My neck skin has become lax. What can I do to reduce this? (Photo)

Question

I’m mid forties and my neck skin has become lax. What can I do to .. 1. Help reduce this ? (I’m frightened of surgery in case it goes wrong) 2. How can I prevent further laxity? Thank you!

Thomas Wright, MD · Answer

Claudia78 Thank you for sharing your photo. I can see some skin laxity in your neck, but I don't think you need a full open surgical neck lift. The non invasive skin tightening like Thermage , Ultherapy, Forma and the like don't work that well especially in this area.  I recommend you consider the minimally invasive, non surgical neck lift with MyEllevate.  The procedure can be done under local anesthetic and involves a set of sutures that go  behind one ear to the other.  This lifts and supports the cervical mental angle where your skin droops.  The MyEllevate procedure is very different from thread lifts because the sutures are placed in skin that has been prepared to tighten in proper place. This is often done in combination energy based skin tightening like FaceTite / Neck Tite or Renuvion which further improves the results of the procedure.

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

Nelson Lee Novick, MD · Answer

HA fillers can work well for treating next skin laxity. Robust HA fillers injected properly on the sides, for example, can be used to lift, pull and refine the contours of the neck, and resilient, low viscosity, cohesive HA fillers can be used to improve the appearance and skin quality of the central portion of neck. Treatment generally should take no more than a fifteen minute session in experienced hands and engender little to no significant downtime.  However, these are advanced injection technques that should not be left to the hands of novice injectors accustomed only to using simple Juvederm or plain Restylane for smile lines. These are advanced injection techniques and you would be wise to consult an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Jason Emer, MD · Answer

​A combination of non-surgical options like Kybella, PDO NovaThreads, Ultherapy and Thermage would do well in combination for skin tightening for the neck. VASER Liposuction (with ThermiRF, Renuvion and InMode FaceTite) is a great alternative for contouring and tightening the chin and neck and can be combined with a neck lift at the same time, if you're a candidate. I suggest getting a formal evaluation with a cosmetic dermatologist to develop a long-term treatment plan that works for you. Best, Dr. Emer.​

Lisa Vuich, MD · Answer

Thanks for your question. Skin tightening is best achieved with the application of heat in one form or another, +/- additional mechanisms such as RF micro-needling with heat. There are many devices which deliver heat to the dermis, which acts as a microinjury, thus stimulating the body's healing cascade. The body response is then the development of new collagen and elastin- which produces smoothing and tightening. Great examples of this are Sofwave (micro-focused ultrasound energy) and Morpheus8 (RF micro-needling). To get a greater degree of tightening you need to deliver heat also to the layer under the skin- the fatty layer where we have the "fibro-septal network". Therapeutic heat delivered here provides an even greater degree of tightening and longer lasting results, but there is some downtime and you need to use a probe moving under neath the skin (inserted just through needle pokes, so still non-surgical and we refer to it as "minimally invasive"). A great example of this is the FaceTite procedure. And sometimes we do combinations, such as FaceTite + Morpheus8 to deliver the maximum result possible in a single procedure. That combination is called "EmbraceRF". FaceTite and EmbraceRF require that you wear a compression garment post procedure for 3 days, then at bedtime only for about a week. In the future to prevent recurrence you would simply do maintenance procedures. For example, a Sofwave treatment every 1-2 years is a great "no downtime" option. I hope that helps!

Camille Cash, MD · Answer

You may be a candidate for FaceTite.  This minimally invasive procedure tightens skin using RF technology.  General anesthesia is not required as the patient is kept comfortable with local anesthetic.  Results can be enhanced by adding Morpheus8 treatments.  You can learn more about these treatments by visiting my website or a local provider near you.

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