Episode 25: How Can I Get Rid of Loose Neck Skin Without Surgery?
How can I get rid of loose neck skin without surgery? This is one of my favorite questions that I get from patients, because there is a really satisfying answer, which is that there are a bunch of ways that we can tighten your neck skin with either no surgery or a minimally invasive procedure, and get a really nice result.
What causes loose neck skin?
Before we can talk about ways to get rid of extra neck skin or turkey neck as it is sometimes affectionately called, we need to look at what's causing that skin laxity in the first place. And there are a few different things that can cause loose skin in the neck and jawline area. And I'd imagine there is some regional variation in the frequency of these causes, but in my New York city plastic surgery practice, aging is probably the most common cause of loose skin in the neck and jawline area. And the skin of the neck and jawline can become saggy or loose with age because the skin loses its elasticity over time.
As it's subject to gravity and motion over many years, the collagen and elastin and other factors that are keeping it tight, begin to loosen up and the skin will simply begin to sag. Another thing that can cause skin excess in the neck region or sometimes what we call the submental area, is massive weight loss.
And that's because when you lose a lot of weight, if the fat in an area, if the volume of the fat in an area decreases, the skin sometimes can't contract enough to keep up with that volume loss. And it's an unflattering analogy, but it works well. But if you imagine a balloon, if you deflate that balloon just a little bit, the skin of the balloon will look just fine.
But if you start to completely deflate that balloon and as all the air comes out, the balloon is going to deflate and flop, and look saggy and folded. And it's the same thing. If you lose a lot of fat in an area and in this case, the area of the neck or the submental region, sometimes the skin just doesn't have enough elasticity to completely contract.
And that is made worse by things like smoking or advanced age and other genetic and environmental factors. And the last thing I'll touch on that can cause skin laxity in the neck or jawline region is poorly planned liposuction. I do a lot of liposuction in my practice.
So I tend to also get a lot of referrals from people that have had not so great liposuction elsewhere, and I'm asked to try to correct those results and get people back to a better place. And one thing that we sometimes see is that people that have had too much fat suction from their submental region, and I have an earlier episode dealing with getting rid of double chins.
And we go through the various things that we have to think about there to make sure that we're doing that liposuction the right way and using the right technology to get a great result. If someone doesn't do this the right way and they just suction too much fat, sometime it's just like if there's a lot of weight loss and a lot of fat and volume is lost from weight loss, the skin can't contract enough.
The same thing applies with liposuction. If there's a lot of suction done, the skin sometimes can't contract enough on its own and we're left with skin excess. So those are the kind of three most common ways that people come to me with skin excess or skin laxity of the neck and jawline.
Can Botox get rid of loose neck skin?
So now let's get into talking about how to treat skin laxity of the neck or loose skin around the neck and jawline. And first we'll address some common questions that we get about this. The first one is, can Botox tighten neck skin? And the answer is unfortunately not.
Botox can help to make the vertical bands of the neck look less severe. And that's because these vertical neck bands are caused by the aging and repositioning of the platysma muscle. With age of a platysma muscle, is a paired flat muscle under the surface of the neck skin. And in young folks, there are two of these, one on either side and they're attached in the midline.
And with age, these muscles can separate from one another in the midline. And when those muscles contract and pull, they can cause these vertical neck bands. And this is where Botox and be helpful here. Botox can soften the severity of those vertical neck bands. And you'll find an earlier episode where we discuss exactly what Botox does and how it can help in this scenario.
What exercises tighten loose neck skin?
The other question that we get a fair amount is are there exercises I can do to tighten my loose neck skin? Or are there creams that I can use to tighten my skin? And the answer to both of these unfortunately is no, there's really no good topical agent that's going to effectively tighten your skin anywhere, and definitely not your neck skin.
Radiofrequency microneedling: Morpheus8
So now getting into things that actually do work pretty well. I'd like to divide the severity of the loose skin into three categories and we'll just call them mild, moderate to severe. And that will organize our discussion of possible treatments for this loose skin. And for the mild skin laxity of the neck, something that can work really nicely is radiofrequency microneedling.
And there are several different devices on the market for this. The one that I use in my practice and the one that I like a lot is called Morpheus8. And the way that this works is you have a bunch of tiny needles that create minuscule physical controlled injuries to the skin.
And then radiofrequency energy is emitted by these needles, which also cause a controlled thermal or heat injury to the skin. And as the body heals these controlled injuries over time, there is contraction because one of the big ways that the body heals wounds is through contraction.
And as that skin contracts, the neck skin tightens and you can get a really nice result. And moving into people that have moderate loose skin or skin access in the neck or jawline area. I also really like radio frequency for this, but we deliver it in a bit more of a powerful way.
Minimally Invasive Skin Tightening: FaceTite
Now with Morpheus8, the radio frequency microneedling is a truly nonsurgical procedure. These are radio frequency microneedles, there are no incisions involved and I don't think really anybody would consider this surgery. The next thing that I'm going to talk about for this kind of moderate or intermediate skin laxity of the neck would be considered minor surgery or a minimally invasive procedure.
And the reason is that while we're still delivering radio frequency, we're doing it from both inside and outside the skin. And in order to do this, we're making tiny two to three millimeter incisions. Those are about maybe two thirds of the size of a pencil eraser and they're in very well hidden locations.
There's one behind each ear lobe and one in the chin crease. So nobody's ever going to see these and we're putting one end of the probe under the skin. And then there's a matching probe that goes over the skin and radio frequency energy is fired back and forth between the probes heating up the skin.
And again, we're getting a controlled thermal injury, but this time it's a bit deeper and it's really passing through the full thickness of the skin and the underlying tissue. And we're able to heat it in a very controlled way and get a very powerful contraction this way.
So it's a minimally invasive procedure that works really well for moderately lax skin of the neck and jawline region. And the thing to know about both of these procedures is that they take several months to see the final result. Well, you'll likely see a little something right away.
We really do like to give it two to three months or sometimes even a little bit longer to see the final result, because remember, we're creating a controlled injury and it takes time for that to heal. The other thing to know about Morpheus8 is the recommended treatment regimen is one treatment every three to six weeks repeated three times. Whereas with the FaceTite procedure, this is something that's just done once.
Minimally Invasive Skin Tightening: AccuTite
For clarity, if we're dealing with very small areas of laxity, maybe the jowls or a very focused area under the chin or neck region, sometimes instead of FaceTite, we'll use a device called AccuTite. And that's kind of FaceTite's little sibling. It's the exact same technology, but it's a much smaller applicator so we can be a little bit more precise with our energy placement.
When we start getting into severe skin laxity of the neck, there really isn't anything nonsurgical or minimally invasive that we can offer here. In this kind of case, you really do need to go ahead and do a skin excision procedure like a neck lift, or if there's also laxity in the face, you would do a facelift that includes a neck lift. So this is kind of the spectrum of options that we have available for treating skin laxity of the neck or the turkey neck.
And as you might expect for the very kind of mild cases we can do something totally noninvasive, that's the Morpheus8. For the very severe cases, we are looking at a more surgical option like a neck lift or a facelift. And for the cases in between, we are looking at things that are kind of minimally invasive, like FaceTite or AccuTite.
And each of these treatments is really kind of individualized and that's why you really need to go to someone who does a lot of this and has expertise with these procedures, to make sure that you are getting a procedure and surgical plan that is best for your expectations and your anatomy.