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What are you doing about your sagging neck?

As we age or as our weight fluctuates, our skin loses elasticity and becomes loose. Often times this is seen as a bulking or a thickening around the lower face and neck. This is also known as the dreaded double chin. There’s also a huge market for neck creams, rollers, and slings for people who are desperate for a solution to the gobble wobble. Many of these lotions and devices are simply hog wash and do not work in the slightest. Don’t get discouraged, as there are some treatments that do work. Here are a few examples of non-invasive, non-surgical techniques that actually work to get a better neckline.

Radio Frequency Skin Tightening

RF tightening works by emitting low level energy waves that specifically target the collagen in your skin. The energy waves will selectively heat up the skin tissue and stimulate the production of collagen. This will rejuvenate the skin and add elasticity to help pull your skin back into its more youthful position. This treatment is ideal for anyone who is of moderate BMI and doesn’t have a huge amount of neck fat. This treatment works best in a series and will require a maintenance appointment every 6 months to prolong your new tighter neck and jawline. The procedure is painless and has no downtime. Each treatment takes approximately 30 minutes for the entire lower face and neck. 


For someone who has fat bulk under the chin and in the neck area, Kybella can be a true savior. Kybella is a form of permanent fat reduction. The multiple tiny injections of this medication will cause a permanent destruction of the fat cells in the area under the chin. You will experience a heat and tenderness in the area immediately after and for the first day after treatment. You will also notice an initial swelling of the treated area as your fat cells are destroyed and your body starts its inflammatory reaction. It takes anywhere from 5 days to 2 weeks for the destroyed fat cells to be completely cleared from the area. Drink plenty of water and remain active after treatment, but you may immediately return to your normal activities. Most patients require 2 to 4 treatments to achieve satisfactory results.

Micro-needling with PRP

The hottest treatment in aesthetics right now is the Vampire Facial, which is the Instagram name for micro-needling with PRP. While this treatment is used for many purposes such as scar revision and pore refinement, the results that are getting the most traction on social media are the skin tightening and smoothing effects. One treatment of Micro-needling with PRP is producing such dramatic results that celebrities and Instagram Influencers are raving all over the internet about their success. The ideal candidate for this treatment has overall good skin health, but may have some loose skin and crepiness or a rough texture due to scarring or clogged and wide pores. Scarring takes multiple treatments to achieve desired results, but minor skin texture corrections can be achieved in just one. Once desired results are achieved, yearly treatments are recommended to maintain skin tightness and smooth texture.

So what is It? 

Your own blood is drawn with sterile techniques and then spun in a centrifuge to produce your own unique and personal PRP (Platelet Rich Plasma). Your face is numbed and then the micro-needling pen painlessly creates micro channels into your skin. These micro channels are a means of bypassing our skin’s natural protective outer layer all the way down to the middle layer which is where the collagen and elastin are formed. Your PRP is rubbed onto your fresh micro channels and then re needled to ensure penetration into the middle skin layer. This process will allow your own body’s natural healing capabilities to stimulate collagen and elastin. The immediate post-procedure effects are redness and tightness similar to a sunburn. With the aid of post-procedure care, the redness and inflammation will be much improved in 24 hours and you can return to your normal activities with tinted physical sunscreen coverage. Over the next two weeks your skin will become much smoother and tighter. 

The most effective facial aesthetic treatment plans utilize a combination of many methods to achieve the most profound results. All three of the above mentioned methods (Radio Frequency Skin Tightening, Kybella, and Microneedling with PRP) can be used in combination to maximize the effect of lower face and neck rejuvenation 

Here are a few sample treatment plans:

Judy R.

Judy R. is a 54 year old female with healthy weight and BMI. She has noticed crepiness on her neck and these two vertical bands that she calls her “turtle neck”. She had some sun damage from her youth but had several IPL photofacials about 5 years ago. After the IPL photofacials she did clear away the sun spots but she also noticed that her skin got tighter and the crepiness was improved. But overtime, the crepiness has returned. She has no upcoming special events and she spends minimal time in the sun and wears daily sunscreen.

