Will a neck lift help the crepey skin around my throat area?

Hi Diva411,I know the area which you are referring to.  In general, I think this is caused by a loss of fat directly under the skin of the neck.  This small amount of fat loss makes the skin of the neck thinner than it was in youth, and in certain positions the neck skin on the throat and decolletage area can appear quite crepey.  The worst positions are when the chin is down and the shoulders are pushed together.  This causes the skin in the front of the neck to not be on any "tension."  This crepiness is often times not seen on before and after photos, and only in certain non-standard positions.  Standard photographs in good posture and looking straight will not show the crepiness you are referring to.I have seen many patients who have had non-surgical skin tightening treatments to the front of the neck (throat) area, and they report that it looks great for about 2 weeks after the initial treatment due to the swelling from the treatment, only to look even worse after the swelling is gone.  I take their comments with a grain of salt, since they are getting the treatment to this area of the neck, there must have been some problem for them to agree to the treatment.  I suspect the non-surgical skin tightening treatments, which are ultrasound, infrared, or radiofrequency based, are melting the thin layer of fat directly under the skin (i.e. subcutaneous fat.)  This is why it actually looks great when there is swelling.  The swelling makes the subcutaneous layer of fat thicker from swelling, but later it may have inadvertently melted some fat which in turn makes the subcutaneous fat even thinner than it was prior to the non-surgical skin tightening treatments.  With an even thinner fat layer, this will make the skin even crepier than it was before the treatment.These treatments are designed to tighten the skin, by making the surface skin temperature reach 39.5-41.5 degrees Celsius, then the deeper tissues will heat up to 50-55 degrees Celsius.  The hope is the the skin tightening is greater than the fat loss, but if the skin tightening is very minimal to nothing, and the heating of the fat to 50-55 degrees actually causes more fat loss than skin tightening, it could very well, make the skin look even crepier after the treatments. Some doctors who don't have the non-surgical skin tightening devices, can improvise with lasers to heat the skin to the requisite 39.5-41.5 degree Celsius mark and try to tighten the skin in a similar manner.I have also some patients who come from more tropical environments with severe crepiness and fat loss of the neck skin in the throat area.  The amount of sun exposure in the tropics directly on the skin, I suspect can heat their skin up to the 39.5-41.5 degree Celsius temperature.  This could be easily determined, by bringing a laser temperature thermometer to the beach and test the skin surface temperature.  I suspect it does reach this temperature, and cause the fat underneath the skin to become damaged and thin out.  This may be why men and women who are very tan are also the same people with very crepey neck, decolletage, arm,  and leg skin.In general, after a face and necklift the main improvement is in the sagging of the neck/chin profile and jawline.  In our before and after photos, the crepiness may appear improved, but if your ask these same patients to lower their chin and push their shoulders together, the crepiness will become apparent.No matter how tight I make the face and necklift, the crepiness is still there, once they position themselves so that their skin is not on any tension.  I suspect the only way to truly improve the skin is to make the skin in these areas thicker.  A similar area is the skin on the back of the hands.  This area has been treated with fillers and fat grafting to make the skin there thicker and it helps to hide the veins and tendons on the back of the hand.  It most likely also helps with the crepiness of the skin on the back of the hand.The aging process is more complex than most people and plastic surgeons realize.  Although many of our results do show a significant improvement in sagging of the neck and jawline, crepiness of the lower neck is still an issue.  Some crepiness of the lower eyelid skin can be improved with fat or fillers.  Perhaps this is the direction where we are headed.  The main issue is that the skin of the neck is very thin and a large area.  Technically it would be difficult to create a perfectly smooth 1-2 mm layer of thickening of the neck skin across the entire front of the neck.  I have done this for a smaller area of 3 by 5 cm for a small area of crepiness along a horizontal neck wrinkle, which improved the crepiness of this rectangular area.  Very good question, but difficult problem to solve.  Hope this insight helps.Good luck on your plastic surgery journey.Best,Dr. YangP.S. 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Without photos, it's difficult to determine if a non-surgical treatment will address your concern. Also, it really depends on the amount of #sagging you are experiencing.  The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. During an in-person examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.The best neck #lift surgeon will evaluate both your anatomical features and aesthetic goals to determine which neck lift procedure best suits your individual needs. In some cases your plastic surgeon may give you more than one option to choose from. If you are not a candidate at the time of your #consultation, your board certified plastic surgeon can recommend non-surgical alternatives to address your conce

hank you for your question. Neck Rejuvenation is often used in conjunction with a Concept™ Facelift, in order to provide rejuvenation to the whole area. Neck Rejuvenation can include tightening the platysma muscle which can be an extra procedure which some patients may need to ensure a tight contour neck.  Tightening of the platysma muscle (also know as platysmaplasty) will require a small incision under the chin away from direct view to gain access to the front edge of the muscle on the neck; they are sutured together with permanent stitches.  The muscles of the neck are the foundations and building blocks of the neck are fundamental to achieving a tight and toned result. Alternatively, some patients may need neck liposuction, for those who have excess fat under the chin.  Overall, to obtain the best results a combination of neck rejuvenation procedure maybe needed. Neck Rejuvenation is often used in conjunction with a Concept™ Facelift, in order to provide rejuvenation to the whole area. I perform my facelift and neck lift under local anaesthetic, meaning minimal bruising and swelling is experienced by patients.  This significantly reduces the recovery time experienced, therefore patients being able to return to their daily lives with public view within 5-7 days.  This is why it is important to have a comprehensive consultation with a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  Best Wishes 

With age, the skin of the neck becomes loose and slack and fat deposits form, leaving you with lax and crepey looking skin. Additionally, years of sun damage can create wrinkles and pigmentation issues. A lower facelift and neck lift will tighten the muscles of the neck, remove excess fat deposits and trim excess skin, restoring and revitalizing the appearance of your neck, throat and lower face. Facelifts should incorporate tightening the SMAS (the layer of tissue under the skin) and platysma to be effective long term. Also, the vector, or way in which the skin is tightened and placed, is key to how the final results will appear. The technique used depends on each person's anatomy.Alternatively, if you have very mild "crepiness" as a result of sun damage, then non-surgical skin rejuvenation treatments, like lasers, to reduce the appearance of fine lines and wrinkles on the neck. Consult with an experienced facial plastic surgeon to find out what procedure will provide you with the best results. 

Recommendations to Improve your neck appearance depends on your exam - Your plastic surgeon will evaluate you for four main features:1.Amount of excess fat (needs lipo or direct removal).2.Presence of Significant Platysmal Banding (requires playsmaplasy or Botox)3.Amount of excess Skin and condition of your skin. For example younger age, darker skin colors and no large weight loss history means there will be better elasticity and therefore better post surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. However for moderate and severe skin redundancy a neck lift or lower facelift is needed with or without lipo for best results. Mild to minimal skin tightening using non surgical means like the Sciton Laser SkinTyte procedure, Ultherapy or Thermage could also be considered.4. Chin deficiency (without adequate chin support your neckline will suffer)

Patients with “excess of skin” in the neck area may benefit
from a carefully done neck lift under pure local anesthesia with minimal discomfort
or pain. Patients seeking for neck rejuvenation should undergo a consultation
with a Board Certified Plastic Surgeon specialized in neck lifts.