Double Deep Horizontal Neck Lines? (photo)

For my horizontal neck lines, I have double lines per band on my neck. It's deep and I would like to make it less visible or have it minimize. When I look down, my neck essentially bunches up. I'm in my mid-20s and I'm completely regular weight and BMI. What is the best non-surgical method to minimize the neck line. Instead of having 4 horizontal lines, is it possible to just have 2?

Doctor Answers 10

Double Deep Horizontal Neck Lines?

Best to start from a very conservative position. Try BOTOX with HA fillers. If happy than repeat this therapy 2 times a year. If not happy consider laser therapy or surgery. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Try BOTOX for horizontal necklace lines!!

Have you tried Botox? Intradermal injections of Botox along the lines can soften the creases. As far as I know this is the best treatment for necklace lines. One of the risks of treatment is difficulty swallowing, so make sure your doctor knows how to perform this procedure.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Cosmetic Surgery is an Art and a Science

At age 20, your options are limited. The neck creases are genetic and will stay with you. In my past, making them less prominent can help. Fat fills and neck lifts as you get older are an option. Consult a board certified plastic surgeon in your area. All the best

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews

Fat Grafting or Fillers for Deep Horizontal Lines in Young Patient

   A neck lift may not be appropriate in a younger patient.  Fillers and or fat grafting to help obliterate the creases may be reasonable considerations in younger patients.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Difficult problem to correct

Unfortunately there is not a lot of great options for this problem.  An assessment in person by a plastic surgeon would be helpful. Release of the bands would be an instinctive thing to do but they would most likely reform again.  Injecting fat into the area after release might minimize the recurrence but could leave you with lumpy looking neck.  I would recommend no surgery/treatment as you could end up with a much worse looking neck.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Neck Correction

This is a very difficult thing to correct without undergoing surgery. I'd advise that you meet with an experienced facial plastic surgeon who can describe to you the benefits of selecting a surgical neck lift and why you may be a better candidate for that procedure as opposed to non-surgical methods.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 9 reviews

Double deep horizontal neck lines?

Thank you for the question and the pictures. The bands are adhesions between the dermis and the underlying platysma muscle. The space in between these babd is filled with fat giving it that puffy look when you look down. You do not have excess skin. The treatment is directed to releasing those bands and removing the excess fat from the neck. My advice for you is get a consultation with a board certified plastic surgeon; in person exam would allow a better determination of the problem.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Neck lift will not help low horizontal neck bands.


Difficult problem.  Botox can relax the platysma muscles, which causes these lines to crease, but it does not always work.  Worth a try.

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

Improving deep horizontal neck lines

Deep horizontal neck lines are a difficult problem to treat.  In a young patient such as yourself a lower face and neck lift would not be appropriate.  The only real option is to consider fat grafting to the area.  This is a difficult procedure and may have to be repeated in order to give the optimal result.  Trying to liposuction the rest of the neck to bring the fuller areas down would not be appropriate.  In older patients the horizontal lines will often improve with a neck lift but at your age that wouldn't be appropriate. 

Jason E. Leedy, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 126 reviews

Horizontal neck lines

Your lines are dermal deficiency creases where the skin folds and the fat layer is thinner under the skin.  Fat grafting is certainly an alternative but could result in some lumpiness under the thin skin.  You may be a candidate for trying some filler such as Juvederm or Restylane.

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 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.