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.

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. 

The neck is one of the most important components of facial aesthetics. A well defined jaw and neck line will improve your overall appearance and youthfulness. With most nonsurgical options, you need to have realistic expectations because they never are as powerful as surgical rejuvenation. However, if you have early aging and neck issues they can improve things without major downtime. The majority of these treatments use heat to tighten the dermis and some deeper layers. Ultherapy is one of the most popular treatments. This also targets the SMAS using ultrasound energy. Surgically, we make well hidden incisions around the ear to allow us to tighten the SMAS layer and remove excess skin. Depending on your individual issues we may also need a small incision under the chin to use liposuction to improve the overall contour. Seek a consultation with a board certified plastic surgeon to get a treatment option that is right for you and your goals. 

Sagging of the neck is normally caused by a number of factors: accumulation of fat, loosening of muscles, excess of skin. Because of this, whilst non-surgical procedures are very effective in treating facial ageing, they are much less effective in treating ageing of the neck. Non-surgical options include using Botox injections for platysmal bands; filler injections for lines in the neck as well as in the jawline which can create a modest amount of lift in the neck; energy based skin tightening for loose skin (examples include Profound RF, Ulthera, Thermage). Ultimately however most people who would like to achieve a significant improvement in their neck contour are better suited to undergoing a surgical neck lift. This involves making incisions around the ear, as well as under the chin. With a surgical approach all aspects of ageing in the neck can be addressed, resulting in a much more significant improvement. 

The neck can get sagging skin for many reasons including a lot of sun exposure, weight gains or loss, pregnancy etc.  Aging of the neck is very common before aging of the face.  It's one of the things that can be very frustrating to patients of all ages especially the turkey neck in patient’s with a family history. The face and neck keep changing as you age. Some of the changes are at the skin level, some at the deeper levels like the fat, retaining ligaments or muscles. There are several nonsurgical and surgical options to treat each of these different areas. Some can be done together and it really depends how much improvement you want to see as well as what part really bothers you. If there is significant sagging, surgery is usually the preferred procedure but can still be combined with injections and laser treatments before or after surgery.  A simple way to think about it - think of surgery as addressing any excess skin and laxity as well as removing fat.  Think of laser as tightening the skin levels. Injections like Kybella can nonsurgically help diminish the fat and offer improvement and there are all sorts of laser procedures that can tighten different layers as well.Most of these procedures can be done safely in the office and the results are very satisfying. An in-office private consultation and examination with a board-certified plastic surgeon would be the best way to fully see and address your specific concerns and determine the right treatment plan.I hope this helps answer your question.  If it does, please take a moment to up vote this answer on the “respond” button on the top right.