What are the best options to treat my turkey neck and double chin? (photos)

Question

Hereditary turkey neck runs in my family and I'm lucky to have only seen it, along with a double chin, creep in over the last year - I'm 47. Thinking about Kybella or Botox or lipo - not sure which procedure would be best for this issue and would love some informed thoughts from the doctors' community.

Tanveer Janjua, MD · Answer

You do not have enough laxity to do a necklift . A thermitight procedure would be more appropriate and will buy you another 5 years at least before having surgery. Botox or Kybella will not work for you.RegardsDr J

Anil R. Shah, MD · Answer

Your skin may benefit from tightening treatments but without a snap-test, it's difficult to sense the laxity of it. From a couple of your pictures it appears that your Platysmal bands are somewhat prominent, which can recede with Botox injection treatments. Ultimately, I would advise an in-person examination with a board-certified Facial Plastics surgeon who demonstrates a profound experience in lower face rejuvenation. I only say this because your pictures do not demonstrate the standard range of profiles for proper under chin and neck evaluation and I wouldn't want to mislead you with treatment options that wouldn't work.Best, Dr. Anil Shah

Jason Emer, MD · Answer

Thank you for your question. Kybella is good for dissolving the submental fat under the chin area while contouring the jawline and making the chin more defined, but a combination approach is needed to get the most improvement with non-invasive options. I recommend a combination approach with thermage, ultherapy, exilis. VASER liposuction in combination with ThermiRF is the best alternative for contouring the chin and can be performed with a neck lift, if you're a candidate. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Jeff Markey, MD, FACS · Answer

The previously provided answers may all be beneficial to different degrees, depending on your tolerance of downtime following the procedure, invasiveness, and price point. Three general categories are available - injectables, non surgical procedures, and surgery. Injectable options for you include Botox and is usually the easiest and least expensive option, but will have the mildest benefit. The procedural options include Ultherapy and Facetite - these are performed in clinic with minimal downtime but take weeks to months to take effect. Surgical options include a central necklift with platysmaplasty and involves a narrow incision hidden in the crease beneath your chin. This would have a great result likely but requires a few days off of work and management of a narrow incision. Hope this helps

Kenneth D. Steinsapir, MD · Answer

In the world of necks, yours is not a fat neck. Forget Kybella. It is not good for your issue.  It is very expensive and a bummer of an expensive, painful, and disappointing treatment in my opinion. If you are interested in avoiding surgery, you can try botox in the neck cord. It often flattens this feature. It will last about 4 to 6 months. If that does not work and you reluctant to have a face/neck lift, there is an alternative. That alternative is a midline platysmaplasty. This is a surgery done through a small incision under the chin. The muscle cord is carefully trimmed and the edges of the platysma muscle are sewn together. It is a sneaky way of getting a long term smoothing of the neck with having a facelift.

Daniel Barrett, MD · Answer

Dear suzy646,Kybella typically takes 3 to 5 treatments to work. This is why I've stopped carrying Kybella in my office.  I recommend neck liposuction more often then any injectable procedure for the neck now. It provides superior results gives me more control over the area than any injectable.  It also costs about the same as what you paid for your first kybella session. The liposuction can be done under local while awake in the office and recovery is about the same as kybella.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Johnson C. Lee, MD · Answer

Thank you for your photos. It appears that you have loose excess skin with very little fat. Kybella only treats fat and therefore will not be helpful. Botox can help loosen some of your neck muscles to relax the skin, but will not remove or tighten the extra skin. Liposuction can help tighten skin but the effect is very mild. You would be best served with a surgical neck lift to remove extra skin and tighten the area at the same time for long lasting results. If you would like to avoid surgery all together, another option is a threadlift which can last a few years. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Shaun Patel, MD · Answer

Your photos show some skin laxity and a prominent platysmal band but no excess fat. Kybella and liposuction are treatments for fat and so I do not think you are a candidate for these treatment. A neuromodulator like Botox and Dysport will help with the plastysmal band. Neuromodulators can also be used to relax the platysma muscle and improve jawline definition. This procedure is call the "nefertiti lift" and it will give you a subtle improvement in jawline definition. Radiofrequency based skin tightening procedure are nonsurgical option for mild to moderate skin laxity of the neck. Surgical neck lift will give you the most dramatic results with regards to skin laxity.

Roy A. David, MD · Answer

Once loose skin and or muscle develop in the neck, very little can compete with actual surgery to tighten and lift these tissues. However, surgery need not involve general anesthesia or a long recovery. My La Jolla Lift procedure targets neck, jowls and cheeks under twilight sedation.

Eric W. Cerrati, MD · Answer

Your concerns are related to the underlying muscle in the neck.  Therefore, Kybella and liposuction will not be effective since they both only address fat, which you do not have.  A non-surgical, temporary option is botox.  The permanent option is a neck lift.  This can be performed through a small (2-3cm) incision under the chin.  I recommend you see a plastic surgeon specializing in the face for a consultation to discuss the options.
Best of luck.

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