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 4

When to move from non surgical to surgical

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

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

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 9 reviews

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

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
4.9 out of 5 stars 166 reviews

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