Young Face, Old Neck? Dr. Herzog Weighs In



Today, Dr. Herzog will address the following question submitted by a Family Savvy reader.

Dr. Herzog, I see many women whose faces look smooth and youthful, but their necks look old and sagging. What can be done to prevent this?

Dr. Jo Herzog

The neck is a difficult area for us, although there are are many treatments available today for the aging face. We have previously discussed toxins such Botox and Dysport for wrinkling that comes from movement. We have discussed several fillers that minimize static wrinkles and volume loss.  We have talked about peels and lasers for tightening skin and for pigmentation problems.  So, now we have beautiful faces that look 10 years younger than our age…but what about our necks?

An old looking, sagging neck will tell the truth for some of us (as will old looking hands).  We should always have treated our neck like we did our face, but most of us did not.  Even having applied all of our facial creams and treatments to our neck would not have kept it as young looking as we would like, but it is never too late to start afresh.

We can start by using sunscreen and retinoids on our neck and hands.  The neck might be a bit sensitive, so it might be best to go slowly in this area. If we do peels and lasers on our faces, we should consider treating the neck similarly but possibly with less intensity.

Even with all of these treatments, the neck can still sag and look old.  This problem often needs individualized attention. and there are a few things that we can do to work on this area.

If you have long bands that stretch from under your chin to down your neck (platysma), they can be relaxed by injections of Botox or Dysport.  The results are variable, and the negative is that it can take a lot of product for a good effect, so this is not inexpensive. Nontheless, if this bothers you, it might be worth a try.

The hanging, fatty looking pouch under the chin (referred to by my children as a “gizzard”) can often be treated with liposuction. This removes any fat that is there, and even if this hanging is not caused by fat, the healing process causes the skin to “stick” back up under the chin more tightly.

The laser can give the neck some tightening, as can (possibly) some of the new radio frequency devices.  I have yet to find a specific one that has me seriously  impressed; however, if you have pigmentation on the neck, or you are lasering your face anyway,  a run over the neck is certainly worthwhile.

If you have severe sagging, or the above measures are not helpful to you, then I think that the best answer might be surgical. If contemplating surgery, you should choose a reputable plastic surgeon who does this often and with whom you feel comfortable.

If you do not have a plastic surgeon, you should be able to call one and expect that some of your questions about options will be explained over the phone. Do not watch a TV commercial then make a phone call (where they tell you NOTHING) and make an appointment. There should be no secrets, as this is YOUR treatment. Use a surgeon that a friend or your doctor can recommend because they know them or have used them. Remember, there are no bargains or miracle fixes to be trusted when your health is a concern.

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