Would Botox help with my loose skin on neck?

The combination of injectable HA skin boosters followed by microdroplets of intradermal Botox injected in a grid pattern across the neck can be helpful for diminishing overall crepey neck skin. In my practice abroad, I would choose Viscoderm and Profhilo along with the Botox. In the States, Restylane Silk would be selected for the skin booster effect. For the horizontal necklace lines, Belotero Balance would be a good choice along with the Botox, the latter being injected at appropriate sites along each line. Make sure to consult with a board certified cosmetic dermatologist with experience and expertise in treating the neck and be certain to ask to see his/her personal befores and afters prior to agreeing to proceed. Best of luck.

Hi @NotSure10! I would recommend Botox for the platysma bands. For skin tightening, I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer

Hello, and thank you for your question. When injected into various points in the jawline and neck, Botox helps relax hyperactive muscles, providing the neck with a more youthful and tighter appearance. Botox softens lines and reduces some of the pull on the lower face by creating a slight lift. While Botox can target lines, it cannot correct skin laxity. For a more comprehensive approach, it is best to combine Botox with other skin rejuvenating procedures such as dermal fillers, laser resurfacing, RF microneedling (Profound RF), and other energy devices that stimulate collagen production. I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with extensive experience with injectables. Your surgeon can do a proper evaluation of your neck, recommend the best procedure or combination of procedures, and ensure the best possible results.

Thank you for your question. Botox is helpful for reducing banding, but it would not address skin texture or laxity. Some additional treatments that may be helpful would entail radio frequency, Radiesse injection, or surgery. All the best!
-Dr. P

Hi, Botox alone will not be effective on your neck wrinkles. Botox is applied only to the platysma bands, preventing them from being visible when talking or stretching with head movements, as this provides some relaxation, neck lines are less visible. However, the lines and loose skin are still visible. A more taut appearance can be achieved with different dermal fillers, device treatments like thermage or surgeries.

Hi, Botox is a muscle relaxant/paralyzer toxin. It freezes muscles from moving. The loose crepey skin will not get much improvement with botox, other than the temporary swelling that you may have for the first few days after injection. The swelling from the injection will likely make the crepey skin look plumper and better, but as soon as the swelling from the injection goes away it will look the same. I am a facelift and necklift specialist. A face and necklift can help with the muscle bands (platysmal bands) and help to remove the loose skin, but the crepey neck skin is not really changed in any substantial way, other than having less neck skin which places the neck skin on some "stretch" when the patient is in a good posture and at "attention." However, if the patient lowers their chin or slouches, the skin on the lower half of the neck can still be crepey, because the necklift does not operate on the lower half of the neck. In the first 3-6 months after a face and necklift, the crepey skin on the lower half of the neck can look better, because the swelling from a face and neck surgery can last several months. This causes the skin of the lower half of the neck to be "plumper" and at least during this "honeymoon" period, the skin indeed, does look less crepey. However, as the term states, this is "honeymoon" swelling and when the swelling finally goes away, the crepey skin returns. For energy based procedures such as a J-plasma or Morpheus, this can also create 2-4 weeks of "honeymoon swelling" which is enough time for a early positive review of the procedure. However, after the "honeymoon" has passed, the skin may look the same ideally and not have overheated the fat under the skin in this area, to further shrink the fat, which might possibly make the skin even more crepey. For this reason, I am very concerned and critical with non-surgical energy based procedures possibly cooking the subcutaneous fat and making the problem worse. If the "honeymoon" give us any clues to the direction we should go in regards to actually improving the crepey skin, it should be in the direction of "plumping" and away from "cooking" the skin. The plumping idea is also catching on in the decolletage (upper chest area) which can also be crepey when the person slouches and the upper chest skin is pushed together. This is when the crepey skin is most visible. Now doctors are injecting Sculptra, Fat transfer, HA fillers as well as a newly FDA approved fat-like injectable called Renuva. I hope you found this response helpful. Good luck. Best, Dr. Yang

Yes, it appears that you have some neck bands which can be improved with either Botox or Dysport which would relax the muscle to make the neck look smoother.

Morpheus8 and TCA chemical peels help so much to tighten loose neck skin that isn't ready for a lift. They are easy to undergo and work so much better than anything else.

Regular treatment with botox can help with lessening the appearance of the platysmal bands you have (vertical lines). Botox will not help with the crepey appearance and the horizontal bands you have. Other treatments-- radiofrequency treatment, CO2 laser, face and neck lifting may be other options for addressing those issues.
Be well,
Christopher Lo, MD