Any procedures that might help address my sagging neck without resorting to surgery? (Photo)

Question

I underwent Bariatric surgery and have been experiencing increasing sagging in my neck area as I age (luckily my face is at a better condition). While I'm open to the idea of a neck lift, I'm exploring less invasive and more affordable options. I've heard concerns about treatments involving heat and their long-term effects. Could I get an advise on alternative treatments or procedures that might help address my sagging neck without resorting to surgery or treatments involving heat?

Lexie Wang, MD · Answer

Hi! Botox/neurotoxin can be used for those vertical bands (platysmal bands) that are in your 2nd to last picture. The only procedure that can remove excess skin, unfortunately, is surgery, and oftentimes this is the only thing that will work post bariatric weight loss. You are always welcome to try radiofrequency microneedling but I suspect you will not get the results you are looking for.

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

Jeffrey H. Spiegel, MD · Answer

For you I would consider first and foremost a deep neck lift, but, barring that you could get nice results from embrace. This is a technology with energy to tighten the skin. We have many videos and before and after photos on our website. It's a come and go office procedure!

Camille Cash, MD · Answer

You may want to consider FaceTite  This minimally invasive procedure uses RF technology to tighten skin.  No general anesthesia is required.  Results can be enhanced by adding Morpheus8 treatments to improve overall skin tone and texture.  We also recommend using medical grade skin care products and wearing sunscreen every day.

Kristin J. Tarbet, MD, FACS · Answer

Ultherapy with FDA approved ultrasound technology would be a safe alternative for your skin tone/fitzpatrick type and great treatment to address your neck area . There's little to no down time and it's one of the best alternatives we recommend to our patience next to surgery because it treats all 3 layers of the skin down to the muscle. Ultherapy.com

Lisa Vuich, MD · Answer

Thanks for your question and congratulations on your journey. In the front view it is apparent that you have two prominent platysmal bands. These can be relaxed with the use of "botox"- consider the longest acting version which is called Daxxify. It would be very difficult to remodel and tighten this region without using heat. A very successful combination treatment if you can tolerate a little bit of downtime is to have a series of Morpheus8 treatments- 3 sessions about 4 weeks apart- possibly in combination with FaceTite (used on the neck) for even more lift. If you are looking for something with no downtime/no needles, consider Sofwave, though that is still a heat-based treatment. PDO thread lifting in the upper neck region is the only non-heat based treatment that would give some improvement, though not as much as the other modalities I mentioned. I hope that helps.

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