ABOUT YOUR NECK – Tightening, Lifting, Transforming


Lift? Laser? Lather?    Model NeckWhat have you tried – and what can you do to improve the appearance of your neck?

As you’ve probably heard (and maybe even noticed first-hand) the neck is one of those areas with a high place on the list of “first things to go.”  We prefer to call it one of the ‘more obvious’ of those things that change over time.  And, it’s not just us.

The late, brilliant writer Nora Ephron shared these thoughts in her book “I FEEL BAD ABOUT MY NECK: and Other Thoughts On Being a Woman”:

“..Oh the neck…The neck is a dead giveaway…you have to cut open a redwood tree to see how old it is, but you wouldn’t have to if it had a neck.”

Ouch. She had a way with words, and telling the truth with humor.

What happens to our necks?  The same thing that happens to the rest of us as we age, or gain or lose weight.  And we see that part of the body more, in its natural state. The neck just seems a little harder to camouflage than other parts of the body. (Turtlenecks and scarves may not flatter everyone.)


 We, and our necks, age differently. But even very fit, toned people will note age-related changes:

Neck lift before and after

Necklift: Dr. Vincent Lepore

  • Sagging and/or loosening skin
  • A “crepe-y” appearance to the skin- in extreme cases, ‘turkey wattle’ appearance
  • Excess fat collection, double chin, jowls

It may begin as early as the 40s. Both men and women start noticing a loss of tone in the neck skin, and the skin may appear thinner. Those with excess fat, will see more effects of gravity. The skin begins to lose its elasticity, and extra fat and skin begin to ‘hang’ and form a kind of pouch. (Before & After photos below)

photo by Dr. Vincent Lepore

photo by Dr. Vincent Lepore

photo by Dr. Vincent Lepore

photo by Dr. Vincent Lepore

We also see differences in the lines in our necks. They’re deeper, and the neck muscles, now operating beneath thinner skin, may form prominent ‘bands’ especially noticeable when we speak, or move.


Help -yes. Removing excess skin -no.

Lasers, injections, and creams of varying types and intensities, can all play a role in improving the appearance of neck skin and contour.  But, if you’re noticing the loose skin, turkey neck, or banding we’ve described, you will notice a subtle result at best.


You’ve probably heard about the relatively new FDA-approved injectable treatment that dissolves fat beneath the chin. The injections can dissolve fat, but do not address issues of significant loose, sagging skin. The treatment involves multiple injections at the site of the extra fat (think of a grid beneath your chin) during one session or more. The information you should remember about the fat-dissolving injections: Improvement for moderate to light excess fat in the neck.  Does not address significant skin laxity, “turkey neck” appearance, or sagging.

(We will look at double chins and treatments, in another blog.)


Back to Ms. Ephron’s thoughts for a moment. In her view, “..short of surgery, there’s not a d**n thing you can do about a neck..”

We won’t go quite that far, but, surgery will produce the most dramatic results for the problems we’ve been discussing.

photo by Dr. Vincent Lepore

photo by Dr. Vincent Lepore

photo by Dr. Vincent Lepore

photo by Dr. Vincent Lepore

  • Neck Lift may be performed as a single procedure, or with a Face Lift.

This is something to think about, and to discuss with your Board-Certified Plastic Surgeon. Will Neck Lift surgery alone produce the results you want, or will you be best-served combining the procedure with a full, mid, or lower Face Lift?

Your surgeon will explain the procedures, the muscle/skin relationships between neck and face, and what would produce your best result.


The incisions that are used, will depend on your particular needs and your individual goals. Traditionally, neck lift incisions are made in the hairline, some more extensive than others. And, a separate, small incision may be made beneath the chin, if Liposuction is being performed to remove fat. During your surgery, excess skin is removed and tightened, along with excess fat. Your doctor may also repair or resect muscles in your neck.

Neck Lift patients note a significant improvement. A more youthful, tighter appearance is restored to the neck.

And, with a nod once again to Ms. Ephron, the reasons for feeling “bad” about at least one thing in life, are removed.

[Dr. Vincent Lepore is a Board-Certified Plastic Surgeon in San Jose, performing Neck Lift and Face Lift for patients throughout the Bay Area. Please call (408) 356-4241 to schedule a free Cosmetic Consultation.]


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