Monthly Archives: March 2015

Neck Rejuvenation


* Individual results may vary. Refer to disclaimer below.

I’m 55 years old and starting to see loose hanging skin on my neck just like my mother had. What can I do to avoid having a turkey neck? Are there any non-surgical options? Thanks! Deb C.

Thanks for the question Deb, I hear this exact story quite frequently from my patients. Neck rejuvenation is one of my specialties so I certainly can help you. I see all ages of patients, both men and women, coming to me with neck concerns. Some people are born with beautiful necks and jawlines, others are not. Unfortunately the aging process takes its toll on everyone’s neck and is difficult to hide. Before we talk about treatments, it is important to first understand what causes your “turkey neck”.

Our anterior neck (the part we see in the mirror) has three main components: skin, layers of fat, and a thin muscle called the Platysma. The Platysma wraps around our anterior neck, covering the vital structures and giving our neck its shape. It has a natural split in the middle. As we age the muscle becomes loose and begins to hang. The split widens and gives the appearance of two hanging folds of skin in the front of our necks. This is called Platysmal banding, but most patients will refer to it as their “turkey neck”. Many people incorrectly believe their skin is the culprit, but actually it’s the underlying muscle that is loose and the skin is just along for the ride.

The fat pads below the chin in the neck can also be a part of the problem. In some people these fat pads are overly large, independent of body mass index, and can exacerbate the hanging skin and/ or blunt neck and jawline definition.

Finally we get to the skin. Like the rest of our body, the skin covering our neck will become thinner as we age and more prone to wrinkles. Unfortunately the skin of our neck is thinner to begin with and constantly exposed to UV photo damage. Many of us remember to put sunscreen on our faces, but forget about our necks. And so the neck skin does become loose and wrinkled with time and accumulates dyschromia (light and dark spots).

Now let’s discuss treatment options. For those of you looking for a quick fix I’m afraid there isn’t one. As I explained above, the aging neck involves skin, fat, and muscle, so attempting to treat the skin only will lead to sub-optimal results. Believe me, I have 5 lasers, IPL’s, chemical agents, neuromodulators, Coolsculpting, and liposuction at my disposal, and I can tell you- they will not help an aging neck. Non-invasive technologies such as ultrasound (Ultherapy) or radio-frequency (Thermage) claim to tighten skin, but results are inconsistent and the results are often temporary. Topical creams can improve the appearance of the skin by balancing skin tone and diminishing fine lines, but they will not correct your aging neck. As a biochemist and principle investigator for a cosmeceutical company I can tell you botanical extracts can and do have a role in supporting healthy skin, but they will not help a “turkey neck”.

The good news is there are several minimally invasive neck lift procedures that have outstanding and long-lasting results. Some can even be done under local anesthesia in our office. I remove any excess fat if present, tighten the loose muscle and fix the midline separation. Lastly I surgically tighten and remove excess skin as needed, but often, when we fix the underlying issues, the skin conforms to the youthful neck shape and minimal skin removal is actually needed. Recovery time is just a couple of days and the results last for many years. Visit my before and after gallery at to see actual patient neck lift results. Thanks for the question. Dr. C

About brown spots

And now a word from our skin care nurse Helene Taylor:

How can I get rid of these ugly brown spots on my face and hands?
What causes brown spots ?
Hyperpigmentation is of the most common tale tell sign of aging skin. Sometimes these ugly brown spots “age spots“ but the formation of these ugly spots actually have nothing to do with the aging process at all. Look at the areas of the body with the least exposure to the sun such as our buttocks and breast, these areas are a good indicator of how your skins naturally ages . Aging skin will sag and the epidermis ( top layers of skin) will begin to thin. Wrinkles and hyperpigmentation are not part of the natural aging process of our skin. This damage to the skin is known as photodamage and is due to our lifestyle choices, mainly overexposure to the sun for a prolonged period of time. When we ask clients about their sun exposure. The usual response is that they wear sunscreen at the beach. This is a big misconception of what truly causes the photodamage to our skin. The truth is the majority of your damage is caused by the UVA ray exposure on a daily basis, in all weather conditions all year long. We educate our clients that the best defense against the aging process is sunscreen every day.
How is hyperpigmentation treated ?
There are several modalities of treatments for these ugly brown spots depending on the size and color of the spot. Clients that present with a light brown diffuse spot on their face and hands usually have good results with just a home care regimen. They are started on a regimen of prescription grade Retin A and Hydroquinone 4% and usually have a clearer complexion within 2 weeks after starting treatment. For moderated amount of hyperpigmentation and some fine lines we recommend a series of medical- grade peels administered by a nurse, spaced one month apart to remove the skin’s upper layers where the brown cells cluster. A prescription grade skin care is also recommended for homecare.
Clients with dark and more pronounced hyperpigmentation we recommend IPL (intense pulse light). A series of 1 to 6 IPL treatments are needed to obtain optimal results. IPL (intense pulse light) penetrates the skin to break up clusters of red and brown pigments. The clusters then slough off the skin’s surface revealing healthier skin. There is virtually no downtime with this treatment and you will be able to return to work the next day. For patients with severe hyperpigmentation and deep wrinkles the best treatment plan is a series of TCA peels which is administered by a doctor and can require a week downtime.
Long term treatment plan
Once the photodamage is reversed and your skin returns to a healthy state you must then begin a maintenance program with a medical grade skin care line for life. The skin is the biggest organ of your body and like your other organs, as it ages it requires medical treatment. Your skin care regimen for home should include a prescription grade skincare line that includes retinols, vitamin C , hydroquinone, glycolic acids and a daily sunblock with zinc ( 7% or higher). It is possible to get rid of these ugly age spots but it will take time, a comprehensive homecare treatment plan and most of all the clients compliance with changing their lifestyle and avoiding the sun.