Turkey Neck

Turkey neck is more than loose skin under the jaw.

It encompasses vertical bands caused by the platysma muscle, horizontal creases, soft tissue laxity in the submental region, and sometimes fat accumulation beneath the chin. Over time, these changes soften the jawline, exaggerate jowls, and create a visually aged appearance, even when the face itself remains relatively youthful.

It is important to distinguish between turkey neck caused by skin laxity and muscle activity versus changes due to volume loss or fat redistribution, as these factors determine the optimal treatment strategy.

The development of turkey neck is multifactorial, combining ageing, genetics, environmental exposures, and lifestyle factors.

Ageing and Collagen Loss
As we age, the skin loses its natural collagen and elastin, reducing firmness and elasticity. This decline leads to skin laxity and crepiness, which is often most noticeable in the neck because of its thin dermis and lack of supporting fat. Bone and soft tissue resorption in the jawline further exaggerates sagging.

Platysma Muscle Banding
The platysma muscle runs from the jawline down the neck. Over time, it can form vertical cords or bands, creating the horizontal or vertical lines often seen in turkey neck. Overactivity of these muscles can also pull the skin downward, contributing to a drooping appearance.

Genetics
Genetic predisposition influences the rate at which the neck develops sagging or bands. Some individuals naturally have less skin elasticity or thinner dermal layers, making them more susceptible to early turkey neck.

Sun Damage
Chronic UV exposure accelerates collagen breakdown, leading to thin, wrinkled skin. Sun-damaged neck skin is prone to crepiness, fine lines, and pigmentation changes, all of which worsen the appearance of a turkey neck.

Weight Fluctuations and Fat Redistribution
Significant weight loss can leave excess skin that sags, whereas repeated cycles of weight gain and loss stretch the skin and reduce its ability to recoil, exacerbating laxity.

Posture and Lifestyle Factors
Forward-head posture can put constant tension on the neck skin, contributing to sagging over time. Combined with a sedentary lifestyle or poor muscle tone, these factors can make turkey neck more pronounced.

While genetics cannot be changed, proactive care can slow progression and maintain neck quality:

• Sun Protection: Daily SPF 30–50, alongside scarves or UPF clothing, helps prevent collagen degradation.
• Topical Skin Care: Retinoids, peptides, and antioxidants support collagen production and improve elasticity. Hydrating ingredients like hyaluronic acid and ceramides maintain plumpness.
• Muscle and Posture Awareness: Exercises to strengthen postural muscles and avoid forward-head posture reduce mechanical stress on the neck.
• Healthy Lifestyle: Avoid smoking, maintain stable weight, and consume a collagen-supportive diet rich in vitamins and protein.

Effective treatment addresses skin laxity, muscle bands, volume loss, and texture, often through a layered, combination approach.

1. Endolift®

Endolift® uses laser energy beneath the skin to remodel tissue, tighten lax skin, and restore neck contour.

• Mechanism: Micro-optical fibres deliver laser energy to subcutaneous tissue, stimulating collagen remodelling and tightening.
• Benefits:
  • Tightens sagging skin and smooths platysmal bands.
  • Improves lower-face and jawline contour.
  • Minimally invasive with gradual, natural results.
• Procedure Details: Outpatient treatment with local anaesthetic; mild swelling or redness may last a few days; results develop over 4–6 weeks.
• Ideal Candidates: Patients with mild to moderate skin laxity or submental soft tissue heaviness; best combined with Profhilo® or fillers.

2. Dermal Fillers

Dermal fillers are highly effective for restoring structural volume lost due to ageing or thin neck tissue.

• Mechanism: Hyaluronic acid-based fillers are injected under the skin to replace lost subcutaneous volume. This lifts sagging tissue, smooths shallow hollows, and supports overlying skin.
• Benefits:
  • Softens fine lines and shallow creases.
  • Restores jawline and submental contour.
  • Masks underlying bony structures accentuated by thinning skin.
  • Supports skin from underneath, indirectly reducing mild sagging.
• Procedure Details: Local anaesthetic used with small cannulas or needles; sessions last 30–45 minutes; minimal downtime with slight swelling or bruising.
• Ideal Candidates: Patients with volume loss or shallow hollows but good skin quality. Not ideal alone for severely lax or crepey skin.
• Duration & Integration: Results last 12–18 months; often combined with Profhilo® or Endolift® to optimise both volume and skin quality.

3. Nefertiti Neck Lift (Botulinum Toxin)

The Nefertiti Neck Lift relaxes downward-pulling fibres of the platysma muscle, reducing vertical neck bands and subtly lifting the jawline.

