What is the best remedy for deep horizontal neck lines and loose skin? (Photo)

Question

20+ years ago I got a chin implant and the doctor said he did lipo under my chin and I would thank him later. Now at 46 it appears uneven. Compound that with the deep horizontal neck creases and my neck looks horrible. What is the best way to tackle this?

Raymond E. Lee, MD · Answer

ElleVee,Thanks for posting your concern and photos.  With age and previous lipo, you are seeing some laxity in the skin overlying the neck and also looseness in the platysma muscle causing the muscle bands to show.  This aging also causes the horizontal neck crease to be more prominent.  In my opinion a neck lift which involves liposuction, tightening the platysma bands, and removal of skin will improve your neck. The horizontal crease will never go away but will be less prominent with this neck lift.  A facelift in addition to the neck lift will further improve this result.  Best,

Jason Emer, MD · Answer

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

Thomas Trevisani, MD · Answer

Based on your photos- it appears that you are a candidate for a neck lift and facelift. This is the only way to improve the appearance of your neck and lower face. Seek an experienced Board Certified PS .

Frank P. Fechner, MD · Answer

You are a good candidate for a comprehensive neck lift. Best would be to combine the procedure with a lower facelift.

David Hansen, MD · Answer

A lower face/neck lift would make such a nice natural improvement and is easy to undergo under local with a little iv sedation for  roughly $9800 on special. You will be so glad you did. Sincerely, David Hansen,MD

Jeffrey M. Darrow, MD · Answer

You have 2 issues.  1) Neck lines - will be made some better by a face/neck lift by smoothing them and may also be improved some by laser resurfacing or radio frequency treatment.  2) Skin excess - this would best be addressed by a face/neck lift to take the excess away.  While both will help improve your appearance your deep horizontal line will not likely disappear entirely.

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, I think you would need a tradiitonal neck lift that would involve dissecting that band away and tightening it, it may need some fat injected as well to help smooth it out. I doubt perfection is possible

James Bonaparte, MD, MSc, FRCSC · Answer

There are some great options for this, some surgical and some non-surgical. 1) Non - Surgical: You could try a combination of methods. One, using radiofrequency skin tightening. Now, this is not the best for very loose skin, but you may see a mild benefit. On top of this, you could add an ablative resurfacing. This means, you use laser or some other device to help reduce the depth of the wrinkles. I think this method would get some results, but likely not what you are hoping2) Surgical - In the end, the best would be a surgical procedure to tighten your neck and remove the extra skin. This would really define your jaw line. However, there are some limitations that your doctor may talk to you about. For one, you may have a "low hyoid" which is a part of your neck. In people with this, its a bit more difficult to get a great result, but still you will notice a difference. On top of this, you can still do the above treatments. I put a link to my site where I discuss options for neck issues. James P. Bonaparte, MD, MSc, FRCSCHead and Neck Surgerypracticing in Facial Plastic and Reconstructive SurgeryAssistant Professor, University of OttawaOttawa, Ontario, Canada

William Portuese, MD · Answer

The best alternative to the aging neck is a lower face and neck lift. The  residual fatty deposits in the neck are removed with open liposuction, the platysmal muscle bands are tightened in front and the muscles also tightened  underneath the ear as well. Loose skin is also tightened to give a natural  rejuvenated appearance.    The  horizontal neck lines will still be present, just not as prominent.

Richard Galitz, MD, FACS (in memoriam) · Answer

You need a necklift/facelift in order to tighten and properly redistribute the skin of the lower face and neck areas.I would avoid or do very slight suctioning only to even out the fat distribution. The repositioning and tightening of the skin should solve most of your problems. In my office all facelifts and necklifts are done with safe and simple oral sedation and local anesthesia. This has the advantage of eliminating nearly all the operative risk, almost all the operative bleeding and most of the post-operative black and blue. Except for a few small needle sticks the procedure is as painless as a regular deep anesthetic without all its potential complications and bleeding