This is the second of two.  Neck tightening has been the ‘holy grail’ of nonsurgical for quite some time, with good options for prevention of sagging by starting early, as in your thirties or forties, to try to avoid surgery.  People often say they had a ‘neck lift.’   A neck lift is just a lower facelift.  The surgeons need to cut up around the ears, usually in front and behind, to accomplish tighter neck skin.  Areas where is excess fat need  debulking with  lipo or other methods with that if the neck is heavier.  So what ARE the nonsurgical options for necks now.

First start with prevention:

  • Good topicals like Nectifirm or Face, Neck and Chest at night with moisturizer over.  There are very few oil glands in neck skin.
  • A high zinc sunscreen every morning to prevent damage with a good antioxidant underneath that.
  • Hats that shade the neck if outside at midday or for a prolonged length of time.

Next step start collagen building consistently a younger age (age 30-45)

Everyone has a different neck.  I have a friend at 62 whose neck is beautiful despite mild sun damage.  Is that genetic?  Probably.  Is it because she’s a cyclist or the way she holds her head.  I have no idea!   I have friends in their 40s who already are starting to show sagging.  Maybe look at you mom or dad, and you’ll have at least some idea of where you’re headed.

  • External or surface applied radiofrequency to do once or twice a year on the neck is just way more painful on the neck.  I recommend avoiding Thermage (good on the face though), Ultherapy, and Pelleve – too painful!  Comfortable on the neck skin are Exilis and Thermi due to the wand applicator.
  • Be more consistent on your sunscreen every single morning.
  • Add a gentle retinol to your neck and chest night regimen.
  • Consider a little Botox/Dysport if you have prominent platysmal bands

Repair phase (usually ages 45-80).  You’ll need a good dermatologist.

  • Do all of the above for 3 months prior to any other treatments to start building a little more collagen and get the skin cells more active.
  • If a pocket of fat under the chin, consider Coolsculpting, Kybella or the new SubQ Profound.
  • If really a lot going on, consider surgery, and get both a surgical and nonsurgical opinion on what to do.
  • Platysmal bands – same as above – try the Botox/Dysport first.
  • Deep radiofrequency works on the neck.  I recommend Profound as currently the best engineered system.  This can change, of course. You want the collagen, hyaluronic acid and elastic fiber stimulation in the dermis itself to tighten the skin.  The treatment starts on the face which helps to pull everything up.  Usually 1-2 treatments are needed and should last several years.
  • Avoid the Thermi tight, and systems like it, with is applied from under the skin, not through the skin into the dermis.  The under skin has more risks of burns, surface bumpiness and temporary nerve damage.

Hope this helps,

Dr. B



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