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what is the best procedure for creepy
and loose neck skin when it comes to
loose skin under the neck it's important
to determine what factors are
contributing to this appearance these
factors include bone volume loss skin
quality skin quantity neck position and
even posture with so many creams devices
sutures threads and procedures claiming
to be the best solution for a loose neck
skin it can be difficult to choose the
best option that's right for you I'll
discuss how I evaluate this area for
people who come in with this concern
every day in my office
I'm dr. Amiya Prasad I'm a board
certified cosmetic surgeon and
fellowship-trained oculofacial plastic
and reconstructive surgeon I've been in
practice in Manhattan and Long Island
for over 20 years a core focus of my
practice is to help people with changes
associated with facial aging we do a lot
of skin and facial rejuvenation
procedures in our practice including
surgical facelifts neck lifts as well as
minimally invasive and non-surgical
treatments I begin with a history and
physical examination I often learned
that a patient has had previous
procedures like neck liposuction and
skin heating procedures the evaluation
is performed to determine skin thickness
the presence or absence of excess fat
the relative skin elasticity the
relative volume of excess skin the
presence or absence of platysmal bands
the extent of facial bone volume loss in
particular the cheekbones the chin the
jawline and jaw angle
the next skin is different from the skin
of the face so it ages differently the
skin in the neck is thinner than the
skin of the face and this area also
doesn't have as many oil and sweat
glands as the face in a situation of a
person in their early to mid 40s who's
had some skin laxity but not enough to
want to face or neck lifting surgery I
think what is desired is better
structural definition I always explain
to a patient that a young face is not a
tight face and an attractive face is not
an over pulled appearance it's really
about definition if the issue is skin
quality such as texture and tone then
there are laser treatments and PRP or
platelet-rich plasma which can be
helpful platelet-rich plasma is derived
from your own blood and as a
concentration of the wound healing
growth factors that stimulate collagen
and increase blood supply after an
injury PRP improves neck skin quality
and texture by stimulating collagen and
fat cells under the skin thus improving
the skin quality improving skin quality
with PRP is optimal with regular
treatment so improvement can be
maximized
we also employed different types of
lasers including fractional co2 RB m and
D AG and q-switch laser to improve neck
skin a very popular procedure now
practice is a non ablative laser toning
with the nd YAG laser the laser was able
to selectively treat the deeper layers
of skin without compromising the top
layer of skin I actually developed a
protocol where I combined PRP delivery
to the skin after laser treatment to
maximize the skin quality through
collagen stimulation radio frequency
devices such as peleve can also help
with skin toning and tightening of the
neck as well as to Indu
a similar collagen response radio
frequency devices are often employed in
place of lasers for people with darker
skin which includes olive Mediterranean
skin types
Asian skin and people with much darker
or in the brown spectrum of skin color
relative volume of skin as well as
elasticity is assessed to determine if a
minimally invasive procedure called
suture suspension may be of benefit
suture suspension is not a thread lift a
thread lift involves a placement of
barbed sutures to try to tighten skin a
suture suspension procedure involves the
placement of sutures comparable to those
used during surgery as is what's done in
surgeries such as in face and neck
lifting the suture is placed into stable
tissue to allow lifting or repositioning
of loose tissue essentially it's a deep
suture placement often used in surgery
without skin removal if you'd like to
address skin quantity or excess skin and
platysmal bands then some variation of a
facelift face and neck lift or even a
limited neck lift is considered
appropriate often laxity of the neck is
associated with laxity of the face when
a patient has loose skin under their
neck I'll show how addressing facial
sagging can also address a sagging neck
we can do sometimes a short scar
facelift procedure to be able to
accomplish quite a bit a procedure like
this takes about two hours to do under
local anesthesia with light intravenous
sedation once it's done it tends to hold
very well and can last anywhere from
five to ten years if platysmal bands are
present without excess skin in
neurotoxins such as Botox Dysport and
XEOMIN can improve the appearance of
those bands if there is excessive skin
and the participants are
relax there are different ways to modify
the platysma surgically which is done
typically during a face and necklift
procedure in our practice we do all face
a neck lifting surgery under local
anesthesia with Lite IV or intravenous
sedation this is as opposed to general
anesthesia which is often a disincentive
for many patients considering surgery
procedures performed with local
anesthesia with sedation allow for
easier recovery and allow for people to
go back to work sooner a very important
concept which is missed often is the
contribution of bone volume loss to neck
skin laxity particularly for people with
limited laxity with a decrease in
jawline definition placement of an
implant or long lasting injectable
fillers at the bone level can make a
significant impact on your appearance
when the cheeks jawline and chin are
more well-defined the relative
appearance of the skin under the neck
becomes less significant the decision to
choose a procedure or procedures to
improve the neck is dependent on proper
diagnosis and a clear understanding of
the benefits of different interventions
there is a constant evolution in what we
do and being able to perform the full
range of procedures from non-surgical
and minimally invasive to advanced
surgical procedures or a combination has
been a successful approach from my
patients in my practice I hope you found
this information helpful thank you for
your question
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