• Mechanism: Precise botulinum toxin injections along the jawline and platysma reduce muscle overactivity, softening cords.
• Benefits:
  • Smooths vertical and horizontal neck bands.
  • Improves jawline and lower-face contour.
  • Non-surgical with minimal recovery.
• Procedure Details: Outpatient treatment lasting 10–15 minutes; results visible in 1–2 weeks; effects last 3–4 months, with repeat treatments maintaining results.
• Ideal Candidates: Patients with platysmal bands and mild sagging; works best combined with skin quality treatments for full rejuvenation.

4. Profhilo® Body, Skin Boosters & Polynucleotides

These treatments target hydration, elasticity, dermal structure, and texture, making them essential for treating crepey or thin neck skin.

Mechanism:

• Profhilo® Body & Skin Boosters: High-concentration hyaluronic acid spreads through tissue, improving hydration while stimulating collagen and elastin.
• Polynucleotides: Improve skin thickness, repair pathways, and regenerative activity—ideal for fragile or thinning skin.

Benefits:

• Improve elasticity, firmness, and smoothness
• Reduce fine lines and crepiness
• Enhance resilience and support the results of fillers or Endolift®

Procedure Details:
Multiple microinjections with mild redness/swelling for 24–48 hours. Profhilo is delivered typically in two sessions spaced one month apart.

Ideal Candidates:
Patients with thin, dehydrated, or crepey neck skin—especially when paired with fillers or Endolift® for a multi-layered rejuvenation plan.

While non-surgical and minimally invasive treatments are highly effective for most patients, surgical options may be considered in cases of severe skin laxity, advanced platysmal banding, or significant submental fullness that cannot be addressed adequately with injectables or laser-based procedures.

1. Lower Facelift / Necklift Surgery

A necklift or lower facelift is the gold-standard surgical approach for advanced turkey neck.

• Mechanism: Excess skin is excised, underlying muscles (including the platysma) are tightened, and tissue is repositioned to restore a smooth jawline and neck contour.
• Benefits:
  • Dramatically improves neck and jawline definition.
  • Smooths deep wrinkles and platysmal bands.
  • Provides long-lasting, structural correction.
• Procedure Details: Performed under general anaesthetic; recovery typically 2–3 weeks with swelling/bruising.
• Ideal Candidates: Patients with severe skin laxity or pronounced platysmal bands who desire a permanent, structural solution.

2. Liposuction of the Submental Area

Surgical fat removal is suitable for patients whose turkey neck is primarily caused by submental fat accumulation rather than skin laxity.

• Mechanism: Small incisions allow fat to be suctioned from under the chin, improving jawline definition.
• Benefits:
  • Reduces fullness under the chin.
  • Enhances jawline contour and neck profile.
• Procedure Details: Typically performed under local anaesthetic with sedation; mild swelling or bruising for 1–2 weeks.
• Ideal Candidates: Patients with good skin elasticity but persistent fat under the chin.

3. Combined Procedures

In some cases, liposuction is combined with a mini-necklift or platysma plication to achieve both fat reduction and skin tightening, providing a comprehensive surgical solution for advanced turkey neck.

4. Fat Grafting (Autologous Fat Transfer)

Fat grafting restores volume to the jawline and submental region, providing long-term structural support and improving skin contour.

• Mechanism: Fat is harvested, purified, and injected under local anaesthetic (minor sedation if needed) into areas of volume loss.
• Benefits:
  • Long-lasting, natural contour improvement.
  • Supports overlying skin, smoothing mild sagging.
• Procedure Details: Swelling/bruising may last 1–2 weeks; full results visible after 4–6 months.
• Ideal Candidates: Patients with moderate to severe volume loss or post-weight-loss sagging.

Consult a practitioner if you notice:

• Sagging skin or soft tissue under the jaw.
• Platysmal bands or horizontal neck lines.
• Loss of jawline definition or submental fullness.

A personalised treatment plan should assess skin quality, muscle activity, fat distribution, and jawline structure. Even early interventions can significantly slow progression and maintain a youthful neck.

• Turkey neck arises from ageing, collagen loss, muscle banding, and volume changes.
• Prevention focuses on sun protection, skin quality, posture, and lifestyle.
• Multi-layered treatment plans combining tightening, lifting, hydration, and volume restoration deliver optimal results.
• Endolift®, Nefertiti Neck Lift, Profhilo®, fillers,  polynucleotides and skin boosters provide complementary benefits.

Turkey neck is highly treatable through layered, evidence-based approaches.

Treatments like Endolift® for tightening, Nefertiti Neck Lift for muscle relaxation, Profhilo® for skin hydration, dermal fillers for volume, and skin boosters for texture address both surface and structural changes. Combining these treatments delivers a smoother, firmer, and more youthful neck without invasive surgery.