My son is getting married in October. How do I get rid of this waddle? (photos)

Doctor Answers 10

Nonsurgical Neck Reduction

Thank you for your question. There are many nonsurgical options out there. Treatment options vary depending on how much fat and/or lax skin you have in that area. To target fat, you could get Kybella injections or do minor liposuction. Kybella involves a series of injections, each 6 weeks apart. Your doctor could approximate the number of injections you'll need upon evaluation. Minor liposuction of the area would be done under local or general anesthesia (depending on your preference and/or budget). After targeting the fat, you could tighten the lax skin in the area with a ThermiTight procedure. This is a micro-invasive procedure that uses gentle radiofrequency heat to tighten tissues and smoothen skin. If you go decide to treat the fat with minor liposuction, ThermiTight could be done on the same day (immediately after liposuction). However if you decide to go the Kybella route, you'll have to complete the injection series before doing the ThermiTight procedure. Hope this helps, good luck!


Los Angeles Plastic Surgeon
5.0 out of 5 stars 10 reviews

Non-Surgical Neck Lift

Thank you for your question in regards to a non-surgical neck lift. A series of Exilis treatments will help improve the appearance of your neck. Exilis is a radio frequency treatment that uses heat without damaging the skin. The heat causes fat to melt away and stimulates collagen production which tightens your skin. To be sure what would be best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 150 reviews

Surgery is likely a better option for you

Considering degree of laxity and loose skin on jowls and neck, a mini lower face and neck lift is probably the best, quickest and even more affordable option. If this is not possible i would opt for minimally invasive procedure such as liposuction with a device called precision tx than can also cause skin tightening, or a similar more gentle approach with a radiofrequency device called thermi tight or viora. Kybella is an option, but requires multiple treatments in your case, and won't address the jowls or significantly tighten skin, and the cost can be prohibitive. Good luck!

Neda Vanden Bosch, MD
West Palm Beach Physician
5.0 out of 5 stars 9 reviews

Non Surgical Neck lift

Non-Surgical Neck Lift
Your non-surgical options are dictated by your specific needs which may include any of the below measures:
1)improving banding: Botox
2)improving under the chin fullness: Liposuction with oral sedation
3)improving skin looseness: VIORA REACTION radiofrequency
A consultation would allow a doctor to customize your treatment plan.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 44 reviews

Getting rid of the waddle

There are various nonsurgical options used to treat minor to moderate neck laxity and fat accumulation, but in some instances, the most straightforward and "sure" solution is surgery.

If you absolutely don't want surgery, you can try different combinations of nonsurgical procedures, but much of the improvement will depend upon your body's ability to generate new collagen. And likely the combination of procedures would get to be quite expensive - and without a promise of gaining the results you want.

Viewing the face and neck as a whole, if you were to only get rid of the fat accumulation, then you would have considerable loose skin. Kybella has shown a tightening effect along with fat dissolving, but the number of treatments and product could add up very quickly. (Kybella is only used under the neck and you also display significant jowling.)

See a board certified plastic surgeon for the best advice.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 21 reviews

Combination treatment

Non surgical improvement of the neck will require a combination treatment.
I usually start by melting the fat in the anterior neck are  (Kybella is very helpful) and tightening the skin of the face and lateral neck with Ultherapy.
This is followed by a second treatment of Ulthera right over the neck area about 2 weeks later.
Non surgical results are not perfect and don't last as long as surgery. But they are generally a lot less expensive and require less downtime.
Congrats and good luck.

