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.

For a turkey neck, the options depend on how much tissue and loose skin and fat there might be. If there is just a little fat under the chin and neck with good skin quality (this is often seen in patients in their 20s – early 40s), then you might consider liposuction of this excess fat. If the skin is of moderate quality and slightly loose, you could consider a minimally invasive procedure such as microneedling with RF (radiofrequency) which creates tiny channels in the skin to allow new skin to grow and stimulates collagen formation. However, if the patient has severe loose skin and fat (a definitive “turkey neck”), then a neck lift in combination with liposuction may be necessary to obtain the best result. For these procedures, I enjoy hiding all incisions in the crease behind the ear so that you can, if a female, wear your hair up or back without any telltale signs of surgery, or – for my male patients – scars would not be easily seen if the hair is short. Please be careful who you choose as your surgeon, and ask as many questions as possible. I have seen many patients who come to me for revisions from other offices who have visible, unnecessary scars that can extend toward the neck, as well as having obliterated earlobes due to subpar surgery. Please consult with a board-certified plastic surgeon to discuss your goals and expectations to see what procedure, and which surgeon, would be right for you.

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.