50 year old man with neck laxity, particularly when looking down. Looking for advice re: options, if any (Photo)

Question

I'm 50. My skin was aged and I lost subcutaneous fat to my face as a side effect of a med in my 30s. Now with time my neck shows increasing laxity. I've had one consultation with a surgeon who said that I don't have enough loose facial skin for a face lift and that a prominent larynx means that any improvement via a neck lift would be minimal. Would resurfacing help tighten my skin? Is collagen depleted skin an issue re: surgery? See previous posts for more photos. Thanks.

Jeffrey M. Darrow, MD · Answer

Everyone has the appearance of excess skin under their chin when they bend their neck forward, as the neck skin is fully relaxed.  Your laxity is a combination of skin, underlying fat and platysma muscle.  In addition to a deep plane facelift where your SMAS and platysma muscle can be smoothed laterally, you need a small incision below your chin to allow access and contouring of those tissues to shape your neck better.  Skin resurfacing is not a powerful enough modality to address your concern.  Regarding collagen content; whatever you have is what’s available to work with.  I am sure a great improvement could be achieved. Best wishes.

Jacob Tower, MD · Answer

Hello, hope you are well. Thank you for submitting your photos and questions! You would absolutely be a good surgical candidate for a lower face and neck lift. The only way to restore the contour of your neck is by removing the redundant skin. There is no minimally invasive technique available that would be sufficient as a standalone procedure (e.g. energy-based devices, resurfacing, or microneedling). Good luck!
Best,Dr. Tower

Lexie Wang, MD · Answer

Resurfacing will 100% not be strong enough to tighten that degree of excess skin. It is hard to tell without having more photos and a full exam what you would need. If you lost a bunch of fat, something as simple as fat grafting could help (and will be more cost-effective than doing a bunch of syringes of filler, although that is also a non-surgical option). Skin laxity- it mostly looks like you do need to get some of that elevated and removed via at least a neck lift if not a lower face or full face and neck lift. I don't know what your surgeon was saying in terms of having a prominent larynx would be bad... that is usually a good sign especially for men showing how much improved definition you could achieve. Collagen supplementation absolutely will be critical and key to not only improve your results from surgery but also maintain it -- that would be doing things like lasers, microneedling with radiofrequency, sculptra, etc. on a regular basis, as well as excellent skincare. There is also a possibility that a chin implant could help redrape some of the skin tighter in combination with the other suggestions above.

Connie Hiers, MD, FACS · Answer

Actually, a facelift would be helpful, but you can get some good improvement with minimally invasive skin tightening with radiofrequency and J plasma like Renuvion plus liposuction.

Adam Hamawy, MD · Answer

Plastic surgeons have several techniques to comprehensively address neck laxity. Achieving the most natural and optimal results involves a strategic combination beyond a mere choice between a facelift or necklift. Even these terms encompass various procedures ranging from office-based minilifts to extensive deep plane facelifts.

In your specific case, I would recommend a blend of multiple modalities to restore the structural integrity of your lower face, reinstating the definition that is presently lacking.

This holistic approach may involve skin tightening through Renuvion helium plasma technology, mini liposculpting of the lower face and neck, suture suspension the underlying neck muscles, and structural volumization of the lower jaw  that are currently less defined to give you a more masculine jawline and neck.  Remarkably, most of the time these procedures together can be executed in an office setting within a span of approximately 60-90 minutes.

William Portuese, MD · Answer

Based upon your photos, you are a candidate for a lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, removing the fat deposits above and below your platysma muscle in the neck, which also includes a platysma plasty to significantly improve your jawline, especially when looking down.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so AZ incision survived a blast. It is a great treatment for men with this problem.

Men to tolerate the scar a little bit better than ladies, and can cover it with stubble as it heals. I have a video on this type of technique called survived a plaster and neck lift on my YouTube channel Adam goodwin surgery if you'd like to learn more about it.

Of course your other option would be a lower face and neck lift which will do very much the same thing but is a little more urgent.

Hope that helps. Best wishes, Adam, Goodwin.

50 year old man with neck laxity, particularly when looking down. Looking for advice re: options, if any (Photo)

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