thumbs_85438-SkinTighteningNecklift.jpg.690x368_q100_cropWhen it comes to tackling the signs of aging, you have to look at the problems that exist—loose skin, a loss of volume and textural changes. “Fillers and injectables and surgery are not substitutes for one another. If the skin needs to be redraped, you need surgery. A filler can do a lot of things but it can’t ever get rid of loose skin,” says New York plastic surgeon Douglas M. Monasebian. MD. He adds it’s important to be educated on the rejuvenating modalities available. “Factors like recovery, risks and expenses need to be considered, too.” When comparing fillers, lasers and surgery, the price tag associated with each can be quite different, ranging froma few hundred to a few thousand dollars, if not more. Fillers and injectables are the most affordable option; lasers fall between fillers and surgery; surgery is the most expensive option.

Choose skin tightening treatments if you have minimal looseness in the neck area: Different from a true laser but often labeled as such, skin-tightening devices like Protégé ELITE (relies on radio-frequency energy) or Ultherapy (uses ultrasound energy) work to tighten loose skin by stimulating collagen at the dermal layer.“They don’t resurface the texture of the skin but instead cause new collagen to be created by deeply heating the underlying layers of the skin with energy like ultrasound or radio frequency,” says New York plastic surgeon Z. Paul Lorenc, MD. “The existing collagen is injured and reorganizes itself as part of the healing process. As it does this it tightens the skin to some degree.”

What it can’t do: Correct textural issues; give the same end result as what can be accomplished with a facelift or necklift

What it can do: Create new collagen, which, in turn, lends a smoothing and tightening effect; can also be used to correct slight looseness in the cheeks and eyelids

Choose a necklift if you have moderate to extreme laxity and sagging in the neck area: A smooth, long neck is a quintessential characteristic of femininity. But with time, the neck loses its elastic support and the muscles become lax. “If we are concerned as to how the neck line is defined, surgery may be the best option to correct it,” says Houston facial plastic surgeon Cecil Yeung, MD. During the procedure, neck muscles are tightened up and extra skin is trimmed away. If extra fat is also a problem, it can be removed.

What it can’t do: Improve skin quality

What it can do: Restore definition to the lower part of the face; reduce banding in the neck

Combination therapies, in which doctors use a mix-and-match approach to rejuvenation, are important. “You almost always have to use lasers, skin care, neurotoxins, fillers and surgery together for the best results. For total rejuvenation I often recommend that several different procedures be done,” says Largo, FL oculoplastic surgeon Jasmine Mohadjer, MD. While you can get good results with just surgery, a laser or fillers alone, using them in tandem may create better results. “Surgery works to first rebuild the structure and foundation of the face so we know how much filler needs to be added to restore the lost volume,” says Beverly Hills, CA plastic surgeon Davis Nguyen, MD. A good ongoing skin-care program is the true icing on the cake.