After weight loss what procedures would be best for my sagging turkey neck? (Photo)

Question

I lost a lot of weight and now have a sagging vertical turkey neck. What procedures would be best?

Randal Haworth, MD, FACS · Answer

It looks like you are a good candidate for a necklift.

Platysmaplasty, or neck lift surgery, is a cosmetic procedure that is designed to tighten and remove excess skin from the neck area. This procedure is typically done to address sagging skin and muscle in the neck that can be caused by factors such as aging, weight loss, or genetics.

During a neck lift procedure, a plastic surgeon will typically make incisions either behind the ears or under the chin, through which they can access the underlying muscles and tissue in the neck. The surgeon will then tighten the muscles and remove any excess skin, resulting in a smoother and more youthful-looking neck.

Because the aging process can affect different people in different ways, neck lift surgery must be tailored to each patient's individual needs. A skilled plastic surgeon will take into account factors such as the patient's skin elasticity, muscle tone, and overall facial structure in order to achieve the best possible results.

Best of luck !

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Lisa Vuich, MD · Answer

Thanks for your question. There are several very effective treatment options for treating neck skin laxity. In non-surgical aesthetics, skin tightening is going to be "all about heat delivery". This is because the microinjury of heat is needed to stimulate collagen and elastin production in the skin, which happens during the healing response to the treatment. Results from any of these procedures are not instant but rather develop gradually over the course of 3 to 6 months:
1.	Sofwave- utilizing microfocused ultrasound to deliver heat to the deep dermis at a depth of 1.5mm, generating new collagen and elastin in the skin. The number of pulses delivered is important- the more laxity there is, the more important it is to do the ‘advanced protocol’ with 4 full passes. Most will need 1 to 2 sessions spaced 4 or more weeks apart. You should have either ‘full face and neck’ or at least ‘lower face and neck’ to get the best result for the jawline. Sofwave has no effect on fat cells as the energy cannot reach that level. Numbing for he procedure is primarily topical. 
2.	Morpheus8- utilizing RF energy delivered at the tips of micropins. With this approach you get the collagen stimulation of the heat PLUS the collagen stimulation of the microneedling, so you can potentially get more result per session, but at the expense of 'some downtime'- puffiness, faint redness for a day or two, potential bruising. The needles can also be set deeper in certain regions so that they will destroy unwanted fat cells- such as in the jowls and the “double chin” zone. Most will need 3 sessions- can be spaced 4 or more weeks apart. ‘Full Face and Neck’ is the ideal approach. Numbing for this procedure is primarily topical but nerve blocks (injection numbing) is very helpful also.
3.	FaceTite- this procedure involves placement of a probe just under the skin to achieve full thickness heating. The probe is introduced  through some simple needle pokes- considered ‘minimally invasive’. Most require a single session. Results typically last 5 years. Numbing for this procedure requires lidocaine injection. 
4.	EmbraceRF- this is a combination procedure pairing Morpheus8 externally with the FaceTite procedure. Ideal for the more advanced skin laxity, for skin laxity that is accompanied by surface wrinkles or crepiness, and/or when there is unwanted fat to be destroyed. If the fat collection is substantial, this can be combined with targeted liposuction. Numbing for this procedure requires lidocaine injection. Given the degree of laxity I see in your image, this would be the one I would recommend for you.
I hope that helps!

Connie Hiers, MD, FACS · Answer

You could get improvement with noninvasive micro-needling with radiofrequency like Secret. You could get more improvement with minimally invasive Renuvion that uses radiofrequency and plasma energy. You would get your best results with a facelift or mini-facelift.

Camille Cash, MD · Answer

It appears your best option would be a surgical neck lift.  Non surgical treatments may give you some improvement, but based on the photo it appears a neck lift would be recommended to remove excess skin and improve the neck contour.  See a board certified plastic surgeon near you to learn more.

Darryl J. Blinski, MD · Answer

The 1 posted photo says it all - hanging loose skin. Only full open surgical neck lift can resolve this issue. Fees from $10,000+. Best to virtual consult with....

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