What Causes the Neck Muscle to Loosen?

Doctor Answers 10

Platysma muscles sag and create an aged appearance

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The muscles in the neck that sag and create an aged appearance are the platysma muscles. The platysma muscles shorten, fibrose, and contract; this creates two bands in the front portion of the neck as we grow older. These bands are tightened in front above the hyoid bone and Adam’s apple and are cut and released down low below the Adam’s apple. This gives a normal neck contour and the bands disappear. The muscle itself is actually shortening, contracting, fibrosing, and bowstringing out from the neck skin. The fascia attachments around the muscle are actually what are loose.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Platysmal Muscles Loosen With Age

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The platysmal muscle in the neck is not bound to other muscles or ligaments and so is extra vulnerable to the effects of gravity and aging. In addition, most people don't exercise their necks, and so the muscle atrophies over time. Another factor that causes sagging neck skin and “turkey necks” is that the skin on the neck tends to be quite thin and is not well-connected to the platysma. The only way to make a dramatic change in the way loose neck muscles and skin look is to perform either a full facelift or a necklift, where the platysmal muscle is tightened and the excess skin removed and tightened. A well-performed neck lift can last up to 10 years. I hope this helps.

The neck muscles sag because they don't have a firm attachment

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The neck muscles (platysma) do not have a fixed attachment like other muscles that attach to ligaments and bone. The platysma muscles are free-floating in the neck and actually are pulled forward by their own contraction.

In facelift surgery, I pull the back portion of the muscle close to the ear again. You can see this in yourself in the mirror. Just pull on the neck at the angle of the jaw towards the ear and see the neck tighten. Once you do this, you will see why most non-surgical treatments for neck sagging don't work if the muscle position is not addressed.

Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.6 out of 5 stars 14 reviews

Neck laxity

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There are many reasons for neck laxity and these have been touched upon and include skin laxity due to decreased elastin formation, actinic damage, subcutaneous atrophy, gravitational changes, bony volume loss, etc.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Multiple reasons.

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 The main reason is gravity, gravity, gravity! Combine that with loss of fat in the neck and loss of elasticity of the skin and muscle, bone absorption, --------well you get the picture.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Loss of facial volume, drooping of the neck, laxity in the muscle layer

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And loss of the connections between your neck muscles and the deeper structures within the neck. The platysma is the muscle that wraps your neck and this is attached to the facial muscles. When you lose volume in the face from losing fat, tissues in your skin and the bones in your face getting smaller, this neck muscle descends.

Also, you lose the connections of your neck muscle with the underlying deep neck structures with time as well. I think that what also happens is that your posture is affected over the course of the years so that the cervical spine also becomes lax in such a way that the distance between your chin and cervical spine is shorter which contributes to the extra tissue between them. Also, as you contract more of your neck muscle, this muscle shortens with time. The shortest distance between two points, your chin and lower neck, is a straight line.

Philip Young, MD
Bellevue Facial Plastic Surgeon

As you age, gravity and depleted connective tissue cause the neck to loosen

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 Unfortunately, over time as you age, gravity continues to pull as the connective tissues in your body loosen.  This causes the skin to loosen and fall.

Neck muscles loosen because of gravity and age.

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The neck muscles (platysma) tend to become thicker and looser with age.  Gravity pulls them down, and we make them worse with years of grimacing and making other facial expresions.

Both a neck lift, and a complete facelift will fix the neck muscles.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Neck muscle loosen

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As you age the neck muscles become a little lax and the skin looses its tone and that is why people need neck lifts.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Loosening Neck Muscles

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Its actually your skin that losens more than your neck muscles. With age the tighter collagen is replaced by more lose collagen and the elasticity decreases. Muscles do not play a big part in the aging appearance of the neck. Its the THINNER and LOSER skin that actually makes the neck look old with prominent muscle bands.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.