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When I button my shirt I notice the skin on my neck is extremely loose and appears to bunch together at the tie-line (where the tie is). Crepey skin. What can be done?

Question posted by Concerned about neck from Toronto

I am a 54 year old male I have not had this issue in the past and have not had surgery on my neck. I have not had a change in weight.

Recently I noticed that the skin on my neck is quite loose and, in particular, when I button my shirt at the tie-line, the skin bunches together (no the shirt is not too tight).

What can be done about this? Note: I do not have oily or dry skin and am of average weight.

To clarify – these are vertical lines, not just horizontal lines.

Doctor's Response

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One thought on “When I button my shirt I notice the skin on my neck is extremely loose and appears to bunch together at the tie-line (where the tie is). Crepey skin. What can be done?

  • Dear Neck,

    It is very common for patients to present to my office in their 50s with this complaint.  As we age our skin undergoes loss of collagen and elasticity with increase propensity to wrinkles and crepiness.  Although you have not had a lot of weight loss this is a common precipitant to your problem.  Normal aging can result in laxity of the neck and when tight neck collars are done up this can result in a bunching or gathering of the skin that looks old and unattractive.

    The best advice is to seek the consultation of a very experienced and certified plastic surgeon with multiple techniques both surgical and non-surgical techniques to offer neck tightening and rejuvenation.  For modest neck laxity and creepiness, painless, non-surgical external skin tighteners such as radio frequency energy devices like Thermage, Forma, Exilis and Venus Freeze devices
    can be applied to the external neck once a week for 4-8 weeks.  This alone can sometimes result in adequate tightening and avoid anything invasive or even minimally invasive.  For modest or advanced crepe loose skin of the neck we will apply external fractional techniques as well as bulkating RF devices previously mentioned and devices such as fractional radio frequency energy such as the eMatrix, the Fractora may be applied together with a bulk heating RF devices to provide additional tightening.  Fractional high frequency ultrasound devices such as Ulthera can also apply additional improvement and new devices such as the Profound, which uses fractional bipolar radio frequency needle energy to tighten the skin, can provide additional therapeutic tightening.

    If external techniques are not enough and there is more than mild to moderate laxity then under the skin heating techniques can be applied.  Inserting small probes under the skin such as a Smartlipo fibre, or a Facetite radio frequency energy fibre or ThermiRF  can result in additional tightening and this could be combined with the non-surgical external techniques to provide very significant contraction without the need for surgery.

    Finally and sometimes most commonly the techniques discussed above can be combined with what I call a “mini guy neck lift” where skin is removed from behind the ear and with inside the ear for an invisible skin only neck lift combined with the heating techniques outlined above.  This mini guy neck lift results in incision and scars that are not visible and can be performed on even male patients with the shortest hair or even bald patients with no hair at all without scar visibility.

    It is fortunate for men that so many new techniques have developed and I would advise you seek the advice of an experienced and certified plastic surgeon with both non-surgical, minimally invasive and excisional techniques and experience.  All techniques mentioned above can be performed under local anesthesia and with recovery times of seven days or less for the minimally invasive and excisional techniques and very little if no recovery for the non-surgical neck tightening procedures.

    I hope this information has been of some assistance.

    For more information, please review our necklift page.

    To schedule a consultation please call SpaMedica at (416) 922-2868 or visit us at our website at and fill out an e-mail online consultation request form.  Best of luck.

    R. Stephen Mulholland, M.D.

    Certified Plastic Surgeon

    Yorkville, Toronto

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Laser Skin Resurfacing (Skin Resurfacing and Fractional Resurfacing)

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