Alternatives to necklift surgery
In my medical spa we offer many non-surgical options for aesthetic enhancement. For the right indication, many of these non-surgical options are quite effective. However, If there is skin excess, surgery is the only effective option.
If a person’s neck does not appear youthful, the face – no matter how limited the aging changes are – will often not be perceived as youthful either, unless the aging neck is concealed.
Even in the absence of other signs of facial aging, a poorly-defined or sagging neck can add years to a patients overall facial appearance. When performed expertly and with great attention to detail, a necklift surgery can dramatically restore a natural and youthful neck profile, with no outward evidence that surgery has been performed. The adjective that immediately comes to mind when I review ‘before and after’ images of my necklift patients is elegant – for restoring a youthful neck contour truly makes the patient appear not just younger but also refined and elegant.
Necklift surgery can consist of a variety of surgical techniques that are carefully selected to meet each individual patient’s particular needs. It is therefore important to select a qualified physician with a great deal of experience in numerous necklift procedures. In younger patients with good skin tone, submandibular liposuction alone may produce a dramatic improvement. For some patients with good skin tone but poor definition at the angle of the neck, I add a suture-suspension necklift to sharpen the angle between the jawline and neck. This procedure is minimally invasive and has a very quick recovery. It will not, however, improve the situation if a true excess of skin is present.
Patients with more advanced aging changes in the neck generally require tightening of their neck skin as well. The neck is the one area in facial rejuvenation where a tighter and more toned surgical result looks natural and aesthetically ideal (as opposed to the face where ‘tight’ and ‘tighter’ just looks like surgery). Neck skin removal is accomplished through incisions around the ears which can be extended a short distance into the scalp if necessary. If the incisions are created and closed correctly and without undue tension, a very natural looking result can be obtained with no obvious signs that a necklift has been performed. A great deal of experience and expertise is required to avoid distortion of the ear and surrounding skin.
Necklifts in a nutshell
The neck has several issues to consider;
1- excess, sagging skin
2-Too much neck fat, or too little if over-treated with liposuction.
3-Turkey Gobblers - This is the result of the muscles in the neck (platysma) sagging and separating in the midline.
Treatments for neck issues;
Liposuction - for excess neck fat in patients with good skin tone and elasticity.Minimal incisions.
Liposuction with platysmaplasty - Liposuction of the neck, correction of the platysmal bands (turkey gobblers), redreaping of the skin for patients with excess fat, platysmal bands, but good skin tone and elasticity. Small incision under the chin.
Necklift - liposuction, platysmaplasty and removal of excess skin from behind the ears. Recovery is short. Patients can return to ordinary activities in 4-6 days.
Submental skin excision with platysmaplasty - Removal of fat, tightening of platysmal bands and removal of excess skin by vertical scar under the chin. 24-36 hour downtime. Limited procedure, great for men and anyone not wanting a full necklift.
Laser treatments and radiofrequency treatments for tightening the skin are a waste of money.
Skin creams are great for prevention. They include; Retin-A, Alpha Hydroxy acid, Anti-oxidants and sunblock.
Scarless, non-surgical Neck Lifts - What is it?
In the youthful neck, the skin and the underlying Platysma muscle are tightly attached to the underlying deeper neck structures with the line from chin to neck to base of neck creating a sharp acute angle. With age, as the skin loosens, as the muscle loosens and forms visible pillars and as fat may accumulate both over the muscle and under the platysma muscle the angle acuity is gradually lost and replaced with what eventually in extreme cases becomes a straight line - chin to base of neck.
In earlier cases of neck aging, the sides / pillars of the platysma muscle can be softened and almost made invisible by expert injection of Botox (DO NOT let a non-doctor or inexperienced physician attempt it). The neck skin CAN be shrunk and smoothed with various modalities (a great one treatment is the Sciton BBL).
But - when the condition progresses to the extent you describe, the only really effective solution is a surgical neck lift. This would involve putting the platysma muscle together in the midline and pulling it up on the sides against the chin to neck line. The loose skin is then removed in front of the ears and, depending on the method and extent of skin, along the back of the ear.
Dr. P. Aldea
Turkey Necks are best addressed with Surgery
I wholeheartedly agree with Dr. Wallach that the options you listed are only going to end up being a waste of time & money for you.
Turkey necks / aging necks are an anatomical problem that occur due to genetics, anatomy and the aging process. As such, in order to really get worthwhile improvement and lasting results surgery is the best option.
There are various forms of neck lift surgery. As a basic outline these are your options:
1. Platysmaplasty : a small incision is made under the chin and the loose neck bands are sewn together and tightened. Depending on how lax your skin is, the wrinkles in the neck may also improve.
2. Necklift : this procedure may be done with or without a platysmaplasty (depends on your anatomy & goals). Incisions are made behind the ear only and the weak muscles of the neck are elevated and secured into a higher position. Any loose skin is removed as well resulting in a more youthful neck.
