38 y/o female. Are there nonsurgical options that can help target side profile and neck sogginess? (photos)

Question

38 years old female, with hx of fluctuations in weight. Currently physically active ( I go to the gym 3x/wk) and following a healthy diet. My profile and neck sogginess and lack of definition are making me increasingly uncomfortable. Is there any non-surgical approach I can do to help improve this problem?

Jeffrey Lisiecki, MD · Answer

Based on your photos, you look like someone who has many options, depending on how much of a procedure and how much recovery you would like. As for "nonsurgical" options, radiofrequency microneedling is a great option, but sometimes requires multiple treatments to get to your desired goals. A minimally invasive surgical option that could be done under local anesthesia is submental liposuction, FaceTite, and radiofrequency microneedling all done together (potentially with some jawline filler). This would be one small incision under the chin and about an hour procedure with local anesthesia, but is a powerful combination for addressing this area.

Jeffrey S. Rosenthal, MD · Answer

There are a variety of procedures that can refresh and contour your face.  Selected fillers to enhance our cheeks.  PDO threads will reposition low lying tissues and Endolift Laser is an amazing technology that stimulates your skin collagen from within to improve skin appearance and quality.

Falguni Patel, MD, FACOG · Answer

Yes, there are non-surgical options that would help to correct the issues you described in your inquiry. It may take several different modalities to achieve the finished results you desire. The first treatment option would be something like Morpheus 8 which is microneedling combined with radiofrequency. This helps to lift and tighten the skin, produce new collagen and contouring the lower face. After completing the treatment series, this can be further refined with full facial balancing with filler and Botox.

A. David Rahimi, MD · Answer

Dear patient, I have treated many clients with similar goals with non-surgical with either Radiofrequency, Ultrasound, Micro-needling with RF, and Mixto Co2 laser resurfacing. Themage FLX and Ultherapy with Deep Sea can gradually over 2-3 months tighten and lift the cheeks. Mixto fractional CO2 laser resurfacing can remove fine lines and tighten the skin. I often do these treatments at the same time.
I do not recommend too much filler in your face. Given the fact that you don't have a narrow face, fillers can make you appear chubby. 
Micro-needling with Radiofrequency is another acceptable option but it takes 3 to 4 sessions to over achieve these results.
I hope this was helpful.
Dr David R.

Ajaya Kashyap, MD · Answer

Thank you for your query. A non surgical face-lift using fillers or autologous fat can help. I often combine this with a non surgical skin tightening treatment like Thermitight, for both the neck and the face. This would be appropriate at this stage and can last upto five years. Please find an experienced Board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You may benefit from RF microneedling treatments to address the neck sagging you describe and improve your side profile appearance. This procedure is effective at tightening and contouring sagging skin in the lower portion of the face.
RF microneedling uses hair-thin needles that create micro-channels in the dermal tissue to stimulate a wound-healing response. Radiofrequency energy travels through the needles to boost this healing response and encourage your body’s elastin and collagen production. The skin will repair itself over the following weeks and months, growing tighter, firmer, and smoother to provide a more youthful appearance. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can suggest the best treatment option for you.

Nelson Lee Novick, MD · Answer

A few simple nonsurgical techniques can address each of the issues you cite. A robust HA filler can help to straighten and define the jawline.  If necessary, another robust HA filler can help to increase chin projection so that it is more harmonious in profile with the projections of the lips and nose (and which will secondarily further tighten the jawline/submental area. Finally, microtox injections of the upper neck and jaw region by countering the downward pull of the platysma muscle that spans from the sternum to three fingerbreadths above the jawline can further help to define and tighten the jawline region. Make sure to seek consultation and treatment by a board certified cosmetic dermatologist with experience and expertise in nonsurgical facial rejuvenation. Also be very cautious when offered the latest, faddish, relativel expensive "bells and whistles" treatments, such as fraxel lasers and RF devices as the hard science for these lags woefully behind the heavy marketing to promote them. Best of luck.

Nuket Eroglu, MD · Answer

Hello; you are 38 years old. However, the looseness in your neck warned my attention. The fat pads on the cheeks; have also shifted to downwards and therefore, fluctuations have begun in your chin contour. In this case, I think you experience for frequent; weight gain and loss periods. Often weight gain and loss; loosens the skin; since the body cannot immediately replace the protein loss. This disrupts collagen production. Due to this, the first thing is to improve skin quality. I advise for Thermage FLX technique for your face. Thermage FLX is applied to every point on the face, neck, chin contour, eye areas and scalp line. The four-millimeter head can go very deep into the tissues and provides rejuvenation in all subcutaneous tissues. Thermage FLX method, raises the subcutaneous temperature to 80° temperature and provides maximum collagen increases. The skin surface remains at 20°temperature and is protected with a special cold applicator and vibration head. For this reason, it is very efficient and safe application. Having Lanluma; applied to your neck and chin zones will maximize your personal satisfaction. Lanluma is a PLA molecule. It is a liquid face lifting. Thermage FLX and Lanluma treatments will keep you looking younger and energetic for many years.

Camille Cash, MD · Answer

From the photo it appears you would be a candidate for FaceTite.  This minimally invasive procedure uses RF technology to tighten skin, melt fat, and stimulate collagen.  It can be combined with Morpheus8 treatments to improve overall skin tone and texture. Visit a provider near you, or my website to learn more.

38 y/o female. Are there nonsurgical options that can help target side profile and neck sogginess? (photos)

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