38 years old, lost about 30 lbs and noticed neck sagging. What are the best procedures to help slow the sagging? (photo)

Question

Hi! 38 year old. I've lost about 30 lbs and am noticing slight sagging in my neck. I realize this could be general aging effects also. My question is, what are the best procedures to help slow the sagging?

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

​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.​

Ryan Welter, MD · Answer

For addressing neck sagging following weight loss, our practice offers effective non-surgical and minimally invasive treatments tailored to your specific concerns. Here are the best options to consider based on the procedures we provide:

Given your recent weight loss and the early signs of neck sagging, Platelet-Rich Plasma (PRP) therapy can be an excellent starting point. PRP uses your body’s natural healing factors to stimulate collagen production and enhance skin elasticity, which can help tighten the skin and reduce sagging over time. PRP is particularly beneficial for individuals seeking a natural approach to rejuvenation.

For more immediate results, thread lifts are a minimally invasive option that can provide a visible lift to the neck area. Threads not only offer structural support to sagging skin but also stimulate collagen production over time. This approach is ideal for younger patients like yourself who want to address mild laxity without undergoing surgery.

We also recommend pairing these treatments with medical-grade skincare to maintain skin health. Products focused on hydration and collagen stimulation, along with the regular application of sunscreen, will further protect and enhance your results. Additionally, periodic maintenance treatments such as Low-Intensity Extracorporeal Shock Wave Therapy (LI-ESWT) can improve overall skin texture and firmness.

We recommend scheduling a consultation to develop a personalized treatment plan tailored to your goals. Combining these options can help slow down the effects of sagging and restore a more youthful contour to your neck area.

Lisa Vuich, MD · Answer

Thanks for your question. There are several very effective treatment options for treating neck skin laxity. In non-surgical aesthetics, skin tightening is going to be "all about heat delivery". This is because the microinjury of heat is needed to stimulate collagen and elastin production in the skin, which happens during the healing response to the treatment. Results from any of these procedures are not instant but rather develop gradually over the course of 3 to 6 months:
1.	Sofwave- utilizing microfocused ultrasound to deliver heat to the deep dermis at a depth of 1.5mm, generating new collagen and elastin in the skin. The number of pulses delivered is important- the more laxity there is, the more important it is to do the ‘advanced protocol’ with 4 full passes. Most will need 1 to 2 sessions spaced 4 or more weeks apart. You should have either ‘full face and neck’ or at least ‘lower face and neck’ to get the best result for the jawline. Sofwave has no effect on fat cells as the energy cannot reach that level. Numbing for he procedure is primarily topical. 
2.	Morpheus8- utilizing RF energy delivered at the tips of micropins. With this approach you get the collagen stimulation of the heat PLUS the collagen stimulation of the microneedling, so you can potentially get more result per session, but at the expense of 'some downtime'- puffiness, faint redness for a day or two, potential bruising. The needles can also be set deeper in certain regions so that they will destroy unwanted fat cells- such as in the jowls and the “double chin” zone. Most will need 3 sessions- can be spaced 4 or more weeks apart. ‘Full Face and Neck’ is the ideal approach. Numbing for this procedure is primarily topical but nerve blocks (injection numbing) is very helpful also.
3.	FaceTite- this procedure involves placement of a probe just under the skin to achieve full thickness heating. The probe is introduced  through some simple needle pokes- considered ‘minimally invasive’. Most require a single session. Results typically last 5 years. Numbing for this procedure requires lidocaine injection. 
4.	EmbraceRF- this is a combination procedure pairing Morpheus8 externally with the FaceTite procedure. Ideal for the more advanced skin laxity, for skin laxity that is accompanied by surface wrinkles or crepiness, and/or when there is unwanted fat to be destroyed. If the fat collection is substantial, this can be combined with targeted liposuction. Numbing for this procedure requires lidocaine injection. 
I hope that helps!

Paul L. Hester, MD · Answer

Great question! FaceTite is a minimally invasive procedure that uses radiofrequency energy to tightenand contour the skin in the neck, chin, and jowl areas. It works by applying controlledheat to stimulate collagen production, resulting in skin tightening and improvedcontour. The results of FaceTite are long-lasting and can be considered semi-permanent. Thestimulated collagen production helps maintain skin tightness, but the aging process andexternal factors can impact the longevity of results. I feel from the photo you are a wonderful candidate for FaceTite.

Camille Cash, MD · Answer

From your photo it appears you are a candidate for FaceTite.  This minimally invasive procedure uses RF technology to tighten skin.  The procedure has minimal downtime and does not require general anesthesia.  Results can be enhanced by adding Morpheus8 treatments.  See my webiste or a provider near you to learn more.

Connie Hiers, MD, FACS · Answer

I would suggest doing the series of 3 treatments of micro-needling with radiofrequency like Secret, and then boost yearly to help maintain and treat aging.

38 years old, lost about 30 lbs and noticed neck sagging. What are the best procedures to help slow the sagging? (photo)

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