What causes my neck to sag and lose its angle? What can be done? (Photo)

"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​​​​"

In your age range and from your photo demonstrating an adequate chin projection, the most common reasons are excess fat in the submental area, or loss of elasticity often familial. Although posture may be a factor it is probably not the main factor. An exam would be most important to see if localized liposuction, removal of some of your submental fat, or skin tightening procedure is most important to improve your appearance.

The most prominent factor contributing to your submental (area under the chin) fullness is likely to be heredity.  Probably one of your parents has a sloping neck line.  A fat accumulation called subplatysmal fat (under the platysma muscle) is probably also a contributing  factor.  We lose support for the floor of the mouth which sags due to gravity as we age.  The hyoid bone, a "trapeze-like" bone to which many of the tongue muscles attach may be more anterior than average.  Finally some people, likely not you, may have platysmal banding which contributes to a sloping neck.Some people would need a facelift at which time several of these factors could be addressed.  For you I would recommend radiofrequency (RF) treatment internally which would collapse the fat and tighten the skin. Thermitight is my favorite RF treatment for this as it treats the problem internally rather than treating through the skin.  Done under local anesthesia, as an outpatient with no incisions (only several small punctures) this should give you a nice neck line. Please go to someone who is experienced in doing this to achieve the best result.  I have tried ultrasound, external RF and other modalities and none seem to work as well.

These issues usually result from genetics, aging and sun damage. Extra tissue under the jaw can usually be improved with liposuction which results in some removal of fatty tissue. The procedure in someone of your young age also typically results in tightening of the skin under the chin and jawline. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

To give an angle to your lower face, you may consider Radiesse to the jawline.  As for the loose skin under the neck, I can't tell if there is fatty tissue there or just skin.  Both an easy fix.  Try some facial exercises as well.