29 year old female with relatively mild neck laxity - what are my most effective non-surgical options? (Photo)

Question

When I lie down, I can pull 1 inch of my skin out around my jawline and under the chin. I know this is suggestive of a necklift/ facelift, but I'm not even 30 and don't want surgery yet. I thought it was excess fat, but I've been told I don't have enough fat to need liposuction. Would a TCA peel help? How can one tell if it's sagging skin vs sagging muscle/fat? My neck is smooth with no lines at all. There is some facial laxity as well, but I recently had a fat transfer and its improved. Thank you.

Muhammad Mirza, MD (license suspended) · Answer

Thank you for you question. I think Kybella is a great option. Laxity comes from loss of skin turgor. Kybella melts fat which can help improve the lax skin.

Raffy Karamanoukian, MD, FACS · Answer

Our Hidef approach to non surgical neck lifting addresses underlying 
muscle hypertrophy, neck laxity, and fascial tightness. We use a 
combination of Venus Legacy RF, NanoRF, and Ultherapy to exact a 
tightening of the neck + Botox for muscle and masseter hypertrophy. 
Retinoid creams are a must and we follow a comprehensive cream program 
for topical creams. 
Finally, fractional laser offers the benefits
 of microablation to improve skin quality and texture. We use this in 
addition to light therapy and PRP.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Andrew T. Lyos, MD, FACS · Answer

Hello and thank-you for your question and photo. 
We have some very exciting new technologies for non-invasive tightening of the Neck. Renuvion Powered by J-Plasma (Cool Helium Plasma) along with liposuction can produce dramatic improvement in skin laxity and fat reduction. Ultherapy combined with microneedling are other non invasive treatments would also be an option. I would recommend an in person consultation with a board-certified plastic surgeon well versed in all aspects of facial rejuvenation.
Best regards, Andrew Lyos MD, FACS

Jason Emer, MD · Answer

A combination approach would give the most improvement. Kybella, PDO Nova Threads, Ultherapy and/or ThermiRF treatments (Venus Legacy) are non-invasive options that would do well in combination for skin tightening. VASER with ThermiRF is a great alternative for contouring and tightening the chin and neck. See a cosmetic dermatologist for a long term treatment plan.  Best, Dr. Emer

Camille Cash, MD · Answer

From your description Morpheus8 sounds like the right treatment for you.  This is a noninvasive approach that combines RF technology with microneedling to improve overall skin tone and texture.  Typically three treatment sessions are recommended for optimal results.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Sean Paul, MD · Answer

Your neck line looks amazing.  I would consider minimal treatment to improve the appearance. A TCA peel can help with skin tightening as can laser, but you mention no lines - so this may be something to consider in the future.

Shaun Patel, MD · Answer

Nonsurgical skin tightening using an energy based device should work well for you. I really like the newest generation Thermage FLX which uses radiofrequency (RF) energy to stimulate collagen production and tighten lax skin.

Justin Harper, MD - Account Suspended · Answer

Hi journeygirl, 
There's actually no need to worry. If you wish you could opt for microneedling with PRP to encourage collagen growth and make the skin more supple.
All the best, 
Justin Harper, M.D.

Celia Remy, MD - Account Suspended · Answer

Hello there - thank you for posting!  
First - I just wanted to say you have very mild neck laxity from your picture.  When you lie down and can grab the skin- I do not know if you are stretching it, or simply grabbing it.  You are too young, and have too minimal of an issue to consider surgery in my opinion - so I would say you ARE NOT a surgical candidate. That is important as you evaluate yourself. I would suggest trying to look at your current state of laxity as really good, and perhaps looking for prevention more than "fixing" anything. Conservative measures would be the most you should look at .  
(***I say that with one caveat. I will assume you do not have any collagen disorder of any kind.  But if, when you pull on your skin- it tends to be more stretchy than your peers, it may be worth considering something called Ehler's Danlos syndrome, or a variant.  This is characterized by distensable skin, loose joints - which leads to pain, and easy dislocation as well as other symptoms. In more severe forms, - this may be the circus performer who can stretch their skin from their face out like bat wings. Many patients are missed, it is not an obvious diagnosis in more mild forms.  One silly, but interestingly helpful clue is if you can bend your thumb all the way forward to lay flat against your wrist, or if you can touch your elbow to your nose. If any of this sounds like you- you are encouraged to be evaluated- there is more to know if you have EDS)
If you do not have any of those issues- I recommend the following: 
Multi polar, or bi polar RF modalities ( venus freeze, venus legacy, etc) with longer time treatments, and temperatures in the skin that stay around 41-42 degrees celcius for as long as possible. This is a comfortable treatment, but those temperatures release stem cells from collagen and will give you better long term results.  Best of luck to you- and sweetie- you have nothing to worry about! Your laxity is very mild! 
I hope that helps! 
Celia Remy, MD

Val Lambros, MD, FACS (retired) · Answer

It matters not at all what you can stretch off your neck, it matters how you look and you look fine with tight smooth skin. You can pull skin form the neck of a 14 year old, skin is elastic, that;s the way it is supposed to be.  Just keep you hands off your neck. Burtterfly kisses are OK. You will get zero benefit from lasers ultrasound injections and the like.

29 year old female with relatively mild neck laxity - what are my most effective non-surgical options? (Photo)

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