It’s no news to me, an esthetician of 30+ years, that people neglect their necks when it comes to skincare. In fact, I often make sure my friends, family, and clients are applying their products correctly by asking them to demonstrate how they apply their sunscreen. More times than not, I’ll watch them apply it to their face and then apply whatever is leftover on their fingertips to their neck– which is far from a generous application. What I want to emphasize is that our necks are an extension of our faces, as well as one of the first areas to show visible signs of aging. Taking the proper steps to care for our necks day in and day out is incredibly important, don’t get me wrong. But it’s important to note that skincare alone has limitations. As we age, our bodies and muscles naturally undergo changes that may require alternative solutions.
So, What Do You Need To Know About The Neck?
Located immediately below the skin in our necks is the platysma muscle. This muscle serves very little purpose in humans except to protect the deeper neck structures. With age, this neck muscle begins to loosen and descend, causing the telltale signs of aging, or sagging vertical neck bands (also known as the “turkey gobbler” – a lovely phrase LOL!). While this is completely normal, it is something that I personally have undergone a variety of treatments for. As some proved more effective than others, I’m here to provide insight to those of you out there seeking professional procedures (surgical and non-surgical) to tighten the neck.
Let me introduce you to my personal board-certified facial plastic surgeon Dr. Sam Lam to discuss what modern-day medicine can do for anyone struggling with visible signs of aging around the neck. Let’s dive in!
Non-Surgical Options To Tighten The Neck
Botox for Platysmal Bands
Botox treatments are a minimally invasive and effective treatment for fine lines and wrinkles. By injecting botox into the edges of the platysmal vertical neck bands every three to four months, the muscles will begin to soften and become less visible. “Botox injections can help with early neck aging, minimize visibility of the vertical neck bands, and delay the need for a face and neck lift,” says Dr. Lam. “However, in moderate to advanced neck sagging, only a facelift will help ameliorate these bands, as Botox will prove ineffective to manage this more pronounced sagging.”
Read more about how Botox can improve your appearance (and quality of life!).
Radiofrequency Microneedle
Radiofrequency microneedling is a form of controlled skin injury that stimulates the growth of healthy new skin by using a fine needle to create micro-wounds in the skin. What separates this procedure from regular microneedling is the needle’s ability to release radiofrequency into the skin, causing additional damage and resulting in thicker, smoother skin. “For non-surgical therapies, I believe that radiofrequency microneedle can help with improving skin tone and crepiness,” says Dr. Lam.
This form of microneedling is also a common professional treatment for acne scars— but is it worth it?
Mesobotox
Mesobotox is a cosmetic procedure that uses a microneedle to inject small amounts of diluted botox throughout the face, generally in the T-zone. This treats the skin quality, like pores, texture, tone, wrinkles, and horizontal lines. “Unfortunately, most people in the United States still do not appreciate Mesobotox even though it is the most potent method of skin rejuvenation out there, is safe in all skin types, with no long-term risks, with profound long-term results, and with little downtime,” says Dr. Lam, adding that he prefers it to radiofrequency microneedle, as it achieves similar ends with less subcutaneous scarring.
Kybella
Kybella is a non-surgical injectable technique that targets fat beneath the chin. According to Dr. Lam, any kind of subcutaneous neck fat reduction is a mistake. “The problem with fullness in the neck actually does not reside in the subcutaneous plane (immediately under the overlying skin) but in the plane that is deep to the platysma muscle,” says Dr. Lam, adding that the procedure risks complications such as premature aging. This procedure exposes the underlying platysma muscle without providing any major improvement.
Other Minimally Invasive Procedures
While there are other non-surgical therapies like Ulthera, Thermage, and many more, Dr.Lam advises against these, saying they “do not provide much neck rejuvenation and can lead to unpredictable subcutaneous scarring.” While popular in the past, he says minimally invasive procedures like threadlifts can cause more harm than good.
As for laser treatments, it’s important to tread carefully. Lasers, especially any kind of ablative laser (where the skin is burned off), have a high risk of scarring due to the neck’s lack of sufficient oil glands.
Read about my experience with Vbeam laser treatment for Poikiloderma here.
Surgical Options To Tighten The Neck
Liposuction
Liposuction is a cosmetic surgery that aims to remove undesired fat from the body (and neck, too!) and is one of the most popular plastic surgeries in the world. However, Dr. Lam believes any use of liposuction to be just as problematic as Kybella.
Neck Lift and Face Lift
Neck and facelifts are specifically designed to address sagging– and they’ve come a long way. According to Dr. Lam, neck lifts are the preferable surgical option, and can be performed in isolation or combined with a facelift. Wondering if you’re a good candidate for this procedure? Dr. Lam says that those approaching or exceeding 40 years or dealing with sagging along the jawline would benefit, so long as there is no excessive neck fullness. “The way that I can easily tell if someone needs a deep neck lift is to simply pull back on the neck tissues with my fingers and if there is still fullness, then a deep neck lift combined with a facelift is the way to go,” says Dr. Lam. “However, if the sag is completely taken care of then a standard deep-plane facelift is sufficient.”
For more on this complicated procedure, see Dr. Lam’s detailed 5-part video series.
Topical Options To Tighten The Neck
While sagging is a natural (and normal!) part of aging, there are things we can do to delay it. My best advice for those looking to postpone the onset of sagging is to use sunscreen and active skincare ingredients that encourage elasticity. A daily application of SPF to your neck and face is the best way to protect your skin from the #1 cause of premature aging: the sun. I also love to use Triple Berry Smoothing Scrub at least twice a week on my neck, as physical exfoliation is really important for making it look smoother.
Procedures I’ve Done To Tighten My Own Neck
The first time I considered getting work done on my neck was after hearing about one of my client’s experiences with Botox for platysmal bands. As someone with a low amount of body fat and a 9-year history of clenching my jaw tightly while doing CrossFit, I had developed quite prominent platysmal bands myself. (Platysmal bands can be more pronounced for those like me who lift weights and make facial expressions while doing so.) While I was diligent about sunscreen and anti-aging care, these bands were still something that I felt had become unsightly with age. This led me to seek out solutions.
When I started seeing Dr. Lam, he began injecting a little bit of Botox into my platysma muscle to tighten it. However, due to my lengthy weightlifting history, the Botox wasn’t doing as much as we had hoped. It was then that we decided to go forward with surgery, specifically platysmaplasty. The procedure required an incision under the chin and I did have to go under anesthesia. Overall, I have definitely seen improvement. My platysmal bands did not entirely disappear, likely due to the fact I still lift weights and have lower body fat, but I am very happy with my results.
All in all, there are several effective surgical and non-surgical methods to rejuvenate and tighten the neck, such as Botox, radiofrequency microneedling, Mesobotox, and neck and facelifts. Now which one is right for you? That’s something that will depend on your individual anatomy, age, lifestyle, etc. For my active lifestyle and low body weight, that meant platysmaplasty. It’s important to research your surgeon and find someone who will steer you in the direction of the best-fit procedure for you– even if that means abstaining from procedures entirely due to budgetary restrictions, problematic procedures, or limitations in desire for surgery.
Next, find out why your sunscreen is pilling (and how to prevent it!).
Celebrity Esthetician & Skincare ExpertAs an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Her hands-on experience as an esthetician and trusted skin care expert has created a real-world solution — products that are formulated for nine different types of skin so your face will get exactly what it needs to look and feel its best. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”
