How to Improve Neck 7 Years After Necklift (photo)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Two issues. Loose skin and fine wrinkly skin with vertical bands.
Based on the lateral photo appearance, further improvement in the cervicomental angle can be done with a secondary lower face and neck lift with lateral traction to eliminate the extra skin that is bunching in the central neck. Another non incisional neck lift approach to tighten the neck at the cervicomental angle would be MyEllevate.
Because the skin is so thin and atrophic in appearance, it would be prudent to avoid any energy treatment that might further atrophy the skin. The addition of fat in the upper central neck to obtain a more normal thickness and appearance by fat grafting is an option. Renuva, an allogeneic extracellular matrix, is an off-the-shelf biocompatible injectable product. It stimulates production of new fat cells without the need for harvesting fat from another part of the body. It does take 2-6 months for full results, may need to be repeated, and does not work as well in fat depleted areas.
For fine superficial texture improvement, a non-ablative fractional laser like the Palomar/Cynosure Lux 1540 erbium laser would be an option.
It is very hard to get this area to look normal, more youthful, without adding some fat, as well as trying to improve the texture.