How to approach improving my neck-- 35 years old and unsure if I would need a mini neck lift, full neck lift, lipo? (Photo)

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Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi there! What you are seeing are the relaxing of the two sheets of muscle in the neck called the platysma. Like the other tissues in our body, the platysma relaxes and loosens as we age, and is closely related to the overlying neck skin, which is why we see this manifested as loose neck skin. A surgeon can address this one of two ways, or using a combination of both ways: 1. corset platysmaplasty - an incision under your chin is made to access the sheets of muscle centrally and sew them together to conceal the banding and laxity, 2. lateral platysmaplasty - incisions are made behind the ears to access the sheets of muscle at the lateral borders and suspend them back up against gravity. There are no great options to effectively address this in a non-surgical manner, and it will continue to worsen as you age. The good news is you can get a long-lasting and durable result with the right surgeon.

Hello. Thank you for the clear description and photos. At your age neck concerns are usually a mix of skin quality, fat distribution and platysma behavior rather than only skin looseness. Your chin and jawline bones look strong which is a real advantage for definition and improves what any treatment can deliver
Without an in person exam any plan is provisional. The outline below can help frame next steps.
What is likely going on• Mild to moderate central laxity with a little submental fullness can read as a softer angle in photos• Platysma can create early banding or a mild downward pull when you contract
Will time fix it• Stable weight and good skincare help but do not reverse structural laxity• If laxity is the driver it usually needs targeted tightening or surgical support
Nonsurgical options while you decide• RF microneedling for skin quality and fine crepe in the central neck• Subdermal radiofrequency under local anesthesia to tighten the undersurface when laxity is mild• Careful neuromodulator to soften early platysma bands if they are dynamic• Deoxycholic acid for small fat pads only when skin elasticity is strong. Not ideal if laxity is primary• Your strong bony support makes these options more rewarding because the skin can shrink wrap to a good framework
When a surgical step makes sense• Persistent laxity or bands at rest despite good care and energy based treatments• An obtuse cervicomental angle that does not sharpen with simple chin elevation
What a conservative plan usually involves at 35• Submental lipo for mapped fat if a pinch test shows good recoil• Limited central platysmaplasty through a small under chin incision if there is banding• Mini neck lift with short incisions when lateral skin redundancy is mild and the jawline needs modest tightening• If the jawline and lateral neck are looser a standard lower facelift with neck lift gives better vector control• With a strong chin and jawline many patients achieve a crisp result with submental lipo plus limited platysma work rather than a full lift
Details that change the plan• Low hyoid or prominent submandibular glands can limit how sharp the angle becomes. These are checked in exam• Chin projection already looks supportive so implants are unlikely to be needed
Expectations and timeline• Energy based treatments improve gradually over 3 to 6 months• Submental lipo has social downtime of about one week with firmness that softens over weeks• Mini neck lift is often presentable by two to three weeks. A full lower face and neck lift needs three to six weeks to feel camera ready
Smart questions for your consultation• Is my main issue skin laxity, fat, muscle bands or bony support• Would you address the platysma centrally and laterally or only centrally• Do I have submandibular gland show that needs to be considered• Which scars are planned for a mini versus a full approach and why for my case• Can this be done with local anesthesia and light sedation or do you recommend general anesthesia
If you would like a case specific view standardized front profile and chin to chest photos allow a tailored plan before any medical evaluation. Coordinators can help collect these details through a short complimentary conversation.
Wishing you a clear path to a cleaner jawline and a neck that looks fresh in photos and in real life.Güray Yeşiladalı, MD