Can lifting devices be used on the neck?

Looking at a neck in profile, three things can be out of place. The skin can be thin and crepey, with fine horizontal lines and a texture like tissue paper.

There can be a pad of fat under the chin that blurs the angle between jaw and neck. And two vertical cords can stand out from chin to collarbone when the jaw is clenched; those are the platysma bands.

Energy devices heat the skin and the layer just beneath it to make the tissue contract and, over months, lay down new collagen. That helps the first problem, mild crepe and laxity.

It does a little for the second, since some devices reduce a small fat pad modestly. It does nothing for the third. Bands are muscle, and muscle is treated with a botulinum toxin or, when severe, surgery.

What a course on the neck looks like

Ultrasound treatment of the neck is usually a single session, with the result judged at three to six months as collagen builds.

Radiofrequency and radiofrequency-microneedling are usually a series of three or so sessions, a month apart, again judged months after the last one.

The treated skin looks pink and slightly swollen for a day or two; microneedling versions leave a grid of tiny marks that fade over a few days.

The result, when it comes, is a tightening of the skin envelope: a cleaner line under the jaw, fewer horizontal creases, less of the bunching that shows when the chin drops. It is not a lift in the surgical sense.

A reader who wants to see how modest the change is can compare published before-and-after sets taken in the same profile view, which is the only view in which the neck can be judged fairly.

Where it goes wrong

The neck has less padding over its structures than the face. Nerves that move the lower lip run close to the surface along the jaw, and the thyroid sits in the midline.

Devices are set and placed to avoid these, which is one reason neck treatment belongs with an operator who does it often.

Too much energy in thin skin can leave a line of hardness or a shallow dent that takes months to soften. On deeper skin tones, some devices carry a risk of pigment change, and the settings and device choice differ.

A neck with a large fat pad or strong bands treated with heat alone produces a disappointed patient and an honest injector should say so before treating.

When the symptom matters, the practical test is the pinch. Skin that lifts away from the neck in a loose fold and settles back slowly is laxity, and heat can help. A soft mound that stays when the skin is pulled tight is fat.

Cords that appear when the teeth are clenched are bands. Most necks have some of each.

What to do next

Ask which device, what it is cleared for, how many sessions, when the result is judged, and what the operator sees as the main cause of the reader's neck laxity. Ask what happens if the cause is bands or fat rather than skin.

Run those questions across a full menu rather than one device, for instance at a practice that lists device treatments alongside injectables and thread lifts, and apply the same test wherever you book.

Plan the session for a day without travel.

The desk has heard from readers who booked a neck treatment before a flight and found the tightness and swelling uncomfortable in a plane seat; the terminal guides at LAWA are useful for many things, but not for that.

And expect a short drive home; a reader coming from a Westside address served by the City of Culver City to a mid-city practice is fine to drive after most device treatments, but not after one that used sedation.

How the desk checked this answer

The desk read the indications for the main ultrasound and radiofrequency systems, the American Society for Dermatologic Surgery's patient pages on non-surgical tightening, and consent forms that name the neck. All describe the neck as treatable and all describe the change as gradual and moderate.

What the desk cannot know is the reader's mix of skin, fat and muscle, which only a hands-on assessment in profile can sort out.