With significant neck sagging you would need a neck lift / facelift with muscle tightening (platysmaplasty). At the same time, lasers treatments (Fraxel, CO2, Erbium, Halo) or microneedling RF (Fractora, Intensif, Morpheus, PiXel8) can be performed to improve crepey skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach: - Microneedling and laser treatments for texture - Botox, Dysport, Xeomin, or Jeuveau to help the Platysmal bands - Intensif, PiXel8, Morpheus or Fractora RF microneedling for crepey skin and lifting - Injectable fillers like Belotero, Restylane Silk, and/or Juvederm Volbella to improve lines and folds - Renuvion, ThermiRF, and/or InMode FaceTite for internal tightening - Ultherapy and Thermage for external tightening - regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness - PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production See an expert for a full evaluation and treatment plan based on your individual situation and goals.