51, weight loss caused crepey neck - what is the best treatment option? (Photos)

Question

I am 51 uk based and lost over 3 stones about 6 years ago. My skin where the fat was under my chin did not bounce back. It is very crepey and bothers me the most However when i smile the crepey skin is not visable. I am not an easy case for surgery because I have a hereditary bleeding disorder Called Thrombocytopenia my platlets are around 45. I also have Hypermobility so everything is stretchy. I have had Botox and fillers with a canula which did cause bruising but it went. Bigger surgeries i have needed transfusions. I dont want something that will last 6 -12 months. I am happy to consider one stitch procedures or laser or any others. Pkease help me by suggesting what you think would work best Thank you

Carl Truesdale, MD · Answer

The combination you're describing &mdash; weight loss + 51 + crepey neck skin &mdash; is one of the toughest scenarios for non-surgical neck treatment. Three things are usually at play:
Skin envelope stretched at higher weight and lost its elasticity. After 35 to 40, skin doesn't snap back well. After weight loss, the lost volume leaves loose skin draping over a thinner underlying frame.
Platysmal muscle laxity. The platysma muscle in the neck loosens with both age and weight changes. Visible vertical bands often appear or worsen.
Skin texture changes (the 'crepey' appearance). Thinner skin shows underlying microvasculature, fine wrinkles, and texture irregularities more clearly.
What surgical lifting accomplishes:Removes excess skin envelope, repositions the platysma in the midline (corset platysmaplasty), and re-drapes the neck skin smoothly. Combined with any necessary submental fat work, gives the most dramatic and durable result.
What skin treatment adds:CO2 laser or fractional ablative laser layered on top of the neck lift addresses the crepey texture component that surgery alone doesn't fix. Done at the time of surgery or as a separate session 6+ months later.
What non-surgical alone can deliver:
RF microneedling (Morpheus8, Genius RF): mild-to-moderate tightening over a series of treatments. Helps texture more than envelope.
Ultherapy: deeper layer tightening, modest results, takes 3 to 6 months.
Topical retinoids + daily SPF: maintains skin quality, doesn't fix laxity.
Realistic expectation: at 51 with post-weight-loss crepey neck, non-surgical treatments improve appearance by maybe 15 to 30 percent. Surgical neck lift with platysmaplasty plus laser resurfacing improves it 70 to 90 percent.
Best path: get evaluated by a facelift/neck lift surgeon who can do the pinch test and palpate the platysma. If skin really has lost meaningful elasticity, going straight to surgery saves money and time vs. iterating with non-surgical first.
If surgery isn't on the table at all, the most impactful non-surgical combo is RF microneedling (3-4 sessions) + retinoid skincare + daily sunscreen. Manage expectations.

Arif Eroglu, MD · Answer

You have excess skin and prominent platysmal bands in the midline of your neck. It's not possible to correct these problems by repairing the platysmal bands alone; a neck lift is also absolutely necessary.

51, weight loss caused crepey neck - what is the best treatment option? (Photos)

Answers (2)

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