What Causes Sagging Neck Issues?

by: Linda Robison / Facial Fitness Specialist @ ABZ

What causes a sagging neck, droopy skin, or those vertical bands often called “turkey neck” or “neck cording”? And is there a way to improve it naturally?

While things like thinning skin, gravity, sun exposure—and yes, even looking down at our phones (tech neck)—can all play a role, the biggest culprit is actually a muscle most people have never heard of: the platysma.

This muscle gets shorter, stiffer, and weaker as we age. And when it starts to break down, the neck begins to lose its support—leading to that saggy, crepey look so many of us notice over time.

This key neck muscle plays a powerful role in lifting and firming not just the neck, but the entire lower part of the face.

What is the platysma muscle?

The platysma muscle is a flat, broad muscle.

This muscle stretches across the entire upper chest, shoulders, collarbone, up the sides of the neck, under the chin and wraps across the lower whole jaw bone.

This muscle is also used to move the mouth and lips up and down and sideways. 

How Platysma Bands Age the Neck

To keep your lower face lifted the platysma muscles are essential.

The problem is this muscle starts to sag pretty early in life because it is a “floating muscle.”

A floating muscle means it's not attached to facial ligaments or bone. And, to make things worse, the platysma is naturally pulled forward by its own contraction.

Also, with age, the platysma bands become stiff and fibrous and begin to separate in the center of the neck.

This separation contributes to vertical neck bands (sometimes referred to as turkey neck, turkey wattle, or neck cording.¹), crepey skin, horizontal lines, and premature aging of the entire neck area.

All of this combined with the reduction in collagen and elastin (thinner skin) causes the look of a sagging neck.

In office & Pro treatments

Tightening & Lifting Treatments

Botox

• Tiny shots that relax tight neck muscles, especially the vertical bands some people get.

Nefertiti Neck Lift

• A special kind of Botox that helps smooth and define the jawline and neck—named after the queen with the famous long neck.

Fillers

• A gel that’s injected under the skin to add volume and reduce saggy areas.

Ultherapy

• Uses sound waves (ultrasound) to heat deep layers of skin, which helps lift and firm over time—no needles or downtime.

Radiofrequency (RF) Treatments

• Uses heat to wake up your skin’s collagen and make it firmer.

Microneedling with RF

• Tiny needles plus heat go under the skin to help tighten and smooth lines.

Thread Lift

• Very thin threads are placed under the skin and gently pulled to lift saggy areas. The threads also help build more collagen.

Neck Lift Surgery

• A real surgery where extra skin is removed and muscles are tightened. It gives the most dramatic results but takes the longest to heal.

Skin-Refreshing Treatments
These don't lift the neck directly, but they improve the look and feel of the skin, making sagging less noticeable.

CO2 Laser

• A powerful laser that removes damaged top layers of skin and helps smooth deep wrinkles and texture.

Erbium Laser

• A gentler resurfacing laser that improves skin tone and texture with less downtime than CO2.

Fractional Laser

• Targets tiny areas of skin in a grid-like pattern, leaving some skin untouched for faster healing. Boosts collagen too.

IPL (Intense Pulsed Light)

• Uses pulses of light (not a laser) to fade sunspots, redness, and uneven tone—makes the neck look clearer and more youthful.

Which neck treatment is right for you?

That really depends on how much loose skin or damage you’re dealing with.

• If you have a lot of sagging, visible neck bands, or extra fat under the chin, neck lift surgery might be the most effective option.
  These cases often need a combination of treatments—like fat removal, muscle tightening, and trimming excess skin. A plastic surgeon can help create the best plan.
• But if you have mild to moderate skin laxity, still have good muscle tone, and are in overall good health, then non-surgical office procedures (and even some at-home options) may help you tighten, firm, and refresh your neck over time.

Prefer natural options?

If you're not quite ready for in-office procedures—or just want to see what natural methods can do first—I’ve got you covered.

I was able to firm up my own sagging neck using a combination of face and neck exercises, massage, and skincare. It takes some consistency, but the results were worth it!

See exactly what I did in my Turkey Neck Rescue guide.

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FAQ: How do you lift sagging neck? 

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