I hate my turkey neck and sagging jowls/marionette folds. Is my skin too tight to get some type of lift? (photo)

Hi, it looks like fillers may not be enough to achieve your desired look. Skin tightening should be discussed with your plastic surgeon. If your current injector is not a surgeon, seek one for a consultation. You may also benefit from fat transfer instead of filler, as it lasts longer and has extra benefits for your skin. Or you may need skin tightening such as a minilift or full facelift. Fat transfer can be added to either of those to enhance your results. I wish you the best!

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

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Fillers are great for areas that need additional volume, but they aren't going to get rid of laxity, and aren't going to lift your "turkey neck". The only person who might say that is someone that can't do a lift and has no other tools to help you. Depending on your age and exam, you might be a candidate for a minilift. It's performed in the office using local anesthetic and just involves some incisions around the ears. Downtime is minimal, especially in patients with longer hair since they can use their hair to cover the sutures. Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa Aesthetic Centers

Fillers are a great option for adding volume, defining contour and slight lifting.  However, the area that you seem to be concerned with is the skin laxity in your neck.  Sometimes treatments like Ultherapy or laser can help tighten the skin, but based on your pictures and description, it seems like a lower facelift / neck lift would give you the best and most long-term solution.  Additionally, while there is more upfront cost for surgical procedures, the longevity and less need for fillers usually balances out as positive for the patient financially.  It would be best for you to schedule a consultation to review all of our options.  In our office, we offer the full range of non-invasive treatments and surgical procedures and can work with you to formulate the best plan of action.  We look forward to seeing you in the office. 

Although I certainly understand your frustration, I just want to be sure that you have all the facts before jumping into relatively expensive, aggressive, surgical face/necklifts that can carry an extended period of recuperation and downtime, and which may not actually address your particular needs and whose results may not last as long as you may think.  To be performed properly, nonsurgical facial rejuvenation using injectable volumizing fillers should respect the following order of treatments: 1) restore the "foundation" of the face by addressing volume loss in the upper cheeks and mid-facial regions, 2) define or accentuate the "frame" of the face, i.e. among other areas, restore the appropriate definition of the posterior angle of the jaw and straighten the entire length of the jawline, and 3) and lastly, to attend to such "refinements" as further improving the smile lines and marionette lines. While I cannot say why the Voluma used for your cheeks did not achieve the desired results or did not last, there are a number of possible reasons, such as poor injection technique or inexperience on the part of the injector; inappropriate amounts used--generally too little injected to get the job done and to ensure a more long-lasting result (which can be up to two years when properly performed); lack of additional treatment of the mid-face (which in the photos provided does suggest loss of volume), and the use of ordinary Juvederm instead of for example Restylane Lyft for refining the smile and marionette lines. I am not much of a fan of energy-based or light-based therapies having found these to be far more supported by device manufacturer backed marketing hype than hard science, so I would be cautious in investing any time and money in these. But before embarking on surgery, you would do well to check out The Nonsurgical 3D Vectoring Facelift & The Nonsurgical 3D Vectoring Necklift in the archives of RealSelf.com and be certain to consult with a board certified aesthetic physician, and make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck.

Although fillers can be a great minimally invasive option to correct many minor signs of facial aging, they will not provide a patient with significant improvement with facial and neck skin laxity.  From your photos, it appears you would be a good candidate for a Mini Facelift combined with Facial Fat Transfer.  The Mini Facelift would tighten your neck and jawline, providing you with the type of tightening you seem to be looking for.  Facial Fat Transfer will replenish vital facial volume which is lost as we age, while also helping to fill deep facial wrinkles and folds.  I suggest you followup with a surgeon who specializes in facial cosmetic surgery.  You will then have the opportunity to evaluate all options for facial rejuvenation, instead of just injectables.  I have provided a link below.  Good Luck.  

From the submitted photos it appears you will have the best results from a combination of treatments. The fillers are helpful, but not powerful enough on their own to give you the results you want. You may want to consider adding FaceTite or Morpheus8 treatments to tighten skin and improve overall skin tone and texture. Evoke Nonsurgical Facial Remodeling is another potential option. We also recommend using medical grade skin care products and wearing sunscreen every day.

You should be able to achieve what you are looking for without having to go under the knife.  A multi faceted approach would be recommended which could include, Kybella for getting rid of the fat under the neck and tightening the area, Ultherapy for generalized firming of the mid face and neck, and for even more firming and tightening novathreads.  Maybe filler as well.  This would achieve an non-invasive lift.   It would be best to have a consultation with a provider that offers all of these modalities to properly assess the best combination.

There are several points I can make from viewing your photos, but you best answer will come from in-person consultations with experienced plastic surgeons.  First, you skin appears fairly young and elastic which helps you respond to injectable and energy device treatments.  Second, the deep layers that support your cheeks, jawline and neck are changing, but not have weakened so much that you would consider a facelift, particularly if you only planned on doing that once.  (Mini-facelifts complicate the discussion, but do not improve the "turkey neck".)  Next, I suspect that Juvederm in the jawline would be minimally effective at lifting the neck.  Finally, your photos suggest you may be an excellent patient for regular maintenance injectable filler treatments for overall facial appearance, even though you have tired of their use so far.  Ask your physician to use fillers and Botox in the areas where you get the best improvement.  Best Wishes