Will nonsurgical neck lift correct sagging, crepey neck, volume loss and marionette lines or should I consider surgery? (photos)

Question

Female, 36, weight loss and sun damage has left my neck and submental sagging and crepey. What can I do to repair it? I also have marionette lines that really bother me from volume loss and sagging, still there after a lot of filler in the cheeks (voluma, vollux, several syringes in the last few years).

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

Camille Cash, MD · Answer

FaceTite is a nonsurgical option to improve the face and neck area.  It uses RF technology to tighten skin.  Results can be optimized by adding Morpheus8 treatments to improve overall skin tone and texture.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.  You can learn more by visiting my website or from a provider near you.

Ryan Welter, MD · Answer

For sagging, crepey neck skin, volume loss, and marionette lines, non-surgical treatments can deliver meaningful improvement, especially when combined thoughtfully. Treatments like Morpheus8, a newer RF microneedling device, can tighten the neck skin by stimulating collagen production at various depths, providing firmer skin and an improved texture. However, while effective, RF microneedling works best for moderate laxity and may require several sessions for optimal results.

Ultherapy, which uses focused ultrasound to reach the skin’s foundational layers, can also support tightening and lifting effects. Meanwhile, Radiesse, a biostimulatory filler, can address volume loss by providing a subtle lift and encouraging collagen production, restoring a smoother, more youthful contour to the neck and lower face. Together, these treatments can help improve the appearance of crepey skin and fine lines.

For patients with more pronounced sagging or deeper creases, a non-surgical approach may only provide partial improvement. In such cases, a surgical neck lift can offer a more dramatic and long-lasting correction by removing excess skin and tightening the underlying structure. Consulting with a skilled practitioner will help determine whether non-surgical treatments alone can meet your aesthetic goals or if a surgical option would better align with your expectations.

Will nonsurgical neck lift correct sagging, crepey neck, volume loss and marionette lines or should I consider surgery? (photos)

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