What can I do for saggier skin after neck lift 11 months ago? (Photos)

Dear Mari,
Non surgical skin tightening devices can help but only so much. You can try them, e.g. Renuvion, but results are variable and your skin looks like it is tethered closer to the neck and bulging between the angle of the neck and the chin. This could have been surgically created or the result of scar adherence.
Trying to contract this bulge seems problematical by use of an energy device. It may require undermining and redistributing the excess anterior skin into the rest of the neck. Your surgeon or another experienced one could advise. Otherwise this amount of excess skin may only be improved by direct excision.

Since you are almost 1 year after neck lift surgery and this defomity does not go away, revision should be considered. Using same incision a sugeon should lift skin only flap, evaluate reason for submental bulge (fat redundancy, scar), correct as needed and redrape the skin without any skin excision. Skin tightening with J plasma or radiofriquency based devices should be considered as a part of revision. This is best to discuss with your surgeon or ask for another second opinion consultation with a true expert in face/neck lift. Good luck.

Based upon your photographs, your surgeon is right: another "neck lift" will probably not help this area. Here are some facts:
1. Ths area under the chin is the furthest away from your ears where the incisions would be made for a neck lift. The further away the area of change is from the incision, the less of an improvement you can expect. 2. If you pinch your skin below the chin, you will see that it can be pinched easily. The skin has a poor attachment to the underlying structures (platysma muscle, etc.).3. A direct excision of such "extra skin" is not a good idea, as the scars will be unacceptable. 4. Your doctor is correct in suggesting a technique called Renuvion treatment of the subcutaneous tissues to tighten the fibrous bands that run between our skin and deeper structures. It may take more than one treatment, but this treatment can be done with small incisions behind your ears and one possibly just below your chin. This technique is often called "J-Plazty:, a technique developed by Dr. Jack Zamora, a Cosmetic surgeon in Denver, Colorado. It utilizes cold plasma energy derived from helium.

"These are all natural parts of the aging process. What we can do is try preventative treatments or get a neck lift / face lift earlier in the aging process. There are numerous non-surgical options available, and some can be used in combination to get best outcomes, but you would need a consultation with an expert.

Some options for skin tightening include:

- Thermage radiofrequency to heat the skin, tighten it over time, and prevent the aging process
- Ultherapy high-intensity ultrasound to contract the muscle, tighten the face and neck, and prevent the aging process
- PDO NovaThreads or InstaLift threads for immediate lifting without surgery and long-term collagen production
- Sculptra injections for collagen production to areas of the face and neck with crepey skin or early sagging
- BTL Exilis Ultra, Venus Legacy, and Thermi250 for monthly collagen stimulation with facials
- ThermiRF, Renuvion (J Plasma), or Inmode BodyTite for internal heating and tightening with or without surgery
- Fillers (or facial implants) to contour the jawline and chin to improve the appearance of the neck
- Face lift / neck lift with fat grafting and fillers if you need a significant improvement​

​I would suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​"