How to Correct Thin, Sagging Skin on Mid to Low Neck Area? (photo)

   Loose Skin in the neck can be elevated during a face and neck lift and the redundant skin removed from the incision lines.

Patty

As more opinions pour in, you will see two basic concepts.  One is that the skin of the neck is influenced by the underlying platysma muscle, and therefore attempts to reposition the platysma via a necklift or facelift will be valuable.  That's the basis for rejuvenating the neck (as well as jowls and midface), especially in patients who show that dominant set of anterior bands that create those two cords running down the middle of the neck.  You picture does not show that as the primary problem.

The second concept is that the thin skin of the neck can lose it's inherent elasticity, creating a dry, hanging, inelastic look to the skin.  That looks more like what you have going on.  The reason it often shows up first in the neck is because the neck skin is thinner, and lacking some of the structures that are more prevalent in face skin. Truthfully there is no surgery in the world that can pull the skin so tight with a necklift or facelift to totally restore a more taught and elastic drape to the skin surface.  Lifts might help, but patients tend to still be bothered by the persistent skin surface.  This leaves a couple of tools to try to improve the skin, all of which we have here in the office.  One is skin tightening technologies using ultrasound or radiofrequency or infrared energy to try a non surgical tightening.  All helpful, but not so much that it would return to normal, and not to a degree of change comparable to a surgery. The other is any form of skin resurfacing, whether it be chemical peel, laser, or fractionated laser resurfacing.  All have pros and cons, but help to tighten the skin to differing degrees as well.  Of course you can do combination treatments or sequential treatments to accentuate the final results too.  

The key to matching technology to expectation is communication.  Just make sure that you fully understand what each surgery or technology is going to do, and not do, since there is no single modality that resolves what your picture implies.