3. Platysmaplasty with Neck lift: to get the maximal results the above two procedures can be combined.
I do all of the above with local anesthesia (that is a matter of preference for surgeon & Patient).
Consider meeting with a board certified and experienced Surgeon who can go over these potential options with you in detail. Definitely save your money & do not try the various products you have listed!
There are many options to improve the appearance of your neck WITHOUT surgery
There are many options available to help improve the appearance and contour of the neck without surgery. Most people who are unhappy with their neck profile have two main problems: excess fat and/or loose skin.
Kybella is a new FDA-approved injectable treatment that works to dissolve excess fat in the submental region and improve the appearance of submental fullness, commonly referred to as a double chin. If loose skin is also an issue, non-invasive therapies such as Ultherapy, ThermiRF or a combination procedure unique to our practice called Ulthermi Fusion can be very beneficial.
While there are many excellent nonsurgical options available, keep in mind that based on the degree of excess fat or loose skin, the optimal result may be achieved with a surgical procedure such as a neck lift.
Ultimately if you are interested in improving the appearance of your chin and neck, please consult with a board-certified dermatologist or plastic surgeon to determine a treatment plan that will provide you with the best results.
I hope this answer is helpful! Best of luck.
Nonsurgical options for the neck
There are effective nonsurgical options to treat sagginess in the neck, however, there is no one treatment that can match a well-executed facelift/necklift.
Here are my comments on a number of popular options:
1. Ultherapy -This is the only FDA approved device for tissue lifting in the face. Results are mild and many are attracted to the no-downtime feature. Younger patients with mild laxity in the jawline are best candidates.
2. Botox-This has a limited role at improving the vertical bands from the platysma muscle that becomes saggy. Some horizontal lines may also be treated.
3. Lasers-These can improve skin texture and lines and I think fractionated CO2 lasers work best such as the Mixto laser. You have to be gentle to this skin though, so choose an experienced laser provider!
4. Fillers can also work very well along the jawline to create definition and minimize jowls. Radiesse and Voluma are my preferred options.
5. Other things such as threadlifting, radiofrequency and skin tightening creams have a limited role.
A good exam by someone who understands your anatomy and your needs is the best start!
Non-surgical options for neck lift
There are non-surgical options for neck lift and they are effective, however, there are certain things that need to be considered.
None of the non-surgical options for neck lift are as effective as surgery. If you elect to proceed with this option, it is important to understand that you are making a compromise.
Not all non-invasive options are equivalent. Ultherapy has a worth it index of 100% Thermage is 40%
There are no miracle treatments. To improve the appearance of the neck it is necessary to induce a healing response to an injury. Our patients that are having Ultherapy treatments are getting results but they are sore for several weeks.
It is possible to obtain short term results with cremes and lotions but the benefit does not last.
Noninvasive Neck Lift
There are many different options for treating the neck area, but there are also degrees of severity. Depending on the level of correction that you are looking for determines what is the most appropriate course of action. Over the counter skin care does not typically provide substantial improvement. Revision, a physician grade skin care line, makes a wonderful topical product called Nectifirm that is indicated to tighten the skin of the neck and chest. If you are looking for even moderate correction, skin care alone will not be enough. The most aggressive non-invasive option is Ultherapy. This device uses high-intensity focused ultrasound to penetrate deeper than any other modality, giving it the only FDA indication for lifting as well as tightening. Depending if there is excess fat in the area, there is a noninvasive injection called Kybella that can dissolve it. Be sure to get a thorough consultation to discuss surgical and nonsurgical options, to ensure you are receiving an appropriate treatment.
Non-surgical neck lift
Ultimately, a surgical neck lift would be your best option. This procedure could include tightening your underlying musculature to give you a better contour and also removing the excess skin laxity. Together this allows for a much better neck contour. In some instances, some liposuction is also beneficial to reduce the submental fullness.
However, if you are looking soley for a non-surgical solution, I am finding that the combination of Kybella to reduce the sub mental fullness (when present) and an energy device to tighten the skin are among the best non-surgical combinations to help your neck concerns.
kybella is an injection procedure that dissolves the fat an may require between 2-4 treatments spaced 4-6 weeks apart. There is some swelling and bruising potential, with the greatest amount with the first treatment.
As far as energy devices, I would recommend Ulthera if you are looking for something with no downtime, or Profound if you could tolerate some downtime. Ulthera is an ultrasound based energy that heats the underlying tissue and stimulates collagen in response. Profound is a radio frequency microneedling device that allows for the creation of Elastin, collagen and hyaluronic acid and hence restores some of the lost elasticity in the neck. It has more visible downtime with the possibility of some swelling and bruising that diminishes in about a weeks time.
Options for a Neck Lift
Thank you for your question! There are some ultrasound and radiofrequency devices that can improve very minor neck issues (such as slight skin laxity). Yet a "turkey neck" description makes me think that you may need a formal facelift (which is also a necklift) with possible platysmaplasty and neck liposuction. I hope this helps!