Are there non surgical options that can help minimize the appearance of a crepey neck? (photo)

Question

In last year or two I've noticed a rapid change in my neck skin. No doubt thanks to sun damage from my youth. Are there any non-surgical options to help with this?

Randal Haworth, MD, FACS · Answer

Collagen induction therapy (CIT) which works with Macroneedling, RF devices, fillers and Botox can work really well as non surgical options.

I hope this helps,

Best of luck,

Randal Haworth

Thomas Wright, MD · Answer

Tammylynn,  Thank you for sharing your photos. I can see that you have prominent platysma bands and some necklace lines.   These problems can be corrected with MyEllevate a non surgical neck lift procedure. Some skin tightening with FaceTite or Renuvion may also improve the skin texture.  These procedures are minimally invasive and are considered non surgical as there is no cutting involved. Unfortunately, there is no completely non invasive treatment that will adequately address your concerns.  Wishing you the best of health.

Jeffrey S. Rosenthal, MD · Answer

The Endolift Laser is FDA cleared to tighten lax skin and stimulate your collagen.  The procedure uses a thin micro-fiber place through tiny pin holes to pass below the skin and target the cells that rejuvenate the face and neck. Fat below the chin can also be contoured using the Endolift Laser.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nima Shemirani, MD · Answer

Hi @tammylynn130! 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. Best of luck, Dr. Nima!

Nelson Lee Novick, MD · Answer

HA fillers can work well for treating next skin laxity. Robust HA fillers injected properly on the sides, for example, can be used to lift, pull and refine the contours of the neck, and resilient, low viscosity, cohesive HA fillers can be used to improve the appearance and skin quality of the central portion of neck. Treatment generally should take no more than a fifteen minute session in experienced hands and engender little to no significant downtime.  However, these are advanced injection techniques that should not be left to the hands of novice injectors accustomed only to using simple Juvederm or plain Restylane for smile lines. These are advanced injection techniques and you would be wise to consult an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Jason Emer, MD · Answer

​A combination of non-surgical options like Kybella, PDO NovaThreads, Ultherapy and Thermage would do well in combination for skin tightening for the neck. VASER Liposuction (with ThermiRF, Renuvion and InMode FaceTite) is a great alternative for contouring and tightening the chin and neck and can be combined with a neck lift at the same time, if you're a candidate. I suggest getting a formal evaluation with a cosmetic dermatologist to develop a long-term treatment plan that works for you. Best, Dr. Emer.​

Lisa Vuich, MD · Answer

Thanks for your question. There are several very effective treatment options for treating neck skin laxity. In non-surgical aesthetics, skin tightening is going to be "all about heat delivery". This is because the microinjury of heat is needed to stimulate collagen and elastin production in the skin, which happens during the healing response to the treatment. Results from any of these procedures are not instant but rather develop gradually over the course of 3 to 6 months:
1.	Sofwave- utilizing microfocused ultrasound to deliver heat to the deep dermis at a depth of 1.5mm, generating new collagen and elastin in the skin. The number of pulses delivered is important- the more laxity there is, the more important it is to do the ‘advanced protocol’ with 4 full passes. Most will need 1 to 2 sessions spaced 4 or more weeks apart. You should have either ‘full face and neck’ or at least ‘lower face and neck’ to get the best result for the jawline. Sofwave has no effect on fat cells as the energy cannot reach that level. Numbing for he procedure is primarily topical. 
2.	Morpheus8- utilizing RF energy delivered at the tips of micropins. With this approach you get the collagen stimulation of the heat PLUS the collagen stimulation of the microneedling, so you can potentially get more result per session, but at the expense of 'some downtime'- puffiness, faint redness for a day or two, potential bruising. The needles can also be set deeper in certain regions so that they will destroy unwanted fat cells- such as in the jowls and the “double chin” zone. Most will need 3 sessions- can be spaced 4 or more weeks apart. ‘Full Face and Neck’ is the ideal approach. Numbing for this procedure is primarily topical but nerve blocks (injection numbing) is very helpful also.
3.	FaceTite- this procedure involves placement of a probe just under the skin to achieve full thickness heating. The probe is introduced  through some simple needle pokes- considered ‘minimally invasive’. Most require a single session. Results typically last 5 years. Numbing for this procedure requires lidocaine injection. 
4.	EmbraceRF- this is a combination procedure pairing Morpheus8 externally with the FaceTite procedure. Ideal for the more advanced skin laxity, for skin laxity that is accompanied by surface wrinkles or crepiness, and/or when there is unwanted fat to be destroyed. If the fat collection is substantial, this can be combined with targeted liposuction. Numbing for this procedure requires lidocaine injection. 
I hope that helps!

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Yes, there are options available. Morpheus8 RF microneedling helps this issue. The device delivers energy to help tighten the collagen and skin. The results are nice and the downtime is fairly minimal. Nectifirm Advanced is another product which tones the skin of the neck. It can be applied daily and rejuvenates the skin. Hope these help provide some guidance!

Camille Cash, MD · Answer

There are some options that can help improve the neck area.  You can consider Morpheus8.  These treatments can improve overall skin tone and texture.  Three treatment sessions are recommended for optimal results.  You can also consider FaceTite.  See a board certified plastic surgeon near you to discuss your concerns and learn more.

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