What's the best procedure for the extra skin on the neck? (photos)

I'm 40 yrs old. Please help.

Doctor Answers 14

Neck lift

Thanks for sharing.  At your age and extent of aging I believe you are a surgical candidate for a neck lift.  This would include chin lipo, platysmaplasty, and skin elevation and excision with incisions behind your ears and hairline and under your chin.  This would give you definitive results and the surgery is not major.  With the right surgeon, it can be done under local anesthesia and oral sedation.  


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 72 reviews

Treatment Options for Neck

Thank you for sharing your question. Based on the photos you provided, you appear to be an excellent candidate for a lower face and neck lift with neck liposuction. This procedure is the gold standard for the treatment of loose skin of the lower face and neck area. Since you are only 40 years old, I can understand if you are not ready to consider surgery just yet. There are some non-surgical tightening procedures available to tighten loose skin in this area. For example, ThermiTight is a radio frequency procedure that uses a heated probe beneath the skin to warm the surrounding tissue to a pre-set temperature. The procedure is minimally-invasive with little/no down time. After 6 weeks, patients notice tighter and smoother contour of the jawline and neck. In some cases, the procedure needs to be repeated for optimal results. For more information on which procedures are right for you, I recommend consulting with a board-certified specialist.

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Best procedure for the extra skin on the neck?

Hi, I have performed facelifts and neck lifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your chin is weak and there is excess fat and skin in the anterior (front) portion of the neck.  However, there are no signs of significant jowls which are the primary indication for some type of SMAS facelift as described below.

 When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.  Excess fat and skin can be removed from below the chin using the same incision that's used to place the chin implant. You may want to try this before having a full Neck Lift which is far more invasive and would also require some form of lower facelift (the vector of pull on the skin with a neck lift pull is upward at a 45 degree angle which causes any excess skin above the jaw line to be affected.  If an incision is not made around the front of the ear and this excess skin removed, a skin pleat can result just below the earlobe).

 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.

  If you have "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 and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • 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.

Hope this helps.

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

Necks can be complicated

Necks are not straight forward. What to do depends on many anatomic factors and the experience of your surgeon. You are relatively young and your skin is probably pretty good. You may benefit from relatively simple procedures like liposuction of the neck only, an anterior limited neck lift (small incision under the chin and adjustment of the fat and muscle), or even Kybella treatments. 

Patients with loose, excess skin need more done--procedures to contour the muscle and fat and remove/tighten excess skin with incisions around the ear.

I would settle for a liposuction or anterior neck procedure if I had your neck. As always, what to do is very much dependent on your expectations. It's always best to keep it simple in minor cases but do what you need to do in more advanced cases.

Mini neck lift or an ellipse of skin removed from this area

In a 40 year old, less is more. I would want to examine you but from the pics you do not seem to have any real skin laxity along the jawline... so maybe just an ellipse of skin removed with an incision mostly hiding in the chin crease might work. Another option is a mini neck lift with the incision hiding behind the ear in the crease on both sides.

Ritu Malhotra, MD
Cleveland Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Double Chin/Turkey Neck/Neck Laxity -- VASER/ThermiRF, Botox, Venus Legacy/Exilis, Kybella, CoolMini

This can be improved with liposuction VASER / ThermiRF combination, kybella or coolmini.  You can add ultherapy/thermage for extra tightening.  Surgically neck lift would be best.  Get a formal consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Under chin looseness

Great question. So, you are only 40, and from the photos, it doesn't appear that the lower half of your face or your neck have any other strong reasons for a facelift or a neck lift except for this looseness directly under your chin. The advantages of Precision Smart Lipo compared to a face lift or neck lift are: the tiny scars are negligible, the downtime is much less, the expense is less, and in your particular case, the results may be just as good or better.  Smart Lipo liquefies the excess fat w/ dual beam laser (initially with the laser beams firing straight ahead and also down), then the liquefied fat is sucked out, finally, a second redirected use of the laser cannula under the skin in the loose skin area - will use up-firing lasers to tighten the skin from the inside out. Hope this helps.

Removing excess skin and or fat of the neck?

Removing excess skin and or fat of the neck? treatment of a turkey neck which is excess skin can only be improved with a face- neck lift. If you do mini procedures you are wasting your money. See a very experienced facelift surgeon for the best results. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Treatment of Extra Neck Skin

The pictures suggest that at least a neck lift with possibly a chin implant would improve the neck and jawline. A picture showing the side of your face in front of the ears would be helpful to rule out the need for any lifting in this area.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Neck Lift

From your limited photographs, you appear to be an excellent candidate for at least a neck lifting procedure where the muscles are tightened in your neck, excess fat is removed, and excess skin is removed from behind the ears. It's best to be evaluated in person by a board certified facial plastic surgeon or plastic surgeon to review your concerns, examine you more thoroughly, and offer any feedback regarding whether you could also benefit from lifting the tissue of your cheek or brow simultaneously. Good luck!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 42 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.