I'm 62. In the last year or so, I have been experiencing horrendous jowling crepiness and excess skin hanging on my neck (Photo)

I would like suggestions for any non-surgical alternatives or surgeries that may help. I have tried Ultherapy and Thermage with no results, and of course I've tried every cream there is with no results. This picture is with filler added to my marionette lines, so it would look even worse without that. I have had conflicting advice about the possible use of a filler to lift the cheek area. Any suggestions would be appreciated.

Doctor Answers 6

Jowl Concern at Age 62

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Depending on the level of laxity, the effects of a neck lift will certainly outlast the effects of non-surgical treatments. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. During an in-person examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.

However, you may also benefit from Lite-lift™. Lite-lift™ is an affordable, quick, and effective innovative facelift developed by board-certified plastic surgeons Dr. Larry Nichter and myself. The goal is to provide a less invasive natural looking option for both men and women desiring to refresh their appearance with less downtime and risks. The LiteLift® is a “real” facelift, which does address the underlying muscle, tissue and overlying skin.

This is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

You should work with a board certified plastic surgeon who will evaluate both your anatomical features and aesthetic goals. She or he will suggest which procedure best suits your needs. In some cases there may be more than one option to choose from.


Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Non surgical neck lift

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Your case would ideally be treated with a good face and neck lift with platysmaplasty. Results in good hands would be great. The only other option with results that could be pretty good but not certain would be a laser liposuction of skin and jowls  to try to tighten your neck and jowl areas. This last procedure if performed correctly can enhance the jaw line and smooth and tighten the neck in about 70%of the cases I have performed. Still the facelift is your best option.

When to move from non surgical to surgical

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Hi and thanks for your question and pictures.  It seems that you have reached the point where non surgical intervention has accomplished what it can.  If you desire further improvement, I think you are a good candidate for a neck and face lift.  Do your research and seek out a board certified plastic surgeon who does a large number of these procedures and you will be in good hands.  Best of luck.

What to Do When Non Surgical Techniques Aren't Doing the Job

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I think you have given non surgical options a good trial. At this point you are probably a surgical candidate for a neck lift. See a board certified plastic surgeon with experience in neck lifts.

Combination treatments

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Your picture reveals significant volume loss in mid and lower face, as well as loss of elasticity and loose skin in neck and Jowls. The best non-surgical option for This appearance is a combination treatment with the following:
  1. botox in chin and DAO muscles, to elevate the corner of the mouth and reduce chin wrinkles
  2. Filler in mid and lower face, such as radiasse, restylane lyft of voluma in cheecks, back of jaw, along the mandible and the jowls and chin, as well as in the marionette lines to lift and elevate the face and jowels
  3. A more aggressive laser or radiofrequency treatment to neck and lower face such as thermi tight, infini (aggressive setting) or exillis ultra
  4. Finally, the new silhouette lift, the non-surgical procedure using sutures made with sculptra placed under the skin and a anchored by bidirectional cones, can create immediate, significant lift in mid face, jowls and neck.
Best of luck!

Neda Vanden Bosch, MD
West Palm Beach Physician
5.0 out of 5 stars 21 reviews

Neck Skin and Platysmal Bands -- VASER Hi Def Liposuction/ThermiRF, Venus Legacy/Thermage/Ultherapy, Botox/Dysport

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You are in need of a neck/face lift.  There are alternatives like VASER/ Thermi or Thermage/Ultherapy. However, they will do very little.  I suggest laser treatments and fillers or fat to give you the lost volume you need as well.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.