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

I am 39 years old, generally slim and youthful in appearance. I am 5'5 and 124 pounds, and have two children. I gained and lost about 50 pounds in each pregnancy. My neck skin is extremely wrinkly, crepey, and saggy. My face and body look 35, but my neck looks like it belongs to a 55-year old. I KNOW I have some sun damage there from some severe burns I got in my teens. I am also wondering if the weight gains and losses of pregnancy contributed to the sagging. What can I do?

Doctor Answers 23

Neck Lift Will Correct Crepy Saggy Neck Skin

Thank you for your question.

Certainly weight gain and loss will cause loose skin under the neck.

From your photo you appear to have loose skin, some residual fat and lax neck muscle.

A Neck Lift with repair of the muscle through a small incision under your chin, and tightening of the muscle and removal of loose skin through incisions behind the ears should give you a very nice result.

Crepey, loose neck skin needs a facelift

While your photos aren't perfect, even at your age, your weight gains and losses have taken away your skin elasticity and it will never return.  No non-surgical treatments are worthwhile in my opinion to make any real difference for you.  The only way I know to dramatically improve what you have is to do,a facelift (cheek and neck lift).  On rare occasions these are needed even in folks under 40 if they have the right anatomy.

Lower Facelift and Necklift

Thank you for your question. Neck Rejuvenation is often used in conjunction with a Concept™ Facelift, in order to provide rejuvenation to the whole area. Neck Rejuvenation can include tightening the platysma muscle which can be an extra procedure which some patients may need to ensure a tight contour neck.  Tightening of the platysma muscle (also know as platysmaplasty) will require a small incision under the chin away from direct view to gain access to the front edge of the muscle on the neck; they are sutured together with permanent stitches.  The muscles of the neck are the foundations and building blocks of the neck are fundamental to achieving a tight and toned result. Alternatively, some patients may need neck liposuction, for those who have excess fat under the chin.  Overall, to obtain the best results a combination of neck rejuvenation procedure maybe needed.  Accessing your picture it looks like lose of skin elasticity is your concern, therefore being straight forward facelift and neck lift which would be needed.Neck Rejuvenation is often used in conjunction with a Concept™ Facelift, in order to provide rejuvenation to the whole area. I perform my facelift and neck lift under local anaesthetic, meaning minimal bruising and swelling is experienced by patients.  This significantly reduces the recovery time experienced, therefore patients being able to return to their daily lives with public view within 5-7 days.  This is why it is important to have a comprohensive consultation with a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve. Best Wishes 

Neck rejuvenation options

Thanks for sharing. Current neck rejuvenation treatments:
  1. Surgical Neck lift with a lower facelift would be the gold standard and get you the best results
  2. Surgical Neck lift would be the next best procedure
  3. Neck liposuction and or laser lipolysis if only fat removal is required, typically in a younger patient
  4. Ultherapy is an FDA approved non invasive tightening using ultrasound technology
  5. Kybella is a new FDA approved injection that melts fat under the chin

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 72 reviews

Loose skin at 39 looking at Face Lift and Neck Lift

 I have performed Face Lifts and Neck Lifts for over 20 years and at 39 you have more loose skin that typical.  This, IMHO, is most likely due to the substantial weight gain and loss as you described.  Your choices, to remove, this amount of skin are limited and would include a formal Neck Lift or some smaller variation of excess skin excision under the chin.  The limited surgery would not make the neck completely smooth like the full neck lift, so the decision, of how smooth, you'd like your neck would dictate what procedure is best for you.

 IMHO, you should not rely on sutures, threads or suture suspension procedures to tighten and lift your loose neck skin.  These procedures, IMO, are all limited by the fact the threads are more stiff then the tissue within which they are placed.  This creates a "wire through cheese" type effect that will cause the threads (sutures) to move towards the surface, of the skin, or loosen which allows the skin to once again sag.  This degree of loose skin will require an incision, tissue dissection and skin removal.  RF or Laser treatrments, IMO, tighten the skin a couple of mm's and would not be able to remove 2 inches of skin, like the Neck Lift.

You should have a few consultations with Face Lift surgeons with good reputations to discuss your best options.  Hope this helps and good luck.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Wear and tear

You hit it on the nose. The weight gain and loss combined with the sun damage has aged your neck skin and likely platysma muscle earlier than it would have aged if you lived a boring life. You have made the right decision though. Be happy and get happy.

For neck rejuvenation it is important to have a good physical exam to determine exactly what is going on. The sun damage and skin changes can be corrected with a laser. Likely low setting (because neck skin lacks deep dermal attachments) fractional ablation. The sagging with either radiofrequency devices or a plastymaplasty and/or necklift. That would be determined after a good facial analysis and physical exam.

Hope this helps.

Best of luck,

DrC

Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Crepy neck skin age 39

A very vexing problem, especially at your age

From the photo the skin laxity appears significant , so while you can try skin tightening treatments like Fractional Laser, you may benefit most from a Mini necklift with limited incisions

Richard A. D’Amico, MD, FACS
Englewood Plastic Surgeon
4.9 out of 5 stars 19 reviews

How to treat loose skin of the neck?

Weight gain and loss, sun damage, genetics, time and gravity all contribute to loose skin of the neck. Neck lifts can be done as isolated procedures or as part of face and neck lift. Suture suspension neck lifts and SmartLipo (Precision TX) are minimally invasive procedures that can help improve neck profile. Non-invasive treatments with radio frequency devices such as the Venus Legacy and the Sublime ELOS Plus are also popular treatments in my practice. Consult with your board-certified plastic surgeon to get the options for your situation.

Best, 

Scott A. Brenman, M.D., F.A.C.S.
Plastic & Reconstructive SUrgery

Scott A. Brenman, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 41 reviews

Necklift with platysmaplasty and fractional CO2 resurfacing

Large weight fluctuations can contribute to the sagging.  There are non-surgical and surgical options for your neck but I think the combination will address each individual component.  The sagging skin is best treated by neck lift.  The platysmaplasty treats the sheet-like muscle in the neck that further contributes to the sagging.  The laser skin resurfacing will tighten the crepiness of the skin quality and must be done with caution and may be repeated.  A detail physical exam will be required to see if you are the right candidate.

Johnny Mao, MD, FACS
Orange Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Saggy Neck Skin

The changes show in the pictures are best treated with surgery. Its my impression that the laxity of the skin surpasses the retraction needed for obtaining acceptable results in the neck area. Many patients invest a great amount of money in non surgical treatments with little to non result.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.