66, moderate skin laxity and fine lines - Recommendation for non-surgical face and neck tightening and rejuvenation?

Question

I am 66 years old and I have moderate skin laxity on my face and neck without a lot of fine lines and wrinkles I would like to know what non-surgical procedure can give me a more lifted and overall skin improvement. I have some brown spots as well. I am considering Morpheus 8 but I am worried about the fat melting potential. I have had RF micro-needling and Ultherapy before with zero improvement.

Kally Papantoniou, MD, FAAD · Answer

There are many options for skin tightening, and the best choice depends on the area being treated, the degree of laxity, skin quality and whether volume loss is also contributing. Since Morpheus8 is another form of RF microneedling, it may not necessarily provide a different result if you have already tried RF microneedling without improvement.

A better plan may be to address each concern separately: restore facial support when appropriate, then use Fraxel, fractional CO2, IPL or a pigment-specific laser for brown spots and overall skin quality. These treatments can improve tone, texture and fine lines, but they will not create a significant lift. Nonsurgical treatments may also require a series to achieve their best result. An in-person evaluation with a board-certified dermatologist can help determine the most realistic approach.

Nelson Lee Novick, MD · Answer

Photos would have been helpful. But, in their absence, generally speaking nonsurgical facelifts and necklifts can usually be accomplished with gratifying results using neurotoxins, such as Botox, for treating dynamic (muscular-movement related) wrinkling, such as frown lines between the eyes; worry lines on the forehead; crow's feet around the sides of the eyes; and horizontal necklace lines around the neck. Robust HA Fillers work well for restoring volume to the cheeks; increasing chin projection to help straighten the jawline and tighten the upper neck; and robust HA lifting fillers can re-establish and more desirable Ogee Curve to the cheeks and help soften smile folds and jowls along the jawline; and low viscosity malleable, cohesive HA fillers can be used to further address the horizontal necklace lines. The results of Botox treatments typically take a few days to take effect. The results of filler treatments are typically immediate and usually engenders little to no post treatment downtime. 
Unfortunately, I am not at all surprised by the lack of success with the expensive, heavily marketed device treatments you received, as these gizmos are backed far more by marketing hype and social media buzz than hard science. Sorry, 
You would be wise to consult with an experienced, board certified cosmetic dermatolgist injection expert and best of luck. .

Anna Chacon, MD, FAAD · Answer

You’re asking exactly the right question, and your previous treatment history is very important. The fact that you’ve already had RF microneedling and Ultherapy with essentially no improvement tells me that simply repeating those same categories of treatment is unlikely to give you the meaningful lifting result you’re looking for.

At 66, with moderate skin laxity, relatively few fine lines, and some brown spots, I would think about this as three separate goals:

Tightening/lifting
Improving skin quality
Treating pigmentation
About Morpheus8 and “fat melting”

Your concern is valid. Morpheus8 is an RF microneedling device, and when it is used at deeper settings, particularly in the lower face of someone who is already relatively lean, it can contribute to subcutaneous fat reduction. Some patients appreciate that effect for jawline contouring, but others feel it makes the face look more hollow or older.

Given that you are 66 and seeking rejuvenation rather than facial slimming, I would be cautious about aggressive deep Morpheus8 treatments, especially if you have any existing volume loss in the cheeks, temples, or around the mouth.

Why Ultherapy may not have helped

Ultherapy tends to work best for mild to moderate laxity in patients with good underlying tissue elasticity. In more mature skin, the improvement is often subtle, and some patients unfortunately notice little or no visible change despite appropriate treatment.

What I would consider instead
1. Fractional CO2 or hybrid fractional resurfacing

Because you have minimal wrinkles but want overall rejuvenation, a fractional CO2 laser (or a newer hybrid fractional resurfacing device) may actually provide more noticeable improvement in skin firmness, texture, and brown spots than another tightening-only procedure.

Benefits:

stimulates significant collagen remodeling,
improves crepey skin,
softens fine lines,
reduces sun damage and brown spots,
and can create a modest tightening effect through dermal contraction.

This is often one of the most effective non-surgical options for overall skin quality improvement in patients in their 60s.

2. Biostimulatory injectables

If part of the laxity is related to loss of structural support, treatments such as Sculptra or hyperdiluted Radiesse can help stimulate collagen and improve skin thickness and firmness over time. These are not lifting procedures, but they can make the skin appear healthier, firmer, and less crepey, particularly in the lower face and neck.

3. Combination approach for the neck

The neck is often harder to treat than the face. For moderate laxity, I’ve found that the most effective non-surgical improvements usually come from combining modalities, for example:

Fractional resurfacing for the skin surface and collagen stimulation
Biostimulatory treatment for skin quality
Occasionally very superficial RF microneedling (not deep fat-targeting settings) if additional tightening is needed
For the brown spots

Your brown spots are likely solar lentigines (sun spots). These usually respond well to:

IPL (intense pulsed light)
Picosecond laser
Fraxel-type non-ablative fractional laser
or fractional CO2, which can improve both pigmentation and texture simultaneously.
Setting realistic expectations

One of the most important things I tell my patients is that non-surgical treatments can improve skin quality and create a modest tightening effect, but they generally cannot reproduce the degree of lift achieved by a surgical facelift or neck lift.

For someone with moderate laxity at 66, I would expect:

Skin quality improvement: potentially 30–60%
Pigmentation improvement: often 50–80%
True lifting/tightening: usually subtle to moderate, not dramatic.
If this were my patient

Based on your history, I would not choose Morpheus8 as the next step if your main fear is fat loss and your prior RF microneedling produced no benefit.

My ranking would be:

Fractional CO2 or hybrid fractional resurfacing → best overall rejuvenation
Biostimulatory injectable (Sculptra or hyperdiluted Radiesse) for facial and neck support
Targeted IPL or pigment laser for the brown spots
Reserve additional RF-based tightening only if performed with conservative, superficial settings and a clear plan to avoid unwanted volume loss.

Given your age, skin characteristics, and prior lack of response to Ultherapy and RF microneedling, I would focus less on chasing another “tightening device” and more on collagen remodeling plus skin resurfacing, which is more likely to give you the overall refreshed, lifted, and healthier-looking result you’re hoping for.

Laser Skin Solutions - Portland · Answer

Addressing moderate skin laxity and changes in facial and neck contours at 66 is a common goal as natural collagen and elastin levels decline over time. When looking for non-surgical ways to tighten and refresh the skin without drastic interventions, focusing on treatments that stimulate deep dermal remodeling can provide beautiful, natural-looking support.
Potential Treatment Options to ConsiderRadiofrequency (RF) Microneedling: This advanced treatment combines precision microneedling with thermal radiofrequency energy, delivering heat deep into the tissue to trigger robust collagen and elastin production, which helps firm loose skin on both the face and neck.
Targeted Clinical Skincare & Maintenance: Incorporating medical-grade topicals tailored to support cellular turnover and skin barrier strength helps optimize and prolong in-office rejuvenation results.
Here at Laser Skin Solutions - Portland, we frequently evaluate facial and neck laxity cases to help patients determine if targeted, clinical-grade non-surgical modalities can successfully restore smoother, firmer contours.

66, moderate skin laxity and fine lines - Recommendation for non-surgical face and neck tightening and rejuvenation?

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