What is the best way to keep a tight neck? (Photo)

Hi there,

Thank you for your thoughtful question — you're absolutely not alone in noticing subtle changes in your neck and jawline in your 40s. The neck is often one of the first areas to show signs of aging due to thinner skin, reduced collagen, and constant movement.

Here’s a breakdown of your concerns and the most effective options:

1. Skin Laxity
For early laxity, a combination approach is often best:

RF Microneedling (like Morpheus8 or Genius): This is one of the most effective non-surgical treatments for tightening the neck. It stimulates collagen and elastin and can be tailored to deeper or superficial layers depending on your needs.

Thermage (monopolar RF): Great for skin tightening and particularly effective for mild to moderate laxity, with minimal downtime. It’s safe for thin-skinned areas like the neck.

Ultherapy (focused ultrasound): Another excellent option, especially for tightening deeper tissue layers without damaging the skin surface.

Sculptra: Useful when there’s volume loss contributing to the laxity, or to stimulate collagen in a more diffuse manner over time. It won’t "tighten" loose skin directly but works well in combination with other therapies.

2. Jawline Contouring
Yes, jawline filler can definitely help create a more defined separation between the face and neck. Strategic placement of hyaluronic acid-based fillers or biostimulatory fillers (like Radiesse) along the jawline and chin can enhance contour and lift.

3. Visible Lymph Nodes
Mild visibility of lymph nodes — especially in thinner individuals — can be normal, particularly the submandibular or cervical nodes. If they're symmetric, mobile, and not tender, it’s typically nothing to worry about. However, if you're concerned about appearance:

A skilled injector may be able to camouflage this area with subtle filler placement.

Addressing overall volume loss or skin thinning in the region may help. Still, I would advise a clinical evaluation to ensure there are no underlying medical concerns.

Bonus Tips for Neck Maintenance:
Daily broad-spectrum sunscreen on the neck (often forgotten!)

Topical retinoids or peptides to stimulate collagen

Avoiding downward neck posture (tech neck!), which contributes to banding and laxity

A personalized combo of RF microneedling + jawline contouring + skin care is a powerful starting point. If there’s early structural volume loss, adding Sculptra or filler can help restore and prevent further sagging.

For early neck laxity, there are many treatment options. Sculptra is great for gradual collagen-building, which can improve skin laxity subtly over time. It’s ideal if you’re looking for volume and firmness to develop naturally. Thermage, on the other hand, uses radiofrequency (RF) to tighten skin by stimulating collagen, offering a moderate lift and slight tightening with minimal downtime.

RF Microneedling is another strong option, as it combines microneedles and RF energy for deeper skin tightening and texture improvement. It can be especially effective for early laxity and may provide more noticeable results in terms of firmness and skin quality. Pairing this with jawline filler can enhance definition, creating a clearer separation between the face and neck, which is often beneficial for those experiencing early signs of sagging.

Visible lymph nodes are common in thin individuals and can become more noticeable with skin laxity. While treatments like fillers or skin-tightening options may help soften their appearance, some visibility is normal due to anatomy. A combination of RF microneedling or Thermage, with a touch of filler along the jawline, could give you a natural, refined look.

Best of luck!
Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS at Center for Classic Beauty, Boston and Danvers, MA

Hello,
You have significant looseness in the neck. The swelling seen under the jawline is also the submandibular gland (salivary gland). If you want neck tightening and to prevent the submandibular salivary gland from being visible, a deep plane neck lift and submandibular gland excision are required. There is no method to camouflage the salivary gland. If you also want to address the skin laxity in the cheeks at the same time, a deep plane facelift would be necessary. If you do not want surgery, treatments such as Thermage, Sculptra injections, and RF microneedling can provide some skin tightening, but it is impossible to know in advance how satisfied you will be with the results. To define the jawline, hyaluronic acid-based dermal filler can be applied to the mandibular angle and jawline

Skin laxity happens as we age, of course. It often shows up first in the neck due to sun exposure and the mobility of the neck. The key to improving lax skin is stimulating collagen and there are numerous ways to do that. The basic start is skin care. SkinMedica, SkinBetter, Skinceuticals (and other physician brands) all offer great neck creams.
Non invasive skin tightening is the next approach (in addition to skin care). As the name suggests, it has no downtime and results are subtle and gradual and last for over a year. Increase in collagen, elastin and hyaluronic acid all result in improvement in skin tone and texture.
More invasive are the biostimulants like Sculptra and Radiesse, these are injected under the skin in dilute form to stimulate the body's natural tissues resulting in a more youthful neck.
Enhancing jawline with fillers like Volux certainly do improve the overall neck contour.
Bottom line, there are choices and combinations of treatments are optimal. The best approach is consult with a board certified cosmetic derm who can examine you, get to know your needs and design a plan that is right for you.

Micro needling with radio frequency, Therma, high focus ultrasound will all destroy subcutaneous fat and result in a neck that looks considerably worse after approximately six months post treatment. Sculpture can add volume, but it has to be used with a great deal of care, especially in the neck. My single best advice to you is to stay at the same weight your whole life as much as possible. The neck becomes looser because people tend to lose muscle bulk and subcutaneous fat as they get older. Every single individual will have an accordion life effect when they put their chin down on their chest, that includes young children. For now just stay healthy and stay in good shape and do work on your neck muscles as they will keep your neck looking younger. As you continue to get older, you can replenish your lost volume with fat grafting. Fat grafting one done properly, produces natural and virtually permanent results. I hope this helps and good luck from Leonard Grossman, M. D., New York City, Plastic Surgery.

Based on your nicely posted photos, your first issue those are not lymph nodes. Those your sub mandibular glands that are slightly lax. Invasive surgery can correct that appearance. To get a minimal intervention, I would recommend the Endo lase tightening laser of your complete neck one session every three months. Fee $5000 per session. Best virtual consult with.