Whether we like to admit 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. Sagging skin on the neck is of particular concern because it tends to be one of the first signs of aging.
“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.”
While there are a handful of surgical options to tighten up the neck, there are also many worthwhile options for people who don’t want to go under the knife or aren’t candidates for more serious surgeries just yet. From radiofrequency to injectables, you can change the appearance of your jawline with a simple visit to your skin-care professional. Here, we hear from experts about the best in-office treatments to sculpt the neck area without surgery.
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. Short Hills, NJ facial plastic surgeon Alexander Ovchinsky, MD says younger patients with minimal skin laxity are great candidates for Ultherapy.
Ultherapy is a micro-focused ultrasound that targets the platysma, and deep dermis in the neck, which helps tighten skin, explains Duxbury, MA plastic surgeon Christine Hamori, MD. One 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.
Concord, CA plastic surgeon Eric Mariotti, MD employs SkinTyte using the Sciton BBL device to combat sagging neck skin non-surgically. “SkinTyte uses infrared light to heat the deeper layers of the skin. This heating is what leads to collagen synthesis and contraction,” he explains. “The device also has a cooling crystal to protect the surface of the skin while allowing the energy to heat the deeper layers of the skin. The light energy is delivered in short, rapid pulses, which leads to the appearance of increased skin tightness.”
In addition to Ultherapy, Arcadia, CA, plastic surgeon Art Yu, MD also recommends Thermage for beginners. “Thermage uses radiofrequency energy and can reduce the fine wrinkles, making the skin texture smoother and tighter,” explains New York plastic surgeon William Lao, MD.
Various injectables can help take the neck back in time a few years. “If the patient has vertical bands in the central portion, which usually are separated platysma muscle bundles, I would offer botulinum toxin injection, which usually requires anywhere from 30 to 60 units, unless the bands are too heavy,” says Dr. Yu. “For horizontal lines or wrinkles, some botulinum toxin injection might also work.” In general, Botox Cosmetic in the neck is best for younger patients with less prominent lines.
New York plastic surgeon Daniel Y. Maman, MD suggests Kybella injections. “Kybella is an injectable to dissolve submental fat,” explains 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 permanently kill fat cells in the targeted area.
Dr. Lao says PRP (platelet-rich plasma) injections can work for deeper neck wrinkles. Although it’s often used for wound healing or hair restoration, it has some volume augmentation effects that may be beneficial for the neck, he explains.
Dr. Ovchinsky says he usually offers Morpheus8 or ThermiTight to his patients with moderate to severe laxity who are not interested in surgical options. “Morpheus is a combination of radiofrequency with microneedling and usually requires three treatments for the full result,” says Dr. Ovchinsky.
ThermiTight is unique in that it is “injectable radiofrequency.” Dr. Ovchinsky explains that during a ThermiTight treatment “a small radiofrequency needle is used to deliver the energy directly to the undersurface of the skin.”
While technically not surgical, PDO thread lifts are a bit more invasive than other treatments on the list. However, it’s worth noting that Dr. Yu says, in certain cases, PDO threads could be very useful in tightening up the neck.
Dr. Lao notes that CoolSculpting is a solid option for achieving a more sculpted look. “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. 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.
Some experts suggest trying microneedling, which Pittsburgh plastic surgeon Leo R. McCafferty, MD notes was recently approved by the FDA to treat wrinkles on the neck. “Microneedling treatments work well for necks with mildly loose skin where patients are not quite surgical candidates but want to be proactive about keeping their necks as young-looking as possible,” says Dr. Maman.
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 fix sagging in the area, it will give the neck a more youthful, sculpted appearance.
“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. Regardless of which laser you decide to choose, those with medium to deep skin tones should proceed with caution.
Whether you want an after-care cream to maintain results or you’re looking to see if a product is enough to tighten your skin on its own, experts have a couple of recommendations. Dr. McCafferty, MD suggests Revision Skincare Nectifirm ($94) and PCA Skin Perfecting Neck and Décolleté ($84) and Dr. Hamori suggests Alastin Restorative Neck Complex ($110).
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