A. David Rahimi, MD
Los Angeles Dermatologist
4.7 out of 5 stars 49 reviews

Best Neck Improvement Options

An exam is needed for the best opinion. Your photo however suggests that you have both excess fat and redundant skin in the neck. The best recommendations to improve your neck appearance depend on your needs, desires, and most importantly an examination to determine the best procedure for you. Your plastic surgeon will evaluate you for five main features that will determine your best options for neck line improvement:
  1. Amount of excess fat typically found beneath the chin, and in the upper neck. This requires liposuction with small cannulas or direct removal especially if the fat is beneath the platysma muscle. The use of Kybella injection may be appropriate for fat in the submental area without significant redundant skin.
  2. Presence of Significant (Platysmal) Banding – this requires bringing the muscles together in the upper/mid neck to a more youthful position and occasionally their release. This procedure is called a platysmaplasty or platysma plication. Mild banding can be treated non- surgically with Botox or Dysport but this requires injections 3-4 times a year for maintenance.
  3. Amount of excess/redundant skin (cutis laxa) and condition of your skin. In advanced stages this is called a Turkey Waddle or Gobble deformity. For example, younger age, darker skin colors and no large weight loss history most likely means there will be better elasticity and therefore better post-surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. Mild to minimal skin tightening using non-surgical means like the Sciton Laser SkinTyte procedure, Ultherapy ThermiTight (RF) or Thermage could also be considered. My personal preference for non-surgical skin tightening of the neck is the Sciton Laser BBL SkinTyte® procedure as there is no down time, more comfortable procdure, is effective and is a more targeted treatment. For redundant upper and mid excess neck skin: I prefer the LiteLift® (lower facelift ) procedure or MACS for skin re-draping for mild to moderate excess skin management as there are minimal scars and the skin is lifted vertically allowing for minimal hidden scars resulting in a natural appearance “non pulled” appearance. However: for moderate to severe skin redundancy , a neck lift or traditional lower facelift (e.g.Lite Lift®, MACS and others) is needed with or without lipo for best results. For advanced Turkey Waddle correction wither a traditional facelift or posterior neck lift often with a platysmaplasty is required with more extensive scars that extend at the hairline behind your ears. The advantage of a facelift procedure rather than a posterior neck lift is that your lower jawline (e.g. jowls and marionette lines) are also improved at the same time.
  4. Chin deficiency. If you have a weak chin then you will not have adequate chin support to your neckline skin which affects your entire neck line. Sometimes especially in younger individuals this is all that is required and this can be done in the office under local anesthesia. There are a number of different sizes and shapes and your plastic surgeon will pick the optimal one for you.
  5. Presence of prominent Digastric Muscles or Submandibular gland fullness from laxity or enlargement. Although not a major concern for most patients, if present then partial resection is usually the best solution.
In summary, picking the most qualified and best plastic surgeon with the most experience in neck improvement is essential to ensuring that you will have a wonderful and lasting result. It is the plastic surgeon’s ability to evaluate both your anatomical features and aesthetic goals to guide you to one or more neck lift procedures to give you the best neck line possible.

How to treat waddle?

I would say the most improvement you could get to your neck would be with surgery.  This would be with liposuction of the neck and a lift to deal with the excess skin.  There would be plenty of time for healing before your son's wedding in October.  Non-surgical options, such as CoolSculpting or Kybella could help reduce the fat in the neck, but would not deal with the excess skin.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Double Chin Treatment / Laxity-- SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, Kybella, CoolMini

you are a candidate for a neck lift with liposuction and likely platysmaplasty.  I suggest seeing a cosmetic surgery for analysis.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Nonsurgical Neck Tightening

Thank you for sharing your photo.  There are several nonsurgical methods of tightening the neck and removing the "waddle" you describe.  If the area consists of fat, #Kybella is a safe, effective way to permanently dissolve the fat.  If there are neck bands, I recommend a neuromodulator (#Botox, #Dysport, #Xeomin) to help with a Nefretiti lift.  If there is simply loose skin, radiofrequency devices (#Pelleve, #Exilis, #Thermi) heat and tighten the skin.  There are also ultrasound devices such as #Ultherapy that can be used to tighten the underlying muscle.  One of the most effective devices for lifting and tightening is #Exilis Ultra.  It combines radiofrequency and ultrasound to painlessly heat and tighten the skin.

Minimally invasive surgical options include traditional #liposuction and Smart Lipo.  The advantage of #SmartLipo is there are three lasers that tighten the skin surface while the liposuction removed the fat. 

Finally, there is a surgical neck lift.  This option is most effective when combined with a lower or mid #facelift.

Please consult an experienced plastic surgeon or cosmetic dermatologist to evaluate you for the ideal treatment for you. 

Best of luck,
Suneel Chilukuri, M.D.
Houston, TX

#necklift, #rhytidectomy, #nonsurgical, #aging, #antiaging, #Allergan, #Galderma, #Merz, #dermatology, #plasticsurgery, #Houston, #RefreshDermatology

Suneel Chilukuri, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 10 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.