As we age, many changes occur throughout the face and body. These changes occur anatomically at different depths and locations. However, they are all linked together. In the face aging manifests itself in multiple ways including lines, wrinkles, and sagging in the cheeks, jawline, and neck. What happens over time if we lose? The factors within the skin and beneath that keep the face youthful. The most pronounced telltale sign of aging in an adult person is a sagging neck.
A sagging neck can begin at a very inconvenient time but nevertheless, it will occur in almost all humans. As with all aspects of plastic surgery, the diagnosis must precede and define the treatment.
So, the saggy neck is a combination of loss of skin elasticity, accompanied by sagging of the muscle that is attached to the skin in the neck area. In other words, this unit of skin and muscle begins to respond to gravity. If there is fat beneath this unit it also will contribute to the SAG.
Sagging Neck Solutions
The gold standard for a sagging neck is a full face and neck lift with muscle tightening and treatment of the fat if it is a factor. This operation when performed properly and on the right patient will turn back the clock, tighten the muscle, eliminate the extra skin, and deal with the fat as needed. None surgically there are less than optimal treatment methods to tighten skin. Radiofrequency, micro kneeling in conjunction with other energy-producing treatments to the face may be of value.
Some practitioners use filler, PRF, lasers, appeals, and threads to address minor facial sag. These modalities have very limited effect on a major sagging neck. The downside for a major facelift is that it is a several-hour operation usually performed under general anesthesia. However, over time this will remain the gold standard for the major sagging neck.
The nonsurgical modalities may be of greater benefit for minor neck sagging. That said there is no substitute for surgical treatment of the face and neck if the patient is a candidate.
THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
