Do I need a lower face & neck lift? (Photo)

Question

I have recently had aggressive CO2 and im 10 days after. My current doctor said he could eliminate the issues of skin laxity in my neck, and it will take 3 months for the final result, but i'm doubtful. I would like a second opinion before I throw more money at it. (I had threads in July). Thank you.

Nashielli Torres Espinosa Chiu, MD · Answer

Hello and thank you for your question! Honestly, so much depends on the elasticity of your skin, age, skin damage, etc.Based on your photo, this skin is not going to become tight within surgery to remove the extra skin. This photo indicates you would need a neck lift to get the best results.

Lucian Ion, FRCS · Answer

Thank you for your question and photograph.

Although the photograph is not very easy to interpret, it seems that there is some volume excess under the chin in addition to slight laxity. In general, these aspects would not be corrected by laser treatment.

Guidance regarding lower facelift and neck lift versus just neck lift depends on criteria that each surgeon tends to develop for their patients so a consultation in person would be necessary to provide you with more customised guidance.

On a personal level, you can evaluate whether you would prefer a combination of facelift and neck lift my examining the appearance of your face lying down completely flat versus standing. The appearance of the face when lying down has a lot of similarities with the impact of a deep plane facelift intervention and will help you to determine whether this is an intervention relevant to you.

In terms of the characteristics of the neck, you can understand better the amount of volume excess by taking profile photographs with the neck in moderate flexion (as if you were looking at your phone). This is known in the plastic surgery field as the Connell view, as Bruce Connell who was a plastic surgeon in the United States described it as a means to understand the problems of the neck contour and whether surgery was successful or not.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. You would likely benefit most from a neck lift to address signs of aging under the chin and around the neck. This procedure can revitalize the appearance of the throat and jawline by tightening the muscles that can cause horizontal banding, as well as removing excess skin.
Lifting the deeper tissues prior to excising loose skin can produce firm, natural-looking results that can last for up to 10 years or more. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to conduct a thorough physical exam to determine the best approach for you.

Zoran Potparic, MD · Answer

It is very unlikely that skin treatment with laser will eliminate issues in your neck like fat deposits and muscle laxity. Only on the basis of in person evaluation one could give you a more accurate plant of threatment; lower face/neck lift seems to be far better choice. Good luck.

Stephen Prendiville, MD · Answer

Although a consultation is necessary to fully elucidate this response, the skin laxity shown in the photo will not be adequately addressed with CO2 laser resurfacing or threadlifts.  Your Doctor is correct that a year is required to see the final result.  However, the final result that most of my patients are seeking is not offered by this modality. A deep plane facelift will address the cheek, jawline and neck.

Jason Emer, MD · Answer

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer

Brian K. Machida, MD, FACS · Answer

Three months will not help. You are wasting your money on lasers and threads if you think it will give lasting solutions. It’s best to go on facelift consults

Tanveer Janjua, MD · Answer

You will not get the same result as a Necklift and lower Facelift. Non invasive treatment like laser gets about 20% to 30% improvement in the neck. Minimally invasive like Thermitight can get up to 40% improvement. Surgery is the only way to get up to a 75%-80% improvement. 
Regards
Dr. J

Jonathan A. Schwitzer, MD · Answer

Hello, unfortunately you appear to have substantial excess neck skin/laxity) on the frontal view (of note, lateral/side views are just as important if not more so for diagnosis/treatment purposes when it comes to the neck). Based upon this photo I would recommend a neck lift to remove the excess skin. Unfortunately I do not believe that less invasive measures (laser, Radiofrequency treatments) will provide the results you may seek. Hope this helps!

Eric Maiorino, MD · Answer

While a small to moderate degree of skin laxity can be corrected the various less invasive and non-invasive techniques, I think a lower face and neck lift would likely be able to give you a contoured and tightened neck and improved jaw line. I'd seek consultation with a board certified plastic surgeon to further discuss your options.

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