Whether we like it or not, sagging skin is a normal part of the human experience. As we age, the elasticity and collagen begin to break down in our bodies, creating a looser, wrinkled look all over. And while loose skin can happen anywhere on the body, sagging skin under the neck is a particular concern for many of us.
“The quality of the neck skin is more fragile than facial skin, and this usually leads to signs of advanced aging and laxity,” says Beverly Hills facial plastic surgeon, Natalie Attenello, MD. “Additionally, patients often overlook sun protection in their neck region which also leads to further aging.”
Luckily, tightening up that loose area between your chin and chest doesn’t require invasive surgery anymore. From lasers to injectables, you can change the appearance of your jawline with a simple visit to your skincare professional. Here, we ask experts for the best in-office treatments to sculpt the neck area without going under the knife.
Harnessing the power of high-intensity focused ultrasound energy to reach deep below the skin’s surface, Ultherapy jump-starts collagen production for a tighter look. “We use microfocused ultrasound [like Ultherapy] for lifting of the laxity at the jawline jowls as well as lifting of some of the neck laxity,” explains Denver, CO dermatologist Joel Cohen, MD.
The treatment can take between 30 to 90 minutes, and is performed by moving a handheld device across the skin’s surface to transmit the ultrasound energy through the skin’s layers. Unfortunately, patients do report feeling a bit of pain during treatment (and some tenderness post-treatment, as well), so many take pain medication before their appointment. Another thing to note: the best results surface about three to six months post-procedure, and experts recommend getting the treatment once a year to help maintain results.
“Kybella is an injectable to dissolve submental fat,” says Troy, MI, plastic surgeon Anthony Youn, MD. “This is great for people who have double chin fat and want an effective solution.” Each Kybella injection contains a synthetic form of deoxycholic acid to permantly kill fat cells in the targeted area. The treatment session requires multiple injections — around 20 to 30 — in the treatment zone, and results are best seen after two to four sessions. “This is best for people who don’t have loose skin or significant platysmal bands,” adds Dr. Youn.
Downtime after a Kybella treatment is minimal, but some swelling usually occurs and resolves within a couple weeks. While rare, damage to the nerve that controls the smile is possible, and can take anywhere from one to four months to resolve.
This treatment uses a handheld device to chill the skin and freeze fat cells to death. “Coolsculpting can reduce the thickness of subcutaneous fat in the submentum,” says Dr. Youn. “This non-invasive treatment uses cold [temperatures] to target fat and destroy it.” Once the fat has been destroyed, the body gradually removes it by natural means. Although, the results can be less impressive than liposuction or Kybella, but patients are often drawn to this option because it is completely non-invasive.
It’s important to note that CoolSculpting does not tighten the skin, so it’s best for people with unwanted fat and relatively tight skin. Most people need two or three treatments to see ideal results. Possible CoolSculpting side effects include redness, swelling, tenderness, numbness, and bruising.
“For patients with creping skin of the neck and jawline, we use fractional microneedling radiofrequency,” explains Dr. Cohen. “Most of these treatments are recommended to be a series [for best results].” The combination of microneedling (which uses tiny needles to provoke a wound-healing response) and radiofrequency (which is a type of energy that penetrates the skin to boost collagen production) addresses both fine lines and laxity on the neck.
While less of a sculpting treatment than others on this list, this procedure improves skin quality for a more youthful appearance. “Addressing the tone and texture of the neck skin can have anti-aging benefits,” confirms Dr. Attenello. However, you’ll need multiple sessions to see your ideal results, and visible changes may take a few months to become noticeable.
For those with visible neck bands or vertical lines, Botox Cosmetic might be the best bet. It can be used in the front-most edges of the platysma, the two muscle bands of the neck, to relax the front of the muscle, explains Dr. Attenello. By relaxing the front of this muscle, the back muscle can pull more, hence tightening the look of the neck. It can also be injected above and below horizontal lines on the neck to relax the muscles and soften the look of fine lines.
In general, Botox Cosmetic in the neck is best for younger patients with less prominent lines. Those with deeper lines may need filler instead (more on that next!). As far as pain and downtime are concerned, Botox Cosmetic can be slightly uncomfortable (it is an injection, after all), and may result in some bruising at the injection site. It also only lasts around three to four months. However, there is little to no downtime and the appointment is rather quick.
Another injectable option for the neck: fillers. These hyaluronic acid-based injectables work by adding volume to lines and wrinkles, therefore plumping them out for a smoother appearance. While filler won’t necessarily fix sagging in the area, it will give the neck a more youthful, sculpted appearance.
The best candidates for neck filler are typically older and have deep set lines along their neck. As with any injection, there is usually mild swelling and occasional bruising post-treatment, but this resolves quickly. Fillers often tend to last longer than Botox Cosmetic, so this is also best for those looking for more permanent results.
“Lasers are also a good in-office treatment, but may require a little more downtime of four to seven days,” says Dr. Attenello. “Certain lasers have slightly lower settings to address the skin of the neck—this can improve sun or age spots, fine lines, as well as improve the skin’s elasticity.”
Studies have shown that fractional CO2 lasers are an effective treatment for improving skin laxity and jowling together with skin surface pigmentation. This carbon dioxide laser removes top-level skin cells so new skin can surface. At the same time, it penetrates the deeper skin layers to stimulate collagen production, which ultimately tightens and plumps the skin.
As Dr. Attenello mentioned, these lasers can have quite a bit of downtime. Lasers with less downtime, like Clear + Brilliant, typically need multiple sessions in order to see visible results. But regardless of which laser you decide to choose, those with medium to deep skin tones should proceed with caution. Lasers have been known to create excess hyperpigmentation in those with darker skin tones. So, be sure to check with your doctor before committing to a laser appointment.
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