Reflections for Ulthera.
Reflections for Ulthera.

Small crow’s feet on the outer edge of the eyes or accentuated laugh lines are signs of aging that you likely notice, and perhaps fixate on. Although these minor features can easily go unnoticed by others, this may not be the case for sagging neck skin.

Wobbliness under the chin. Turkey neck. Jowls. Whatever you want to call them, they’re one of the most obvious tells of a man or woman’s age.

“The front of the neck is one of the primary features we use to guess a person’s age. It often catches our eye first,” said cosmetic surgeon Rod Rohrich, of the University of Texas Southwestern Medical Center. “Sagging neck skin is the telltale sign of true aging, so restoration of the neck is an important part of facial rejuvenation or facial plastic surgery.”

Signs of aging on the neck include a banding pattern, extra fullness or wrinkles, which can be made even worse if you happen to have a smaller chin. Moreover, unavoidable head movements and the position that you sleep in can cause the skin around the neck to sag and lose shape.

When neck creams and strengthening exercises can’t reduce the appearance of a wrinkly neck, you may start to think about other cosmetic procedures.

“The key is to identify the underlying problem,” explained Dr. Rohrich. “Is it wrinkles, or is it only deep lines that bother the patient? Maybe it’s just sagging skin, but not wrinkles. Perhaps the problem is both the skin and fat. Or, it could be all three: skin, fat and muscle.”

If the problem is little more than deep lines, Botox or fillers like Restylane may lead to a younger-looking neck. For a fuller-than-desired neck, laser liposuction can prove a slimmer neckline.

Another option is a relatively new procedure called Ulthera, which uses gentle sound waves to stimulate collagen production and perk up underlying neck tissue. Since the treatment can lead to higher levels of natural skin-firming collagen, results look natural and can last a long time. Moreover, it requires no incisions or injections, which means no scarring.

Ulthera may also be a viable option for people who want a mild eyebrow, face or buttock lift, as well as those who experience unwanted sagging of the skin around the knees.

Medical Director at

Dr. Mitchell Chasin founded Reflections Center for skin & body as a place where physicians specializing in cosmetic medicine could focus on helping empower patients to feel their most beautiful. Dr. Chasin believes strongly that the best cosmetic physicians are those who are dedicated to mastering their craft through continuing education and collaboration with the industry’s top doctors.

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