Treatment Plan:

5 sessions of radio frequency skin tightening to the entire face and neck area.

One treatment of microneedling with PRP

Botox to loosen the vertical neck bands (Platysmal Bands)

Photo Courtesy of Age Perfectly

Maintenance Plan: 

Daily physical sunscreen and hyaluronic acid serum each night

Monthly Customized facial with alternating hydrating serum, dermal infusion, and dermaplaning

1 session of radio frequency skin tightening every 6 months

1 treatment of microneedling with PRP once per year.

Botox to the vertical neck bands every three months.

David D.

David D. is a 45 year old male. He is in good shape, goes to the gym regularly, and eats a healthy diet. He has always been conscious of his profile, neckline, and jawline. Despite how fit he is and all the exercise that he does, his neck has always been his trouble spot. He tried wearing beards and goatees as a young man to hide his double chin, but now with his job, he cannot wear facial hair. David currently has no skin care routine besides daily shower and shave, and he does not wear daily sunscreen. 

Treatment Plan:

4 sessions of radio frequency skin tightening to lower face and neck spaced 2 weeks apart

4 treatments of Kybella spaced 6 weeks apart. 

4 syringes of HA filler to the chin and jaw

Photo Courtesy of Dr. David Mabrie

Maintenance Plan:

Daily sunscreen, and cleansing routine with enzyme cleanser, toner, and retinol

1 session of radio frequency skin tightening every 6 months

HA Filler maintenance once a year ( 1-2 syringes per year)

Heather G.

Heather is a 26 year old female who is overweight. She has been living a healthier life style for the last year and has lost a significant amount of weight so far. She still has more weight to loose before she reaches her healthy goals. One thing that she has noticed is that her neck is not responding to weight loss. Her neck is not as full and thick as it used to be, but there is still a large proportion of fat in that area and the skin is also getting loose and sagging. She is very discouraged by the appearance of her neck and she is wanting help to see results faster in this area. 

Treatment Plan:

4 sessions of Kybella spaced 6 weeks apart.

3 sessions of radio frequency lower face and neck tightening spaced 2 weeks apart

(This patient also chooses to do skin tightening on her stomach, knees, and arms. This patient is part of the Causey Med Weightloss and Wellness program. We are also reevaluating her skin laxity at each 40lb interval of her weight loss journey)

Photo Courtesy of Clevens Face and Body Specialists

Maintenance Plan:

1 session of radio frequency skin tightening on her lower face and neck every six months

Jessie A.

Jessie A is a 30 year old female who is of healthy weight and is in the beauty industry. She has a makeup video blog and instagram page devoted to everything about makeup, skin care, and hair. She is very precise about contouring her makeup and has perfected her selfie pose. Her main objective with contouring and posing is to hide her double chin. She has an extensive beauty and skin care routine, but it changes frequently as she trials new products and beauty enhancement treatments. She is interested in a more permanent solution for enhancing her beauty and confidence.

Treatment Plan:

1 treatment of microneedling with PRP

2 syringes of HA filler along the jawline

(This patient also opted for botox for the full upper face and filler in the cheeks and tear troughs, she also chose eyelash serum)

Photo Courtesy of The Manse Clinic

Maintenance Program:

1 treatment of microneedling with PRP once per year

1-2 syringes of HA filler per year along the jawline

Consistent skin care routine including enzyme cleanser, toner, moisturizer, and vitamin C serum.

(Upper face maintenance consists of botox every three months and re apply filler to cheeks and tear troughs every one to two years, replenish eyelash serum every 3 months to maintain length and fullness)

NOTE: All patients are real life patients of other physicians and used by Causey Med Aesthetic as solely hypothetical patient summaries. Your results may vary.

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