35 and thin with a waddle/turkey neck. What's my best option? (Photo)

The best recommendations to improve your neck appearance depend on your needs, desires, and most importantly an examination to determine the best procedure for you. Your plastic surgeon will evaluate you for five main features that will determine your best options for neck line improvement:Amount of excess fat typically found beneath the chin, and in the upper neck. This requires liposuction with small cannulas or direct removal especially if the fat is beneath the platysma muscle.Presence of Significant (Platysmal) Banding – this requires bringing the muscles together in the upper/mid neck to a more youthful position and occasionally their release. This procedure is called a platysmaplasty or platysma plication. Mild banding can be treated non- surgically with Botox or Dysport but this requires injections 3-4 times a year for maintenance.Amount of excess/redundant skin (cutis laxa) and condition of your skin. In advanced stages this is called a Turkey Waddle or Gobble deformity. For example, younger age, darker skin colors and no large weight loss history most likely means there will be better elasticity and therefore better post-surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. Mild to minimal skin tightening using non-surgical means like the Sciton Laser SkinTyte procedure, Ultherapy or Thermage could also be considered. My personal preference for non-surgical skin tightening of the neck is the Sciton Laser BBL SkinTyte® procedure as there is no down time, more comfortable procdure, is effective and is a more targeted treatment. For redundant upper and mid excess neck skin: I prefer the LiteLift® (lower facelift ) procedure or MACS for skin re-draping for mild to moderate excess skin management as there are minimal scars and the skin is lifted vertically allowing for minimal hidden scars resulting in a natural appearance “non pulled” appearance. However: for moderate to severe skin redundancy , a neck lift or traditional lower facelift (e.g.Lite Lift®, MACS and others) is needed with or without lipo for best results. For advanced Turkey Waddle correction wither a traditional facelift or posterior neck lift often with a platysmaplasty is required with more extensive scars that extend at the hairline behind your ears. The advantage of a facelift procedure rather than a posterior neck lift is that your lower jawline (e.g. jowls and marionette lines) are also improved at the same time.Chin deficiency. If you have a weak chin then you will not have adequate chin support to your neckline skin which affects your entire neck line. Sometimes especially in younger individuals this is all that is required and this can be done in the office under local anesthesia. There are a number of different sizes and shapes and your plastic surgeon will pick the optimal one for you.Presence of prominent Digastric Muscles or Submandibular gland fullness from laxity or enlargement. Although not a major concern for most patients, if present then partial resection is usually the best solution.

It's best to begin by consulting with a surgeon in-person. 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 what treatments will best rejuvenate your 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. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern.

Patients with neck-bands irregularities or “waddle/turkey neck” usually have loose neck
muscle (platysma muscle). In these cases, neither liposuction of the neck fat
or non-invasive “tightening “ of the neck muscle address the main problem:
loose neck muscle. Patients with “waddle/turkey neck” may benefit from
tightening of the neck muscle through small incisions behind the ear crease.
This procedure addresses the problem while keeping incisions inconspicuous.
This procedure can be performed under local anesthesia with minimal discomfort
or pain, thus avoiding the risks of going to sleep. Patients interested in
management of “waddle/turkey neck” should make a consultation with a Board Certified
Plastic Surgeon specialized in neck lift surgery.

I know this may seem like an excuse, but this is a problem that can only be answered after an examination.  There are many reasons why you have a waddle in you neck.  Without know the cause, I could not offer a reasonable solution.  Possible causes of your waddle and their solutions1)  Excess Fat---Some form of fat removal--Liposuction or direct removal of neck fat.  I believe in direct removal of fat.  2)  Low Hyoid Bone-- Neck lift with platysmaplasty3)  Excess fat and skin-- Plastymaplasty with possible neck lift4)  Weak chin---Add chin implant to above5)  Platysmal bands--PlatysmaplastyThere are a variety of non-surgical treatments already mentioned.  I am no expert in these treatments, but they are an option.  Typically speaking, the results from non-surgical are not a robust as surgical, but depending on your goals and exam, it may be the best option for you.In conclusion- you have many different options.  The most important decision is the doctor you choose.  I hope this helps.  

It is possible that you may be a candidate for what I have termed, "The Laser Assisted Weekend Necklift:" It is a minimally invasive procedure. Cervicofacial Liposculpture is first employed to contour the unfavorable fatty changes seen in the face and neck as time passes by, such as the ‘Turkey neck’ and ‘double chin’.Careful attention is then turned to tightening the neck muscles and eliminating neck bands. Finally, I employ laser technology to ‘resurface’ the underside of the neck skin, thereby ‘shrinkwrapping’ the skin of the neck restoring a youthful contour.A consultation with a board certified facial plastic surgeon will help determine which procedures will provide the best results for you.

From reviewing your pictures, I can see where your complaints lie.  In your age group, this is typically secondary to excess fatty tissue, laxity of the platysma muscle, excess neck skin, or a combination of those factors. Liposuction and mini neck lift are possible options, although if there is a lot of excess skin, a lower facelift may be needed.  I would suggest you consult with a board certified surgeon specializing in facial rejuvenation to discuss your options.  Good Luck!

I think a combination of botox, liposuction, and thermage or ultherapy would help.  Likely you will need a surgical intervention, and liposuction with smart lipo performed properly can give you an amazing neckline.  Followed with tightening with thermage or venous legacy and you will look amazing.  I suggest seeking the advice of an expert.  You need a full evaluation to ensure that none of this is muscular, which would mean a neck surgery is the only treatment.  Best, Dr. Emer.

One option is laser liposuction of the submental region.  Through a very tiny incision under the chin, a laser filament is used to eliminate the small amount of fat and tighten the skin.  Find someone in your region  that can help.  Take care and good luck.

Your changes at this time are very slight and the excess skin you have can only be removed with a form of facelift. I feel that Ultratherapy gives such minimal results that it is a waste of your money. You need to decide when you want to "bite the bullet" with a facelift. See you veryexperienced facelift surgeon for this.

Most likely full open lift SMAS lift is needed. But you can try Ultherapy first as a non invasive attempt. I hope it works but have my doubts. I also might try instead, ThermiTight RF /Smooth therapies as a better option than Ultherapy...