How to Tighten Crepey Skin in the Neck?

I'm a 45-year-old man. I'm having crepey skin on the front of my neck. What's the best way to tighten it up and smoothen it out? Thermage? Laser treatment?

Doctor Answers 10

Loose skin on the neck can be a challenge to rejuvenate

Loose skin on the neck can be a challenge to rejuvenate, but some people do respond well to thermage or titan, which are external energy based tightening devices. Often a neck lift is required to give sufficient improvement, and this can be combined with external tightening devices. I have seen patients who have consulted me for scarring produced by various fraxel laser treatments, so it is wise to be cautious about this approach to neck rejuvenation.

Metairie Dermatologic Surgeon
3.5 out of 5 stars 2 reviews

CrepeySkin of the Neck

If the "crepey" skin is the primary problem then I have had quite good success with the Fraxel Re:Pair laser. It rejuvenates the face and the neck (the neck can be done separately or independently if desired) and there is skin tightening as well as rejuvenation of the skin (more even tone, resolution of pigmentation changes, etc). It should also last several years (although if the starting point were more severe you may need a second procedure at about 6 months). In my experience Thermage is mild in it's effect, temporary and more painful. Of course, you need an in person consultation to determine your goals and expectations, examine your anatomical problems, to get a review of alternative treatments, and then to decide on the best treatment for you. Your physician should let you know how close he/she can get to your expectations with your particular skin problems, and whether the skin is too lax or loose and you should possibly have a neck lift.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 7 reviews

Skin-tightening options for neck

For non-surgical neck-tightening, I recommend Ulthera (Ultherapy). Using ultrasound technology, Ulthera uses focused ultrasound to lift and tighten loose skin over time, without any downtime. However, nothing can quite compare with the fantastic results of a surgical necklift. Non-surgical procedures have to be repeated to maintain the look you want - which means that in the end you'll likely end up spending as much as you would have on a necklift, which is longer lasting.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 150 reviews

Non surgical neck lifting

I would recommend Ulthera if you are looking for something with no downtime, or Profound if you could tolerate some downtime. Ulthera is an ultrasound based energy that heats the underlying tissue and stimulates collagen in response. Profound is a radio frequency microneedling device that allows for the creation of Elastin, collagen and hyaluronic acid and hence restores some of the lost elasticity in the neck. It has more visible downtime with the possibility of some swelling and bruising that diminishes in about a weeks time.  The Elastin creation may be your best option to reverse the 'crepiness' of the skin that you describe.

I would visit with a board certified plastic surgeon who has the portfolio of non-surgical options in your area who can help explain the treatment options for you and the limitations of each option, both surgical and non-surgical.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 38 reviews

Nonsurgically treating skin laxity in the neck

ThermiTight is a great alternative to a surgical necklift in the appropriate candidate. It can produce excellent skin tightening results that allows someone the option to avoid a surgical procedure. There is a limit to how much skin laxity can be treated with ThermiTight so you would need an evaluation to determine if this device is right for you.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Skin Tightening Lasers- Do Not Get Caught Up In Brand Names

Skin Tightening Lasers- Do Not Get Caught Up In Brand Names


First of all you should ask -"Do they really work?" I would urge you to find a responsible and knowledgeable plastic surgeon and not focus on brand names as this is the least important part of your decision.  As far as longevity- the six week results of your intervention are as permanent as anything in your body can be.  you will continue to age depending on your genetics and environmental factors.

The problem with noninvasive skin tightening is that everyone wants it and everyone wants to believe it works.  The result is practitioners of all sorts capitalizing on this demand.  The truth about skin tightening interventions is that almost all of them work AND NONE OF THEM WORK.  What I mean by this is that there are many ways to convert energy into heat inside or below the skin causing contraction.  The problem is that to deliver clinically effective results the tissue needs to reach at a minimum 43 C which is uncomfortable and can be scary for the patient and the practitioner.  This often results in ineffective treatment and wasted time and money.  I have developed extensive experience with noninvasive technologies mot because I'm a fan but because my patients demand it.  After using several "best in class" technologies to deliver definitive results, my patients were relatively pleased but I was underwhelmed.  THis is why I started using  a treatment that we call Maerckks Multimodal Therapy(MMT) in my practice.  All this is is an intelligently designed multitechnology treatment customized for the individual patient.  I use multiple diffferent frequencies and administration systems for radiofrequency delivery, three different ultrasound frequencies, infrared pulsed light, two different laser systems in concert to deliver immediate significant results that are hard to argue with and continue improving for weeks.  I think the only way to get real results is to combine technologies under the direction of a plastic surgeon that understands the capabilities and limitations of noninvasive skin tightening.  No one technology really delivers anything significant.  Also realiize that even my MMT results that I am very proud of do not remotely compare to what I can achieve with surgery and the cost can approach or exceed that of surgery depending on location and individual patient findings

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 75 reviews

Loose neck skin

Obviously, this is a difficult question to answer without an examination.  Generally speaking, most of the non-invasive modalities will help to a degree.   The problem with the non-invasive techniques (Thermage, Accent, etc.) is that the results are unpredictable.  You may be ecstatic with the result or disappointed.  That is why I ask the question:  Is it worth $2,500 to find out if your result is going to be worth the expense.  Surgery offers a much more predictable outcome, but there are associated issues, ie. cost, scarring, complications.  Sorry to be vague, its just that this is a complicated discussion due to the variations in presenting conditions with the skin, and the variety of options available. 

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Neither Thermage or lasers are better than a neck lift surgery!

Both of the non-invasive treatments you describe will leave you unhappy with the very minimal result they provide, if any change occurs at all. What you need to do is visit an excellent plastic surgeon and be evaluated for a neck lift. This will remove fat, tighten the muscles and either the extra skin will be allowed to shrink or it will be removed. You will wind up with a restored youthful angular neck line.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Neck lift.


Men tend to be specifically bothered by their neck (not their face). Unfortunately, in my rather long experience, non invasive procedures are not effective in the neck. This is specially true in men, who have thicker skin. Thermage can be good for the jawline, but not the neck.

Of course, I haven't examined you, and I might tell you to leave things alone for a while. Or you might be a good candidate for an isolated neck lift, which we do much more frequently in men than in women.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Neck tightening

Without a picture is hard to give specific advice for your situation. However, depending on the severity of laxity in your neck, you may need anything from laser to a neck lift. You can have external laser such as Fraxel or internal laser such as Smartlipo or Acculift. If you need surgery, a neck lift would involve an incision behind your ears and a small one under your chin. I hope this is helpful.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

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.