The decision to undergo neck lift surgery can be a big one. Evaluating your available options can help you feel you made the right decision. The process starts by scheduling a consultation with your cosmetic surgeon who can explain all the options available to you, including neck lift alternatives.

Neck lift surgery involves the removal of fat and/or excess skin and potentially tightening the neck muscles to give off a more toned, defined appearance to your neck. The surgery typically requires about 10 to 14 days of recovery time and is associated with post-surgical bruising, swelling and some discomfort. The surgery offers the most noticeable and dramatic results when compared with non-surgical procedures, however.

The surgery is unique in that it is not an entirely anti-aging approach. Even young people can have a poorly defined chin or jawline.

“Some patients have a young-appearing face, yet loose-appearing skin under the neck,” says Chad Gordon, DO, Assistant Professor of Plastic and Reconstructive Surgery and Clinical Director of the Facial Transplant Program at Johns Hopkins Medicine. “The effect can be aging alone and likely solved with a neck lift and muscle tightening.”

Other options are available for patients who do not need as drastic of a change or are concerned about investing so much time and money into a regular neck lift procedure.

Thermage Stimulates Collagen Fibers

Thermage is a non-invasive procedure designed to tighten skin. The procedure was initially used specifically for the face, but is now used to tighten neck, stomach, knee, leg, butt and arm skin. The procedure is performed in your doctor’s office where a physician holds a wand-like device over your skin. The device delivers radiofrequency energy that penetrates your skin and stimulates the collagen fibers responsible for giving your skin a toned, tightened appearance.

While the energy pulse heats the layers under your skin, the device cools the outer layer of your skin to minimize discomfort. However, you may note some warming or pinching sensations. Each pulse takes between two and seven seconds, and your physician may take about an hour to complete Thermage on your neck. The process typically takes several applications for maximum effectiveness. However, you may notice your skin feels and appears tighter after a single treatment.

This procedure may be a good neck lift alternative if you need only a small amount of skin tightening in the neck area. If you desire dramatic results, however, a neck lift may be the better option for you.

Botox Cosmetic “Freezes” Neck Muscles

Although Botox Cosmetic is FDA-approved for the reduction of facial wrinkles, it has been used in an off-label, or not FDA-approved, fashion for reducing visible neck sagging. Botox works by temporarily “freezing” muscles, thus making skin appear smoother. This is commonly injected into the forehead to keep the muscles from appearing furrowed and wrinkled.

When used as an alternative to neck lift surgery, Botox targets the platysma muscles on your neck. These muscles originate around your collarbone and overlap before connecting in several places around your jaw, lower lip and cheekbones. During neck lift surgery, your surgeon can tighten these muscles to reduce the appearance of skin sagging.

If the platysma muscles are bunched together, this can give the appearance of skin sagging or folding. To combat this effect, a trained cosmetic surgeon can inject Botox into the muscular bands to relax them, creating a smoother effect under the neck. The neck angle may appear less rounded and more angular, giving you a more defined jawline. This also helps to reduce the appearance of creasing or wrinkling on your neck.

Botox is not for all patients. If your skin wrinkling is too pronounced, you may not experience an improvement after the injections. Also, Botox works for a limited timeframe of between three to six months. While less expensive than neck lift surgery, you will need to undergo frequent treatments to maintain your results. Ask your plastic surgeon how many of these treatments he performs on a weekly or monthly basis. When incorrectly applied to the neck, Botox may affect your swallowing.