What will help me the most with loose neck skin, threading or co2 laser? (Photo)

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.


Best,
Dr. Karamanoukian
Realself100 Surgeon

With significant neck sagging you would need a neck lift / facelift with muscle tightening (platysmaplasty). At the same time, lasers treatments (Fraxel, CO2, Erbium, Halo) or microneedling RF (Fractora, Intensif, Morpheus, PiXel8) can be performed to improve crepey skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach:​ - Microneedling and laser treatments for texture - Botox, Dysport, Xeomin, or Jeuveau to help the Platysmal bands - Intensif, PiXel8, Morpheus or Fractora RF microneedling for crepey skin and lifting - Injectable fillers like Belotero, Restylane Silk, and/or Juvederm Volbella to improve lines and folds - Renuvion, ThermiRF, and/or InMode FaceTite for internal tightening - Ultherapy and Thermage for external tightening - regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness - PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production See an expert for a full evaluation and treatment plan based on your individual situation and goals.

Threading, which I gave up performing years ago, is expensive and has an unacceptably high rate of complications, such as infections, skin puckering, surface irregularities and "spitting out" of stitches. To boot, even under the best of circumstances, the results do not last nearly as long as promised and not much longer than those achieved with injectable fillers. Ablative lasers, such as the CO2 laser, have an unacceptable risk profile for scarring and dyspigmentation, particularly when used on the delicate skin of the neck. I have had gratifying results with the combination of the use of robust fillers to help to better contour the neck and HA skin boosters to help hydrate and tighten crepey skin. Although difficult to determine without a profile view, it is likely that a robust filler used along the jawline would not only help to diminish jowls there, but secondarily improve the submental region of the neck immediately below the jaw. Make sure to consult with an experienced board certified cosmetic dermatologist and let him/her suggest the appropriate treatment plan for you, instead of simply getting what you ask for, which may not be the best, safest or least expensive route to achieving your aesthetic goals. Best of luck.