Neck lift or lipo with necktite? (Photo)`

Question

I'm 36 and still losing weight (20lbs more to go) from having a baby but started forming this saggy skin. I'm concerned lipo will make it worse along with losing more weight. I've also seen tightening treatments make saggy skin worse in this area. So would neck lift be the best option instead? Thank you.

W. John Bull, MD · Answer

IN reviewing your photos, it seems you have some skin laxity as well as some platysmal bands. I believe a good option would be necktite and my Ellevate which is a suture suspension platysmaplasty to get rid of the neck bands elevate the tissues, but combining it with the face/necktite would be a really good result that is long lasting without scars. Typically I suggest losing most if not all the weight first.

J. Timothy Katzen, MD, FACS · Answer

Hello Witty023786 in Mesa, Arizona,
Thank you for reaching out with your question about the best approach to address your neck concerns. Based on the information you've provided and the images you've shared, it's important to carefully consider your options, especially in light of your goal to lose an additional 20 pounds.
From the analysis of your pictures, it appears that the primary issue is excess neck skin rather than excess fat. This distinction is crucial because neck liposuction, even with NeckTite, primarily targets fat and may not be effective for skin-related concerns. In your case, since there isn't significant fat to address, liposuction may not yield the results you're hoping for and could potentially worsen the appearance of the neck by leaving more loose skin.
As you plan to lose more weight, it's likely that the amount of excess skin in the neck area could increase, making the need for a surgical intervention more apparent. A neck lift, which involves the removal of excess skin and tightening of the underlying tissues, seems to be the most appropriate solution for your situation. This procedure can provide a more contoured and refined neck profile, aligning with your aesthetic goals.
Given that further weight loss might exacerbate the skin laxity, it would be wise to consider undergoing a neck lift after you've achieved your weight loss target. This way, the surgery can be tailored to the final contours of your neck, ensuring optimal results.
It's important to have a detailed consultation with a board-certified plastic surgeon who can evaluate your neck in person, discuss your goals and concerns, and provide a personalized recommendation based on your specific needs.
Best wishes as you make your decision and continue on your journey.
Sincerely,
Dr. Katzen

Carey Nease, MD · Answer

Based on your age you should not need a surgical neck lift. You should definitely wait until you get to your goal weight and then find a surgeon who can do a minimally invasive skin tightening procedure. My favorite is Lipo with Renuvion. Other options include laser lipo, FaceTite or even something less invasive like Morpheus or Virtue RF (microneedling).

Ryan Rebowe, MD · Answer

More aggressive treatments, such as a neck lift, will always provide more impressive results. While noninvasive and minimally invasive treatments have less downtime and generally less cost, this often comes at the expense of a less impressive result. I will say that the area you are concerned about is a tough one to tighten without a neck lift, so I would be wary of a surgeon that offers minimally invasive treatments without significant experience or even before and after photos that look specifically like your preoperative issues.

Lucian Ion, FRCS · Answer

Thank you for your enquiry and sharing your photographs.
One of the difficulties with weight loss is that the distribution of the fatty tissue reduction does not accurately reverse the weight gain volume.
Your neck contours suggest relatively little fatty tissue under the skin and if you are losing more weight, laxity may become more obvious, but not always. I am not aware of any nonsurgical treatments that can address this problem very effectively but it is definitely worth having this conversation with someone that has experience with nonsurgical treatments and perhaps see some before and after photographs to understand your potential benefits from such treatments.
A neck lift intervention can direct the volume reduction under the platysma muscles and combine it with sculpting of the fat above the platysma just to produce a more even volume distribution. There are some areas where definitely fat should not be reduced in your neck even as it is now, let alone after more weight loss.
I suspect that a combination of deep plane volume reduction (under the platysma muscles) and skin tightening is likely to provide you with the more balanced outcome.
Since you are planning to lose more weight, it makes sense to do that first and then revisit your desired changes and treatment options.

Gianfranco Frojo, MD · Answer

I would highly recommend against necktite. The best options is a necklift to address the loose skin and platysma muscle. I would go see a board-certified plastic surgeon (with plastic surgery residency and aesthetic fellowship training) for a consultation.

Jeffrey M. Darrow, MD · Answer

You are correct in that liposuctioning this area would simply remove the minimal amount of fat underneath your skin, and the skin would look worse. The skin tightening modalities available also would not likely give you as smooth and as long lasting improvement as a neck lift would give. Have a detail consultation with your plastic surgeon. Best wishes.

Zoran Potparic, MD · Answer

Based on these photos it appears that a neck lift with liposuction of the jawline and lateral neck would be the procedure to consider. In-person or teleconference consultation with a board-certified plastic surgeon with expertise in neck lifts is recommended. Good luck.

John L. Burns Jr., MD · Answer

with excess skin only removal of the excess skin will give you an optimal result.  Lipo alone might leave the skin even more wrinkled.

William Portuese, MD · Answer

Even at age 36, you have significant inelasticity of the skin on your neck, which will only worsen when you lose more weight or perform liposuction. A neck lift would be required with skin removal to tighten the  inelastic skin. Noninvasive treatments will only give very minimal benefit, if anything.

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