43 years old with saggy neck. Can I avoid a full neck lift? (Photo)

Question

43 years old with saggy neck. Help. I've tried creams, Botox, nova threads, none of which have worked. My career has me carrying weighty equipment around the shoulders/neck area which has taken a toll. My face looks young. One PS told me to come back in ten years. One PS said he would do the full neck lift, but the scars scare me. My neck makes me so insecure. I hate looking in the mirror.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. You seem to be an ideal candidate for the laser-assisted weekend necklift, which is an exciting new way to improve the look of your neck and jowl regions because the procedure is less invasive and offers a quicker recovery than a full neck lift. I suggest that you move forward and consult with a board certified facial plastic surgeon.
Best wishes,

Jason Emer, MD · Answer

"These are all natural parts of the aging process. What we can do is try preventative treatments or get a neck lift / face lift earlier in the aging process. There are numerous non-surgical options available, and some can be used in combination to get best outcomes, but you would need a consultation with an expert.

Some options for skin tightening include:

- Thermage radiofrequency to heat the skin, tighten it over time, and prevent the aging process
- Ultherapy high-intensity ultrasound to contract the muscle, tighten the face and neck, and prevent the aging process
- PDO NovaThreads or InstaLift threads for immediate lifting without surgery and long-term collagen production
- Sculptra injections for collagen production to areas of the face and neck with crepey skin or early sagging
- BTL Exilis Ultra, Venus Legacy, and Thermi250 for monthly collagen stimulation with facials
- ThermiRF, Renuvion (J Plasma), or Inmode BodyTite for internal heating and tightening with or without surgery
- Fillers (or facial implants) to contour the jawline and chin to improve the appearance of the neck
- Face lift / neck lift with fat grafting and fillers if you need a significant improvement​

​I would suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​"

Gregory S. Keller, MD, FACS · Answer

FaceTite is a technology that tightens the skin (several studies done and published in peer reviewed journals) 25-35%.  In someone as young as you, FaceTite should provide adequate tightening of the skin without posterior incisions behind the ear and into the hairline.  FaceTite is performed through needle holes, similar to those made when blood is drawn from your arm. It also can tighten the jowls.  
A platysmaplasty can be performed for the bands that you have under your neck, through a small incision under the chin.  We have performed many of these combination techniques, and they work well, particularly in the 40-55 year old age group.
These procedures can be performed under local or general anesthesia.  There is very little bruising or bleeding.

Ronald Schuster, MD · Answer

There are non-surgical tightening procedures, such a the Viora Reaction, that can help tighten the neck skin. The biggest risk is really just a financial one. Will i work well enough for you to feel as though yoo have gotten your money's worth? Fillers and Botox are not the answer. An isolated necklift is a great procedure with very minimal scars. It really depends on your anatomy and what you don't like. At this point I recommend going fo some consults. Good luck.

Farhad Rafizadeh, MD · Answer

The limited view on your pictures shows the laxity of your neck under the chin. An in person examination will show if the two bands under your chin are skin laxity or platysma muscle bands. It looks like the problem could be solved by a short scar cheek lift. This should eliminate the excess skin under your chin without an incision behind you ears. If the bands are muscle related they can be taken care of through a small incision under your chin. I do this under local anesthesia with some sedation and the recovery is fast. if you like to send full face pictures from front and the sides, I can give you more information about what can be done. I don't think there is anything short of surgery to help you. The main question is, how can surgery be done with the shortest scars, quickest recovery and the best results.

William Townley, MD, FRCS(Plast) · Answer

Hi there. Many thanks for your post and photos - the views are relatively limited but it appears you have a youthful lower face but some loose skin and separation of the muscle from the midline in the neck. Patients with this picture can often get significant improvement with a mini-neck lift, which just involves a small incision under the chin and can be performed as a daycase. Best to arrange a consultation with a board-certified plastic surgeon (BAAPS and/or BAPRAS member). Good luck!

Alan B. Brackup, MD, FACS · Answer

Thank you for your question, by looking at your photos I would recommend an evaluation for a lower face and neck lift. You will also want to tighten the muscles that are hanging. Non-invasive therapies can help to tighten and lift skin to some degree, but I have yet to see those procedures tighten muscles. Most incisions for a lower face and neck lift are hidden within the hair line around the inner edge of the ear, and the small incision under your chin should never be noticed. Hope this helps.

Jed H. Horowitz, MD, FACS · Answer

It's difficult to assess online per the photos provided. Non-surgical procedures can only temporary resolve the issue and require few to several attempts. Depending on the level of laxity, the effects of a neck lift will certainly outlast the effects of non-surgical treatments. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. During an in-person examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of 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.
A board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from and and if you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

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Thank you for your question and pictures.  You would be an excellent candidate for a lower facelif and necklift with muscle tightening.  
Most of my patient want a facelift however do not want the downtime associated.  The Concept Facelift and Necklift is the procedure I perform, which combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. 
If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.
What are the benefits of a local anaesthetic facelift?
Minimally invasive as it is a short scar faceliftThere is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsPlease make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may
benefit from a mini neck lift.  If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

43 years old with saggy neck. Can I avoid a full neck lift? (Photo)

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