Crepey, Saggy Neck at 39, What Are My Options?

Thank you for sharing your question and your photograph. Here are my thoughts. 
You are young, but not too young to have this problem. While there are a number of contributing factors to aging of the neck, some people are just burdened with poor genetics and inelastic tissues. 
Sometimes a weak chin or jawline will accelerate an aged appearance of the neck, but I can't evaluate your bone structure from the single photograph provided. Not only is your skin inelastic, but there are some band-like deposits of subcutaneous fat in your neck and there is early sagging of the deeper structures (e.g. platysma muscle), especially on the left side. 
I think the best and longest lasting result would be achieved with a lower face and neck lift  including platysmaplasty.  Neck lift alone is a reasonable second choice, but would not be as effective in creating a smooth jawline.
My patients have seen good improvement of crepey and inelastic skin when treated with a combination of  microneedle radiofrequency (Profound RF) and Fractional CO2 laser; however, energy based devices will not tighten or support the deeper structures and will be less effective overall than a surgical procedure.  My very best.

Thank you for your question and your photo. It appears as though you have excess skin and some sagging in your submentum. Its hard to visualize your jawline in the photo you have provided, but based on your complaints it seems as though the neck is your issue. I would recommend seeing a facial plastic surgeon in person for an evaluation for a surgical necklift. You could *consider* non-invasive options, but I am not sure how happy you would be with those results. In my hands, I would recommend the surgical procedure. 

Thank you for your question. Weight fluctuations can result in extra and loose skin. You also appear to have some platsymal banding. Surgically, a neck lift would be able to address these issues and give you a very nice result that would last for years. Nonsurgical options would make a smaller impact and require more maintenance as the results only last ~2 years or so. Ultherapy and laser resurfacing are two options that could help tighten the skin and improve the overall texture. I wouldn't recommend liposuction alone for your issues. I hope this helps. 

"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​​​​"

The impact of pregnancy weight is significant for many women, and affects various parts of the face and body. The pattern of skin excess under the chin is usually treated better by a combination of facelift and necklift because the more vertical vector of the facelift controls the skin tightening in that area.You can evaluate which approach would have better impact for you by tensioning the skin either in front of the sideburns (facelift simulation) or earlobes ( necklift simulation). If you feel the improvement from a necklift simulation is adequate, it typically translates into a similar effect in surgery. It is important to do the simulation with mild tension. With high tension, which cannot be replicated by surgery, the vector no longer matters. If the necklift simulation appears short of expectations, a facelift and necklift are more likely to address your concerns.

Thank you for your question and photos. Based on your photos provided, you do have excess skin and this can be caused by weight gain/and or loss as well as genetics and sun damage. You are an ideal candidate for a neck lift. I would advise you to schedule a consultation with a board certified plastic surgeon for a detailed examination to discuss all possible treatment options and what your expectations are.

A surgical neck lift has the ability to rearrange and adjust amounts of tissue, thus they can remove excess skin and tighten muscle bands. Nonsurgical skin tightening treatments can improve the quality of the tissue left behind,  which can have an immediate affect and help age proof your neck and jawline moving forward. 
Overall, tightening can have improvement to the jowls and neck to some degree, but they do not truly alter the amount of position of those tissues.  When true tissue excess is present, whether that is skin, fat or muscle, surgery is needed. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.Cameron Chesnut #realself hall of fame Physician 

There are many options for improving the texture and skin laxity of the neck skin, with a number of skin-tightening lasers such as Thermage, SkinTyte and Ultraformer III that improve skin laxity with minimal or no down-time. These however need to be continued for ongoing improvement.The surface texture of the skin can be improved by laser resurfacing with the HALO and Medical grade Fraxel DUAL lasers the best for this, although there are other options such as needling.
For a more long-lasting result then a lower facelift and necklift is the best option to improve skin laxity, although these do not improve the actual skin texture, so other resurfacing treatments may be necessary.

The neck can get saggy for many reasons including a lot of sun exposure, weight gains or loss, pregnancy etc.  Aging of the neck is very common before aging of the face.  It's one of the things that can be very frustrating to patients of all ages. 
The face and neck keep changing as you age. Some of the changes are at the skin level, some at the deeper levels like the fat, retaining ligaments or muscles. There are several nonsurgical and surgical options to treat each of these different areas. Some can be done together and it really depends how much improvement you want to see as well as what part really bothers you. If there is significant sagging, surgery is usually the preferred procedure but can still be combined with injections and laser treatments before or after surgery.  
A simple way to think about it - think of surgery as addressing any excess skin and laxity as well as removing fat.  Think of laser as tightening the skin levels. Injections like Kybella can nonsurgically help diminish the fat and offer improvement and there are all sorts of laser procedures that can tighten different layers as well.
Most of these procedures can be done safely in the office and the results are very satisfying. An in-office private consultation and examination with a board-certified plastic surgeon would be the best way to fully see and address your specific concerns and determine the right treatment plan.
I hope this helps answer your question.  If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

Hi,Thank you for your question and adding your picture to the question.As the short of my reply I agree that weight gain and loss cause loose skin under the neck.
You have loose skin, some sort of residual fat tissue and lax neck muscle.
 An isolated neck lift will be a good and satisfactory option for you. I will repair the muscle through a small incision under your chin, and tighten the muscle and remove loose skin through incisions behind the ears.  I hope this helps

Significant weight gain and loss can often lead to laxity of the neck.  Based on your photos you would be a good candidate for face and neck lift surgery.   Alternatives would include facetite a minimally invasive procedure which may significantly improve your neck without  skin excision.  The gold standard would be surgery.