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 14

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

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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
4.8 out of 5 stars 204 reviews

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

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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
4.7 out of 5 stars 28 reviews

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

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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?

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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

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  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
4.8 out of 5 stars 155 reviews

Neck lift

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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 24 reviews

Who is a Lite Lift™ Candidate

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During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.
Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic may also be a candidate for a Lite Lift™.

It is also possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews


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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

Neck lift, Botox

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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 21 reviews

Tighten lower face and neck

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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

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.