In cases where surgery is not possible or not desired, or when neck laxity is mild to moderate, a variety of nonsurgical approaches may prove helpful for smoothing and tightening the neck. These include the appropriate uses of injectable neuromodulators, such as Botox (or Dysport or Xeomin) to help to diminish "necklace lines" that ring the neck and vertical "cords and tighten jawlines ("Nefertiti" Lift);" injectable volumizing fillers to help to straighten a jowly jawline and increase chin projection--both of which can lead to secondary improvement of neck laxity; injectable "skin boosters" to help to hydrate and stretch the skin; injection by fanning or boluses of Profhilo, a unique bioremodeling agent that stimulates new collagen and elastic fiber synthesis and improves fat cell viability. A treatment course might consist of treating the jawline and chin with a volumizing filler, combined with one or two treatment sessions of Profhilo spaced a month apart accompanied by the injection "skin boosters." If necessary, Botox may also be used as mentioned above. Volumizing filler results tend to be immediate, as are those from "skin boosters." The effects of Botox typically take one to seven days to achieve maximal improvement and those of Profhilo typically take about two weeks to achieve maximal improvement. Profhilo has been available for several years already in Europe and Israel, where I have a satellite facility, but awaits entry into the U.S. market. And Restylane Silk is the closest equivalent to a skin booster currently available in the States, although once again a whole variety, such as Viscoderm Hydroboosters, Restylane Skin Boosters, and Restylane Skinboosters have also been available in Europe and Israel for several years already. As to threadlifting, this approach has proved quite disappointing with one recent study showing that its benefits were significantly lost after only about six months and its adverse complication rate reaching an unacceptable 34 percent. Relatively expensive bells and whistles devices, like radiotherapy and ultrasound machines are far more backed by device manufacturer supported marketing hype and claims than hard science. So, investigate these with healthy skepticism. For more information, check out of the archives of RealSelf under "nonsurgical necklifts." Make sure that you consult with a board certified aesthetic physician and be certain to ask to see his/her before and after photos before agreeing to proceed. Best of luck.