Neck rejuvenation: the best treatments for neck laxity, banding, and double chin

The neck is one of the earliest and most noticeable areas to show aging, yet it receives far less attention in aesthetic planning than the face. Neck concerns generally fall into three categories — and each requires a different approach.

The three main neck concerns

1. Submental fat (double chin): Fullness under the chin, from genetics or weight.

2. Platysmal banding: Vertical cords that run along the front of the neck, caused by the platysma muscle (a thin sheet of muscle under the neck skin) becoming more prominent as it weakens and loses adherence to the underlying tissue.

3. Skin laxity and crepiness: Loss of collagen and elastin creates loose, textured, or "turkey neck" skin appearance.

These often occur together, but they have different causes and optimal treatments.

Treatments by concern

Submental fat (double chin)

Kybella (deoxycholic acid): FDA-approved injectable that destroys fat cells under the chin. 2–6 sessions, each with 1–2 weeks of significant swelling. Appropriate for patients with moderate submental fat and good skin elasticity. See our Kybella guide for full details.

CoolSculpting (CoolMini applicator): Cryolipolysis for submental fat. Less swelling than Kybella, 1–3 sessions. Similar overall cost and outcomes.

Surgical liposuction (submental): Single session; $3,000–$6,000; 1–2 weeks downtime. Most effective option for larger fat deposits; also allows tightening of deeper tissue layers.

Important: Submental fat reduction alone in patients with poor skin elasticity may make laxity more visible (removing the volume support exposes the loose skin). Providers should assess elasticity before recommending fat reduction.

Platysmal banding

Botox / Dysport ("Nefertiti lift"): Injections into the vertical platysmal bands relax the downward pull of the platysma, softening the appearance of bands and providing mild elevation of the lower face and neck. 20–60 units typically needed. Effect lasts 3–4 months.

This is the primary treatment for visible platysmal bands. It doesn't eliminate them (they're structural), but it reliably softens their appearance.

Cost: $200–$600 per treatment (varies by units used and provider).

Neck skin laxity

Ultherapy (HIFU): Targets the platysma layer (SMAS) at 4.5 mm depth — the same layer a surgeon would address during a neck lift. Stimulates collagen production and achieves mild tissue lifting over 3–6 months. The gold standard non-surgical option for neck laxity.

Cost: $1,000–$3,000 for the neck; full neck + face treatment: $2,500–$5,000.

Thermage FLX (body applicator for neck): RF surface heating that tightens skin without needles. Less depth than Ultherapy; appropriate for mild laxity.

Cost: $1,500–$3,500 for the neck.

RF microneedling (Morpheus8): Combined microneedling and RF can address neck skin texture and mild laxity. 2–3 sessions; appropriate for texture + mild looseness.

Surgical neck lift: For significant laxity, platysmal banding, and skin excess, a surgical neck lift produces results that non-surgical devices cannot replicate. Recovery: 2–3 weeks. Cost: $6,000–$15,000.

Combination approaches

Neck rejuvenation is often best addressed with multiple modalities simultaneously:

Submental fat + skin laxity:

Kybella (fat) + Ultherapy (skin tightening) — combined in the same session or staged 6–8 weeks apart
Note: treating fat first, then addressing skin, is often preferred — seeing the final fat-reduced result helps assess remaining skin tightening needed

Platysmal bands + neck laxity:

Botox (bands) + Ultherapy or Thermage (laxity) — complementary; Botox relaxes the muscle, energy devices address the skin

Full neck + lower face package:

Ultherapy full face + neck is a common combined treatment addressing both areas simultaneously

Prevention and maintenance

The neck is notably thin-skinned and often neglected in skincare routines. The same SPF and retinoid regimen applied to the face should extend to the neck. Daily broad-spectrum SPF 30+ prevents accelerated photodamage. Retinoids (tretinoin or OTC retinol) applied nightly to the neck improve skin quality over time.

Many patients who maintain Botox for their face benefit from extending Botox to platysmal bands on the same schedule.

Realistic expectations by concern

Submental fat: Significant reduction achievable with Kybella or CoolSculpting (2–6 sessions) or single surgical session. Most dramatic non-surgical results.

Platysmal bands: Softened and less visible with Botox; not eliminated. Reassess every 3–4 months.

Skin laxity: 15–30% improvement with Ultherapy in ideal candidates (mild-moderate laxity). Moderate laxity sees noticeable improvement; severe laxity requires surgery.

Questions to ask your provider

Which of my concerns is most prominent — fat, muscle banding, or skin laxity — and which treatment do you recommend first?
If I treat the submental fat, will the remaining skin be tight enough, or do you recommend adding a tightening treatment?
For my level of laxity, is Ultherapy or a surgical neck lift the more appropriate investment?
What Botox protocol do you use for platysmal bands, and how many units do you typically need?
Should I extend my current facial filler protocol to the neck, or are energy-based devices more appropriate here?

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