Nonsurgical Facelift & Necklift

Dr. Melanie Palm is a nationally recognized dermatologist and cosmetic surgeon specializing in nonsurgical options for facelifts and necklifts with skin tightening procedures. Her offices are located in Solana Beach, CA just north of San Diego. Dr. Palm lectures nationally on neck rejuvenation and facial rejuvenation and is a clinical investigator, speaker, and thought leader for multiple laser, device, and injectable filler manufacturers. She offers many effective treatment options for enhancing the chin, jawline, and neck.

Skin Laxity in the Aging Face & Neck

In many of us, characteristic anatomical changes begin to appear on the face and neck and signal an aging appearance to the skin and supporting structures below including the fat, connective tissue, muscles, and even bone. These changes with time may be seen as skin sagging, often referred to in medical terms as skin laxity. Many times, it is a combination of lack of support from deeper structures, loss of volume in the face and neck, as well as aging changes in the skin including a loss of elasticity that leads to a saggy appearance along the jawline, lower face, and neck.

Characteristic facial and neck changes with skin laxity that can be addressed with nonsurgical options include the following:

  • Droopy eyelids
  • Sagging eyebrow
  • Appearance of jowls on lower face
  • Loss of a sharp, well demarcated jawline
  • Crepey skin texture on neck
  • Vertical bands on neck, accentuated with clenching teeth
  • Horizontal “necklace” lines running along the neck
  • Prominent salivary glands below jawline
  • Loose skin on the neck

Nonsurgical Skin Tightening Treatment Options for the Face & Neck

The choice of facial and neck rejuvenation treatment depends on the underlying cause, the anatomic location, and patient preference in terms of downtime or invasiveness of the procedure. The following treatments are commonly used alone or in combination for improving skin texture and tightening & lifting tissues on the face and neck:

  • Droopy eyelids: commonly referred to as dermatochalasis, excess skin tissue on the upper and lower eyelids can be addressed through skin tightening and restoring proper volume support around the eye. Injectable fillers such as Restylane, Restylane Refyne, and Belotero may be used to re-inflate and restructure the upper and lower eyelids. Excess skin can be addressed nonsurgically through skin tightening by either Ultherapy, Protégé Elite, or laser skin resurfacing. Botox can also be used strategically in the face to offer a nonsurgical lift to the eyebrow and eyelids. Further information on eyelid rejuvenation can be found under the Eye & Brow Rejuvenation
  • Sagging eyebrow: Nonsurgical treatment options include energy-based devices FDA-cleared for skin lifting and tightening. Ultherapy is an ultrasound device that received its first FDA-approval for a nonsurgical browlift. Protégé Elite is an RF device that provides subtle skin tightening and lifting around the eye area with a series of treatments. Botox or Dysport placed around the tail of the eyebrow on many patients also provides a nonsurgical browlift. Lastly, the brow loses fat volume over time and various injectable fillers or even fat can be used to re-inflate the brow nonsurgically. More information can be viewed on the Eyebrow rejuvenation.
  • Sagging cheek & Jowls on lower face: Jowls along the jawline often occur due to lack of proper facial support and skin laxity over time. Therefore, a combination approach may be needed.
    • Fillers: Oftentimes, adding volume to the angle of the jawline and lateral jawline and lower cheek picks up the jowl and softens its appearance. Various injectable fillers may be used for this application such as Sculptra, Radiesse, Restylane Defyne, or Juvederm Ultra Plus.
    • Skin tightening procedures: They can greatly enhance the appearance of jowls and include nonsurgical and surgical options. Instalift is an in-office procedure performed under local anesthesia. It provides support and lift of the jawline and cheek through absorbing sutures placed under the skin. Ultherapy is a nonsurgical option for skin lifting along the jawline and jowls. Finally, Accusculpt, a laser liposuction device, can be used to gently heat areas of skin laxity in the cheek and jowls to enhance skin tightening.
    • Fat removal & dissolving: modest and careful liposuction can greatly improve jowls. A nonsurgical option is Kybella, a bile acid derivative FDA-approved to treat a double chin. It may be used carefully in small doses in an off-label manner to address mild jowls.
  • Loss of a sharp, well demarcated jawline: Treatment of the sagging jawline is similar to jowls and cheek sagging. Fillers and skin tightening devices are commonly employed. A detailed description of treatment options can be found on the Defined Jawline page.
  • Crepey skin texture & Skin laxity on neck: Fine textural changes, especially along the front of the neck, and skin looseness characterize hallmark aging changes to the neck. Laser skin resurfacing, Ultherapy, and Protégé Elite are all device options to improve skin texture and lift the neck skin. Instalift placement along the jawline can also improve skin laxity along the neck. Topical treatment with neck rejuvenating creams can complement in-office procedures or be used on their own.
  • Vertical bands on neck, accentuated with clenching teeth: The platysma muscle, the muscle that covers our entire neck from the lower jaw to the collarbone, ages with time. In many of us, it creates vertical bands that are accentuated when we bite down. These bands may be softened through Botox or Dysport. Severe platysmal banding may require surgical treatment to correct.
  • Horizontal “necklace” lines running along the neck: Many of us are born with horizontal folds or wrinkles referred to as “necklace” lines along the neck. Lighter fillers such as Belotero, Vollure, and Restylane Silk may be carefully placed in the horizontal lines of the neck, greatly softening their appearance.
  • Prominent salivary glands below jawline: In thin patients and patients that have undergone a previous facelift or necklift, glands along the jawline may become more visible or appear enlarged. This interrupts a harmonious jawline. These submandibular glands may be treated with Botox or Dysport to shrink them slowly over time, improving the appearance of the jawline and neck.

A combination approach is sometimes ideal for creating a pleasing and attractive lower face, jawline, and neck. Facial and neck skin tightening procedures are often combined at Art of Skin MD to achieve the aesthetic goals of our patients in regards to face and skin laxity as an alternative to surgical options such as a facelift or necklift.

If you are looking for a non-surgical alternative for getting rid of wrinkles and lines in the San Diego area, call Dr. Melanie Palm at 858.792.SKIN (7546) to schedule your appointment.