What can I do to fix loose vertical skin on my neck? (photos)

Question

I have vertical bands forming on my neck. I am thin and the bands feel like they are just loose skin. My neck is also losing definition. What are my options?

Sam Speron, MD, FACS · Answer

The neck can get sagging skin for many reasons including a lot of sun exposure, weight gains or loss, pregnancy etc.  Aging of the neck is very common before aging of the face.  It's one of the things that can be very frustrating to patients of all ages especially the turkey neck in patient’s with a family history. The face and neck keep changing as you age. Some of the changes are at the skin level, some at the deeper levels like the fat, retaining ligaments or muscles. There are several nonsurgical and surgical options to treat each of these different areas. Some can be done together and it really depends how much improvement you want to see as well as what part really bothers you. If there is significant sagging, surgery is usually the preferred procedure but can still be combined with injections and laser treatments before or after surgery.  A simple way to think about it - think of surgery as addressing any excess skin and laxity as well as removing fat.  Think of laser as tightening the skin levels. Injections like Kybella can nonsurgically help diminish the fat and offer improvement and there are all sorts of laser procedures that can tighten different layers as well.Most of these procedures can be done safely in the office and the results are very satisfying. An in-office private consultation and examination with a board-certified plastic surgeon would be the best way to fully see and address your specific concerns and determine the right treatment plan.I hope this helps answer your question.  If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. As other doctors have suggested, there are a couple of approaches to rejuvenate the neck area. The first is to target the muscle with Botox injections, which can reduce the appearance of lines. If skin laxity is the biggest concern, a neck lift will provide the most dramatic, long-lasting results. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and design a treatment plan tailored to your precise needs and goals for the best possible result.

Edwin F. Williams, III, MD · Answer

I see and hear your concern.  In the long run, surgery in the form of a neck lift is the treatment option that will provide the most value to you (in terms of a good result, long-term effect, financial cost, and time spent).  You can certainly try nonsurgical options first.  However the nonsurgical options do not provide much value in this area, and the time/cost tends to add up.  Hope this helps!

Zoran Potparic, MD · Answer

Considering your age and good quality of skin my first suggestion would be a neck lift. This is done thru a small incision underneath the chin in twilight or local anesthesia. Other option to soften those muscle bands would be treatment with Botox which is, as you know, temporary. Good luck.

Thuy-Van Tina Ho, MD · Answer

Dear Amanda32184,
Thank you for your question. It is difficult to make an accurate assessment and recommendations based on photographs alone. I recommend you seek an in-person consultation with a facial plastic surgeon or plastic surgeon who can perform a thorough evaluation and discuss with you the best treatment options to meet your goals. If the vertical bands are muscle bands in your neck (plastysmal bands), they can be relaxed temporarily with neurotoxin injections or be treated definitively with surgery through a procedure called platysmaplasty, which can be performed in conjunction with other procedures of the neck such as necklift and submental liposuction. If the bands are due to more of a skin laxity issue, then skin tightening procedures versus necklift may be the more ideal treatment to pursue.

Brian K. Machida, MD, FACS · Answer

Your optimal treatment would be a necklift with platysmaplasty. It’s best to go for a personal consultation.

Toby Mayer, MD · Answer

Vertical neck bands and  early facial aging. The best treatment for this is a neck lift with or without excision of the bands depending on what is found during an actual examination. See several very experienced facelift surgeons who have natural results for  similar patients.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question. Depending on what your skin shows in an in-person examination I would first start with a neuromodulator like Botox to help improve the appearance of the bands.  Ultimately correction will require a neck lift procedure to tighten the muscles but an injectable treatment may offer you temporary improvement that you find agreeable.  Hope this helps.

Jason Emer, MD · Answer

A combination approach would give the most improvement. Nonsurgical options such as Kybella, PDO NovaThreads, and Ultherapy do well in combination for skin tightening, but the results are mild compared to surgical options.
I would recommend a VASER Hi-Definition Liposuction with ThermiRF, Renuvion (J Plasma) and InMode BodyTite to contour and tighten the chin and neck. A neck lift can be performed at the same time, if you're a good candidate. I suggest seeing a board-certified cosmetic dermatologist to develop a personalized treatment plan that works for you. Best, Dr. Emer.

James F. Boynton, MD, FACS · Answer

Thank you for your question.  In reviewing your photos, I would recommend starting with neurotoxin (i.e. Botox). This can treat the "platysmal bands" that are bothering you and can do quite a nice job in most cases. There are a number of neurotoxins available (Botox, Dysport, Xeomin, and now Jeuveau).  I would recommend starting with this and seeing how much improvement you get. The next step may be neck lift which could range from a less invasive neck lift such as Neck - Ellevate or ICLED or even a suture suspension neck lift with percutaneous division of the plastysmal bands. A formal platysmaplasty may also be necessary.  I would visit with one or several board-certified plastic surgeons in your area to discuss your options.  Good luck!

What can I do to fix loose vertical skin on my neck? (photos)

Answers (17)

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