Sagging neck skin ("turkey neck"). What asurgical and non-surgical options are available to firm sagging neck skin?

Excessive sagging of the neck skin is usually a result of a variety of factors including:

Quality of skin
Skin redundancy
Laxity of the platysma muscle

Surgery, including a neck lift would improve the amount of skin redundancy and the laxity of the platysma neck muscles by sewing them along the midline. This can usually be accomplished through a small incision under the chin and two small counterincisions in back of the ear.
Alternative treatments that address the skin will generally not recreate the neck line or improve the laxity of the platysma muscle.

A number of surgical techniques deal effectively with sagging neck skin. Some, such as a neck lift, are designed to focus entirely on the neck and require smaller incisions and faster recovery.  However, neck tissue and facial tissue are closely connected, so dealing with only the neck in a patient with substantial sagging can result in an incomplete correction or an unnatural look.  It is important to evaluate the surgeon's experience with his or her preferred technique and to see examples of post-operative results.  In general, there are no short cuts.  A small procedure will produce a “small” result.  There are no good non-surgical options.

To get the best results with Neck Lift, the following is needed;


Bringing the edges of the Platysma muscles together if indicated.

Doing some degree of Liposuction to sculpt the area

Re-draping the skin to help contour the entire neck

placing a chin implant only if indicated.


Please consult a Board certified plastic surgeon with training in head and neck surgery for best results.

Hope this helped.

The neck ages rapidly compared to other parts of the face. This is because the fan like platysma muscle is extremely mobile and the constant turning and lifting of the head and neck leads redundant skin, fat and muscle. 

Non surgical options in my hands include sculptra, fat transfer and botox. The first two refill the volume while botox can be used to relax plastysmal banding.   Laser resurfacing can be used to treat very fine rhytids of the neck though this is more successful for the fine lines of the perioral and periocular areas. It will give a modest amount of tightening to the most superficial skin of the neck and face. 



Surgically we offer a neck lift and plastysmaplasty. The neck lift is one of my favorite procedures. This is because the results are natural and the patients do so well. The incisions are hidden near the ear and in the neck and behind the ear hairline. Plastysmaplasty treats the banding that people often see in the midline of their neck. This is treated with a small incision that is well hidden just under the chin. The recovery time for these surgeries is about 2 wks and progressively improves. There is a bruising and swelling phase followed by resolution. 



I hope this helps.



Best of luck,



DrC

Sagging neck skin can be due to several mechanisms:- volume excess combined with skin laxity- mostly skin laxity like after significant weight loss- Platysma bands and skin laxityDepending on whether the neck shape is combined with presence or absence of heavy jowls the best procedure may be a necklift or facelift and necklift. A necklift alone does not improve the jowls significantly, but can be suitable when the jawline is reasonably good.In most instances though, a combination of facelift and necklift is most effective.A less common procedure is direct removal of the excess skin under the chin, also referred to Z-Plasty or Direct necklift. 

The sagging neck is an area that can be treated surgically for substantial and long lasting results.  The platysma muscle is the muscle underlying the neck skin.  Sagging of this muscle is largely what causes the 'turkey neck' that you mention.  Our practice treats sagging necks with a Deep Plane Neck Lift that tightens and tones this muscle to reveal soft and smooth skin overlying it.  This procedure can result in long lasting treatment with a substantial improvement in the neck profile and neck skin.

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.

There are many options for improving neck contour, both surgical and non-surgical - which is best depends on the degree of fat present, whether you have loose skin, and whether you have platysmal (muscle) bands and laxity. If you  have excess fat and are relatively young and have good skin quality then liposuction will give a good result - this is a simple procedure with quick recovery.For early skin laxity then there are a number of skin-tightening lasers such as Thermage, SkinTyte and Ultraformer III that improve skin laxity with minimal or no down-time. These however need to be continued for ongoing improvement.For more advanced skin laxity then surgery - lower facelift and necklift is the best option, giving you a long-lasting result

Neck firming options include surgical or non-surgical. Non-surgical options are for less severe neck laxity cases. Tightening machines can tighten but only to a certain extent and in a small patient population. For more moderate to severe cases surgery will provide more consistent results. Depending of the amount of loose skin or fat, a neck lift with liposuction may be necessary. If there is platysmal banding a tightening of the platysma may be necessary. 

The number of both surgical and nonsurgical treatments available for neck rejuvenation is astounding and there are too many options to even begin to list. So, let me just say that, in general, nonsurgical options are effective for only those patients with a very mild amount of sagging skin or excess fatty tissue in the submental neck. For patients with any degree of sagging skin or excess fat beyond mild, a surgical option is usually the most appropriate option. An in-person consultation with a board-certified facial plastic surgeon or plastic surgeon would be the most appropriate next step in the process.

Great question- and this answer should really be dependent on a few things. 1- your age2- the amount of laxity you have3- your expectations or goals from the procedure (your desired results)For someone younger, with minimal laxity there are non-surgical options, currently I use the Protege Elite which uses Radio-Frequency to lift and tighten. As my background is surgical (oculoplastics), I am very weary to recommend non-surgical options for the wrong person. I think there is a lot of marketing from these companies and the results they show are their outliers. I would recommend having an in person examination to discuss what I mentioned above. Hope this helps.