Is neck lift the only solution? (photo)

I am 39 and have wrinkly neck. I've been the same weight (110 lbs) for the last 15 yrs. When I tilt my head or move my chin forward, the vertical veins appear and skin looks wrinkly. If I tilt my head to the side, middle of neck folds and forms a million lines. I tried 3 sessions of Pelleve, but it made it worse. What caused this? Is it too early to have a neck lift? Is there an alternative? If do opt for the lift, how long will the results last and would the problem reappear in a few years

Doctor Answers 6

Is neck lift the only solution?

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Botox to the platysmal bands may be worthwhile.  I think that the necklift will not produce a substantial benefit in your particular case.

Kenneth Hughes, MD

Los Angeles, CA

Neck lift question

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I have treated a number of necks like your with botox with great results. I would also have you start a cream with growth factors to improve the skin. Find a plastic surgeon who can take care of this for you. Good Luck! The only negative is the botox wears off in 3-4 months.

Is neck lift the only solution?

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Maybe consider BOTOX injections to the platysmal bands of the neck. The units could reach 100 units needed.. Otherwise only a possible surgery will be effective.//

Botox for the neck

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It seems that your neck bothers you when you contract your platysma muscle. Botox might help relax it. It would be a lot easier and cheaper to try that first before you think about a neck lift.

Fat loss causing Thinning and Crepiness of Neck Skin

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Hi Lavanilla,

Necklifts help with sagging neck skin, were the skin is actually hanging away from under the chin and neck. A necklift is essentially a fancy tailoring procedure which tightens any hanging muscle bands which is protruding through the surface of the skin, as well as tailor out any excess neck skin which is hanging.

Since this is a tailoring procedure, it does not change the quality of the neck skin itself. The necklift simply stretches the crepey neck skin so it looks smoother, since it has some tension on the skin. If you then lower your chin to your chest or push your shoulders forward, the neck skin and decolletage skin is no longer under tension and can still look crepey when the tension is reduced. When you then go back to your normal posture it looks less crepey again.

In your case, the neck actually looks very good, when you are not straining. If this is the case, then the necklift will essentially look the same on a before and after photo. When you actively strain your neck, the same things will likely happen.

So your question might be, why is this happening. As we age, our skin thins and loses fat under the skin (subcutaneous fat: sub-under, cutaneous-skin) The thinner the skin the more we can see the structures under the skin. One analogy would be comparing a comforter versus a bed sheet. If we had some random things laying on the bed, the comforter, may completely hide what those random items look like, while the bedsheet will show and outline of each object.

One of my concerns with the newest not surgical "skin-tightening" treatments or laser liposuction or lipolysis, is that they are being marketed to tighten the neck. I actually worry that this may backfire and not tighten the skin enough and instead melt more fat than tighten the skin. If the skin can be tightened without melting any fat, then that would be the best way to prevent the crepiness from getting even worse. Surgical necklifts are a "cold" way to tighten the skin through skin removal, without melting additional fat. Currently there is not a standard method to fat grafting the neck and the risks are that the fat is not easily grafting in a perfectly smooth thin layer and lumpiness or uneven fat survival may make the skin uneven.

A similar aging problem occurs on the back of the hands, where older hands you can see every vein and tendon, whereas the younger hands have these exact same structure better camouflaged. Examples of Fat transfer or Fat grafting to the hands show significant improvement in hiding these structures.

In general, when I perform necklifts I am very aware of the amount of fat under the skin (subcutaneous fat) and only perform liposuction on the rare patient. What I am currently doing is to immediately find the platysma muscle (the muscle that forms the neck bands and cords) and peel the fat directly off of the platysma. This way the fat on the skin is as "thick" as possible. If you search Google for "cobra neck deformity," it is a condition caused by too much liposuction under the chin, exposing the muscle cords.

One skincare product that we use in our office for crepey eyelid skin or crepey neck and decolletage skin is OBAGI Elastiderm Eye Cream and Elastiderm Decolletage system with Tretinoin (AKA Retin-A). The Elastiderm ingredient is Copper Zinc Malonate, which stimulates the formation of Tropoelastin. Tropoelastin is the precursor to Elastin, which are the "springy" or elastic fibers in the skin. If collagen is like wires, then Elastin is like springs. For the face itself, when we smile the skin can wrinkle when it gets too thin, so thickening the collagen can help with wrinkles. However, in areas will thin skin we don't want to just thicken the skin, we actually need it to be more elastic so it can spring back to shape when different movements of the area.

Tough problem. As a Necklift specialist, these are the kinds of things that I discuss with my patients prior to having the procedure. If their main concern is crepiness, I worry that the necklift will not solve the problem to their satisfaction.


Dr. Yang

George Yang, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 33 reviews

Nonsurgical Neck Lift

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Dear Lavanilla: I looked over your photos and it appears that you have too much muscle activity in the muscles of your neck which would include the platysma and the sternocleidomastoid muscles. When you tense these muscles, it makes them stand out against your skin. Conversely, when you relax, your neck looks much smoother.

A neck lift can address loose skin, jowls, or a turkey gobbler. I don't think this is your issue and a neck lift would not benefit you.

I think treating your neck with Botox would work best. I have used it on similar necks and had great results. The important thing to remember is that Botox lasts for about 3 months, so it would be something you would have to continue if you were pleased with the results.

Find an experienced injector in your area and find someone you feel comfortable with.

I hope this helps

Dr S

Travis L. Shaw, MD
Richmond Facial Plastic Surgeon
4.8 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.