What procedure would you recommend to tighten my lower face and neck? (photos)

Hello and thank you in advanced for your time. I am 41 year old female who has loose skin around neck and the beginning of what I think are jowls. Would love to know your thoughts on the right treatment. Mini lift? Lazers?Chemical peels? Thank you !

Doctor Answers 13

Neck Skin and Platysmal Bands -- VASER Hi Def Liposuction/ThermiRF, Venus Legacy/Thermage/Ultherapy, Botox/Dysport, Kybella

There are many options for neck skin such as lasers, microneedling, radiofrequency, ultrasound (ultherapy). I suggest you see an expert to determine what is best. Dr. Emer

Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

What procedure would you recommend to tighten my lower face and neck?

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. From the photos your cheeks are flat anteriorly (in the front), jowls are present and there is loose skin in the neck. 

Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

"Jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

To address the loose neck skin, a formal neck lift would be required. This would require a general anesthetic and several hours of additional surgery time with a post op pressure dressing, drains and longer recovery. If you want the front portion of the neck smooth, a full neck lift combined with a limited lower facelift seems the most appropriate course of action.

Hope this helps.

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

What procedure would you recommend to tighten my lower face and neck? (photos)

I think it would be premature to do a face lift given your young age and limited amount of skin laxity/excess.  There are some less invasive procedures (such as suspension-suture neck lifts) that might offer you improvement.  It is very important that you have an in-depth  consultation with a board certified plastic surgeon who has a wide range of experience with facial rejuvenation procedures.  

David A. Caplin, MD

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Treatment of excess skin and sagging of the lower face and neck?

Treatment of excess skin and sagging of the lower face and neck?  Excess skin and banding in your neck requires removal to give you a good result. See a very experienced facelift surgeon who can tighten both the skin and muscle without creating the overdone look. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
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Lower face and neck lift to tighten inelastic and loose neck skin

  A lower face and neck lift  can significantly tighten loose and inelastic skin that may be present. In our practice, a lower face and neck lift accomplishes lifting the jowls and the SMAS layer, tightening loose facial and neck skin, tightening loose facial and neck muscles, and removing any fatty deposits in the neck. For many examples, please see the video and the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Neck lift

It looks as if you could benefit from a neck lift.  I don't think lasers or chemical peels
would treat your problem adequately.  Its best to seek consultation with a board certified surgeon
experienced in this area.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 reviews


Thank you for your question. I have performed many Facelift under local anaesthetic administered properly, patients are comfortable and have an easier recover.  I have pioneered my Concept Facelift, which targets the SMAS muscle and skin, therefore giving the same longevity as a traditional facelift, however is performed under local anaesthetic.  This ensures a significantly reduced recovery period, with minimum swelling and bruising, therefore patients returning to their daily routines within 5-7 days. My reasons for pioneering this were because patients did not want the health risk of going under general anaesthetic (especially as is it not a necessity procedure), local anaesthetic or twilight sedation would be a great alternative, not only for health reasons but your recovery period will be shorter.  My patients will experience slight discomfort when injecting the local anaesthetic, then will feel very relaxed and calm throughout the procedure (please watch video).  Overall, the Concept Facelift giving our patients fresh, youthful and long lasting results. You can also combine your facelift with a neck lift. This gives fantastic results and goes hand in hand. Liposuction can also remove the fat in the neck but I would advice having a neck lift if you have lipo so that you do not have any sagging skin.Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best

Amir Nakhdjevani, MBBS, MRCS, FRCS (Plast)
London Plastic Surgeon
5.0 out of 5 stars 44 reviews

Neck lift, Botox

There is no doubt that you would benefit from tightening of platisma and skin in your neck and face. However, in skinny neck like yours  platisma muscle bands will come back soon after surgery regardless of the quality of lift. You have no fat in your neck and there is no other way to hide discrete movement and bands that live active muscle like platisma will produce. Before committing to surgery you may try Botox for treatment of  muscle bands: it works well in patients with thin necks like yours.
You should seek a consultation with a reputable plastic surgeon in your area for clinical evaluation and discuss your options. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Tighten lower face and neck

Thank you for asking about your lower face and neck.
  •  You truly need an examination to get your best advice.
  • The neck bands can be treated with Botox.
  • Botox and filler will help the lines around your mouth.
  • A neck lift may be the best approach to the loose neck skin -
  • Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

Skin tightening on lower face and neck

Loose skin on the neck and lower face can be improved by non-surgical or surgical treatment. The most suitable non-surgical treatment, in my opinion, would be a radiofrequency (RF) treatment. The Apollo tripollar RF treatment is very effective for most patients. It is safe for all skin types including dark complexions. It requires multiple weekly treatments (8-10) and the final results are usually apparent 4-6 months after completing the treatment series. This treatment is performed in the office, is painless and does not require any recovery time. The RF treatment is supported by using topical Vitamin C solution on the face and neck twice a day, and Nectifirm cream on the neck twice a day. Sun protection is essential to optimize results. The treatment works be generating heat in the deeper reaches of the skin, causing skin shrinkage and formation of new collagen over the next 4-6 months. Think of it as "shrink- wrapping" the skin. The results are maintained with a maintenance treatment every 4-6 months and on-going sun protection,  application of Vitamin C solution and Nectifirm cream. You can look at pre and post-photos on my website. 
Micro needling is helpful as well. However, it involves multiple needle punctures in the skin and is not non-invasive. It requires multiple treatments for optimal results.  
Fractionated CO2 laser treatment can also tighten skin but is more risky on the neck. Ultrasound (Ultherapy) is yet another option.
If you're open to surgery, a face-neck lift will give you more aggressive tightening but entails potential complications of surgery (which can be minimized by an experienced surgeon), and a longer recovery period ( a few weeks before all the swelling has subsided). The results are more controlled than non-invasive treatments. However, if you're on a blood thinning medication that cannot be discontinued for a few weeks, surgery cannot be performed and non-surgical tripollar RF treatment is ideal. 
I hope this helps you in your exploration of the ideal  treatment for you.

Renuka Diwan, MD
Cleveland Dermatologic Surgeon
5.0 out of 5 stars 12 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.