Only 36 and so unhappy with my neck. What procedure would you recommend to smooth my neck line and eliminate neck bands? (Photo)

Question

Neck bands present at rest. No extreme weight loss/gain, no previous procedures. Just unlucky and so self conscious. My goal would be to have a procedure that smooths my neck line and eliminates neck bands. Is this possible, a realistic expectation? What procedure is recommended? Cost in DC area? Complications/liklihood? Recovery time? Scaring? How long will results last? When/if the bands return, will they be worse than if I had nothing done? Please help!!! I'm miserable.

Franklin D. Richards, MD · Answer

The bands on you neck are visible because your underlying platysma muscle is split and it has stretched the skin. This will require a procedure to provide long term correction. Either a platysmaplasty or mini-neck lift would work. I would recommend the mini-neck lift if the skin is quite loose, but this could only really be determined after an examination by your surgeon. Both procedures can be done in the office and it does not require general anesthesia. The cost would be $5K to $9.5K depending on the procedure needed. The results, especially in a young person, should last 12 to 15 years. If the bands return, the procedure can be repeated. Scaring is minimal. The platysmaplasty requires a small incision under the chin and the mini-neck lift requires an incision around the bottom and behind the ear. Both scars are inconspicuous. There can be complications with either procedure, but are unusual.

Jason Emer, MD · Answer

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

Jed H. Horowitz, MD, FACS · Answer

It's best to begin by consulting with a surgeon in-person. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine what treatments will best rejuvenate your neck . During an in-person examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.
A board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern.

Mark Anton, MD, FACS · Answer

Hello Me x 3-You are young and look youthful. Please try botox in these neck bands but make sure the enough of the medial edge of the platysmal band is injected. This is your best option currently.A conservative anterior neck dissection with approximation of the medial bands and back-cutting of the platysmal muscle may be option, but understand the risks. Good luck.

Shlomo Widder, MD · Answer

Dear Me x 3, Thanks for submitting your pictures. From the pictures it appears that you have very little skin laxity and mainly sub mental and lateral platysma muscles bands.  Since you are so young, you have few options : 1. Botox injections - They need to be repeated every 3 -4 months and will eliminate or significantly reduce the bands. There is no surgery and no down time. 2. Platysmorrhaphy - Small incision under the chin. Undernining the skin and exposing the platysma muscles that are being undermined too, subsequently. If there is fat under the muscles centrally , it is  removed and the muscles are being plicated and the excess muscle is excised. 3. Neck lift - This option appears to be excessive in your case because it's done to tighten excess skin and muscles laterally and the incision goes around the lower ear , extending into the hairline. 4.  MACS  face lift - This option is good if you have deep naso labial folds, tear trough deformity and jowls. This surgery is the most comprehensive and improves on the face and neck, including the bands. The incision goes from the pre temple hairline ( the incision here is beveled and allows hair to grow through it and camouflage it ), continuing downward and ending around the ear lobes. In summary, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, make sure that the surgeons show you many before and after pictures  that are consistent and attractive. Discuss cost issues with the surgeons, because as you can see, there are few treatment options and there is the additional time element that is dependent on the complexity of the procedure. The cost of Botox in my practice is $12 per unit.              Best of luck,                             Dr Widder

Toby Mayer, MD · Answer

Facelift for jowls and neck bands.Your bands and excess skin and early jowls need a facelift---just your genetics. It should last 10 years or more. We reset the clock but cannot stop it unfortunately. Mini lift will not do what u want and u r wasting money.

Cameron Chesnut, MD, FAAD, FACMS · Answer

There are numerous surgical and nonsurgical options for neck bands. These bands are caused by a muscle called the platysma, so nonsurgical options like neuromodulators (Botox, Dysport, Xeomin) are aimed at paralyzing this muscle so that it does not form those contracted bands. At your young age, you should have plenty of skin elasticity to pull your neck skin back up once these bands are disabled by paralyzing the muscle.Once you get to a point where you no longer have that elasticity, a neuromodulator can still help to soften the bands, but help is needed to lift that skin back up into place. This is when you begin talking about neck lift or a platysmaplasty. Cost wise, it does not take that many units of a neuromodulator to paralyze this muscle, so cost is relatively low. With neck lifts you start talking about several thousand dollars, but when properly selected this can still be a great deal for the amount of benefit that it gives you.Be sure to see a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these core four

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

You have very prominent platysmaplasty bands. You may benefit from a neck lift. Another option would be to consider neurotoxin injection. Have your neck evaluated by a board certified facial plastic surgeon.

Sharon Y. Giese, MD · Answer

A temporary solution would be Botox.  This may last 3-5 months.  Since it appears that you have little fat, I don't think liposuction of neck will improve your situation and could make it worse.  So a mini neck lift would improve the appearance.

Darryl J. Blinski, MD · Answer

Appears a few issues related to aging. The Platysmal bands, slight if any neck skin laxity. The simple first treatment for temporary improvement of the banding is the use of BOTOX (most likely 80 to 100 units fee $1200). Otherwise even 'cutting' the bands is a very difficult option that costs thousands with poor results. As for neck laxity either non invasive RF therapy, minimal invasive ThemiTight RF, or a neck lift. Best to seek a few IN PERSON opinions!!!

Only 36 and so unhappy with my neck. What procedure would you recommend to smooth my neck line and eliminate neck bands? (Photo)

Answers (18)

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