Ultherapy non surgical neck lift with fractional co2 to help improve the texture and tone of your neck and lower face. Best, Dr. Karamanoukian Los Angeles