How to Get Rid of Excess Neck Skin

I also think that non-surgical methods, whether laser resurfacing, liposuction, laser liposuction, radiofrequency tightening of the skin will only help so much.

Shrink a shirt/Tailor a shirt analogy

 I think my colleagues have all made excellent points regarding surgery versus the non-surgical methods.  I will use an analogy to help make my point.  

The non-surgical method is like trying to shrink an oversized shirt which you are trying to make fit skin tight.  You can wash it and dry it in the dryer to try to shrink that shirt, but it may only shrink so much and you really don't have control how much it will shrink.  Yet the goal is to make the shirt fit skin tight.

Surgery is really tailoring.  By tailoring the fat, muscle of the neck, and redraping the neck skin, will you ultimately get the "tailored" result that you are looking for.  The tailor would need to open the seams of the shirt and remove the extra fabric, then sew the seams back together in the same places that you would expect for a shirt.

The analogy may seem a bit hokey, but I hope it makes some sense when you are thinking about your options.

Best,

Dr. Yang

There are excellent non-surgical options available to address lax skin of the jawline and neck.
Patients with moderate skin laxity of the lower face and neck are ideal candidates for the Endolift Laser which is FDA approved and used throughout Europe. The Endolift Laser targets pockets of fat in the jowl, face and neck. It stimulates collagen so the skin looks significantly better and tighter. The benefits are that the Endolift Laser is placed through tiny pin holes so there are no scars and the healing is rapid. This is an outpatient procedure with minimal discomfort during or after the procedure. The Endolift Laser is amazing in the hands of well trained individuals who understand how to avoid complications and know the optimal manner in which to target lax tissues. When used in combination with PDO Threads and possibility facial fillers, the results are ideal and the downtime is minimal. You may also benefit from selective facial fillers: Radiesse, RHA or Restylane to contour your jawline and cheeks. This will support lax skin and muscle of the lower face. The combination of the Endolift Laser, PDO Thread Lift and selective Facial Fillers is the choice for patients who wish rapid recovery, have moderate laxity of facial and neck skin and wish a natural and rejuvenated appearance. Botox will not assist sagging skin but when appropriate can diminish prominent neck bands or muscles.
Seeking a consultation with a well qualified individual is the first step.

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Choosing a plastic surgeon is important in this process, even if you choose to undergo a non-surgical procedure. 
Neck laxity can be caused by muscle tightening, masseter dysfunction, loose skin, and fascial dehiscence and loosening. 
Our Hidef approach to non surgical neck lifting addresses underlying
muscle hypertrophy, neck laxity, and fascial tightness. We use a
combination of Venus Legacy RF, NanoRF, and Ultherapy to exact a
tightening of the neck + Botox for muscle and masseter hypertrophy.
Retinoid creams are a must and we follow a comprehensive cream program
for topical creams. 
Finally, fractional laser offers the benefits
of microablation to improve skin quality and texture. We use this in
addition to light therapy and PRP.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

It really depends on how much skin we are talking about. Most noninvasive modalities can shrink the skin 5 - 60 %, with Embrace RF(Facetite + Fractura) being approximately 60%. This requires looking at the amount skin you can pinch in the neck to achieve the result you want. For anything more than the 60%, you will require a neck lift.

Without photos, it's difficult to determine the treatment to address your concern. Depending on the level of laxity, the effects of a neck lift will certainly outlast the effects of non-surgical treatments. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. During an in-person examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results. Liposuction under the chin is also another option your doctor can discuss.
Your board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to improve your concern.

Ultimately, a surgical neck lift would be your best option.  This procedure could include tightening your underlying musculature to give you a better contour and also removing the excess skin laxity.  Together this allows for a much better neck contour. In some instances, some liposuction is also beneficial to reduce the submental fullness.However, if you are looking soley for a non-surgical solution, I am finding that the combination of Kybella to reduce the sub mental fullness and an energy device to tighten the skin are among the best non-surgical combinations to help your neck concerns.kybella is an injection procedure that dissolves the fat an may require between 2-4 treatments spaced 4-6 weeks apart. There is some swelling and bruising potential, with the greatest amount with the first treatment.As far as energy devices, I would recommend Ulthera if you are looking for something with no downtime, or Profound if you could tolerate some downtime. Ulthera is an ultrasound based energy that heats the underlying tissue and stimulates collagen in response. Profound is a radio frequency microneedling device that allows for the creation of Elastin, collagen and hyaluronic acid and hence restores some of the lost elasticity in the neck. It has more visible downtime with the possibility of some swelling and bruising that diminishes in about a weeks time.

A neck lift is the most suitable surgical option but if you prefer nonsurgical, laser skin tightening technology may help firm up loose skin to some extent. 

Off the bat, with any sort of an issue related to aesthetics of the neck, the best thing I can tell you is to go seek the advice of an expert who has many options at their fingertips. "Many options" means a wide range from both surgical what lifts through noninvasive options such as lasers and neuromodulators. The first thing that needs to happen is a determination of what process is happening to cause your neck to look aged. Often times the skin of the neck loses its elasticity while the platysma muscle that holds that skin firm against the angle of your neck also loses some integrity and causes that banding or turkey gobbler look of your anterior neck. You may also have a fullness in your neck from excess fat or even enlarged salivary glands that may be amenable to both nonsurgical and/or surgical correction. The bottom line is, what appears to be excess skin may not be excess at all, and there may be other reasons for the look of an aged neck. It takes an expert to recognize the subtle changes and determine what treatment options will suit you best. To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Aging changes to the neck can vary person to person.  Loss of collagen, gravity, and changes in fatty volume affect the appearance.  Anatomically then, loose hanging tissue may be skin, muscle, and fat.  The structure of the underlying bone and muscle anatomy affects the changes to these areas person to person.Under the chin there can be bands of skin that usually also include a thin muscle called the platysma.  This muscle can extend to areas towards the ear.  Tightening this muscle during a lifting procedure will improve the 'loose skin' under the chin.While a surgical procedure is still the gold standard for improving this area, there are nonsurgical options such as Ultherapy, Botox, and sometimes lasers.  A careful evaluation by someone who has all these tools at hand will help you with the correct choice for you.

It is possible that you may be a candidate for what I have termed, "The Laser Assisted Weekend Necklift:" It is a minimally invasive procedure. Cervicofacial Liposculpture is first employed to contour the unfavorable fatty changes seen in the face and neck as time passes by, such as the ‘Turkey neck’ and ‘double chin’.Careful attention is then turned to tightening the neck muscles and eliminating neck bands. Finally, I employ laser technology to ‘resurface’ the underside of the neck skin, thereby ‘shrinkwrapping’ the skin of the neck restoring a youthful contour.A consultation with a board certified facial plastic surgeon or board certified plastic surgeon will help determine which procedures will provide the best results for you.