Loose skin after weight loss - What will help my neck the most? (Photos)

Question

I’m including some pics here. After weight loss, my neck looks very loose. I’ve always had acne scars that I hate, but I couldn’t tolerate laser. I don’t even know where to start… But my neck bothers me the most. Suggestions for the surgery I should have?

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for a deep plane face and neck lift. This will lift and restructure the neck and lower face, giving a natural, more youthful appearance. Be sure to see a facial specialist for consultation.

Muhsin Yilmaz, MD, FEBOPRAS · Answer

From what you describe, I would consider addressing both the face and neck rather than treating the neck in isolation. After weight loss, significant skin laxity can extend from the neck into the lower face, and treating both areas together can create a much more balanced and natural result.
A face and neck lift would address the loose skin and underlying tissue laxity, helping to restore a more defined jawline and neck contour. Since you also have acne scarring and have not tolerated laser treatments well in the past, CO2 laser resurfacing could be considered at the same time, depending on your skin type and the degree of scarring.
The advantage of combining the procedures, when appropriate, is that the structural laxity and the skin quality can be addressed during the same treatment plan. The facelift and neck lift address the sagging and contour, while CO2 laser focuses on the skin texture and acne scars.
Of course, the exact technique and whether you are a good candidate for CO2 would need to be determined during an in-person assessment, but based on your concerns, I would definitely discuss a combined face and neck lift with CO2 resurfacing rather than focusing only on the neck.

Mert Demirel, MD · Answer

After weight loss, loose neck skin is usually best improved with a surgical neck lift or lower face and neck lift. Non-surgical treatments can help mild texture or skin quality, but they usually cannot remove true loose skin.
From the photos, the issue seems to be skin laxity and soft tissue descent in the lower face and neck. A neck lift can tighten the platysma muscle, remove or reposition deeper tissue, and redrape the skin more smoothly. If there is also jowling or lower face laxity, a lower facelift combined with a neck lift may give a better and more natural result than treating the neck alone.
Liposuction alone would not be the best option if the main issue is loose skin. Removing fat without tightening the skin can sometimes make laxity look worse. Energy-based tightening may give only limited improvement in this degree of looseness.
The acne scarring is a separate skin-quality issue. If laser was not tolerable, you could ask a dermatologist about alternatives such as microneedling, RF microneedling, subcision, chemical peels, or staged lighter treatments. But for the neck contour, surgery is likely the more effective option.
I would recommend consulting a board-certified facial plastic surgeon or plastic surgeon experienced in face and neck lifting. Ask whether you need a neck lift alone or a lower face and neck lift, and whether your skin quality after weight loss changes the surgical plan.

William Portuese, MD · Answer

From the limited photographs presented, it appears that you have significant laxity of the skin in the neck, platysma muscle cords, and fat deposits located both above and below the platysma muscle in your neck. You're going to need it, lower face and neck lift with special attention, directed towards rejuvenating the neck along with removal of the fat deposits both above and below the muscle. Study the before, and after photographs of your perspective, surgeon and make appointments with at least three different experienced face/necklift surgeons

Lexie Wang, MD · Answer

A face/neck lift is going to be the most effective option to treat your concerns. I would consider a laser at the same time while you're asleep.

Zoran Potparic, MD · Answer

There is no doubt that a good lower face and neck lift should be first to consider regarding facial rejuvenation. Next step (it can be done simultaneously) would be skin resurfacing with laser or dermabrasion. In person consultation with a board certified plastic surgeon with good reputation in face rejuvenation is recommended. Good luck.

Kyle Kimura, MD · Answer

Thank you for your question and photos!
This is something we have been seeing more frequently with the weight loss supplements that have become available. With weight loss comes a decrease in facial fat which can leave the skin looking loose and stretched. The best option in my opinion is a face/neck lift based on areas of concern. While I understand the neck is your biggest concern, it is important to also consider addressing the fat loss/excess skin in the face as a whole via a full face lift rather than just the neck alone. 
Your best option is likely to schedule a consult with a plastic surgeon that specializes in facial rejuvenation and discuss the nuances of the surgery and decide what would be best in your situation.
Hope this helps and best of luck!Kyle Kimura, MD

Tatiana Luna, MD · Answer

Congratulations on your weight loss! Based on your photos, a Deep Plane Facelift and Necklift would likely provide the greatest improvement by addressing the loose skin, underlying muscles, jawline, and neck contour.
For the acne scars and overall skin quality, surface-improvement treatments such as microneedling with exosomes may be considered after surgical healing. An in-person consultation is essential to determine the best plan for your anatomy.

Loose skin after weight loss - What will help my neck the most? (Photos)

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