If you have noticed that the skin beneath your chin has begun to droop, that vertical cords are visible along your neck, or that your once-defined jawline has softened into a blurred silhouette, you are not alone. A sagging neck is one of the most common aesthetic concerns that patients bring to Pacific Plastic Surgery, and it is a concern that responds well to a range of carefully chosen treatments. Whether you are searching for sagging neck treatment in Vancouver, BC, exploring neck surgery in Vancouver, or simply trying to understand your options, let’s walk through everything you need to know before booking a consultation with Dr. Tregaskiss.

About Dr. Ashley Tregaskiss

MB, BS, MSc, FRCS (Plast), FRCSC

Dr. Ashley Tregaskiss is a board-certified plastic surgeon in Vancouver with over 20 years of experience and a practice increasingly dedicated to advanced facial and neck rejuvenation.

Following a decade at Vancouver General Hospital treating complex craniofacial trauma and head and neck conditions, he transitioned fully into private practice in 2024. This background provides a level of anatomical expertise and surgical precision that directly informs his aesthetic work.

His approach is defined by careful planning, technical precision, and a commitment to outcomes that are balanced, elegant, and undetectable.

What is a Sagging Neck?

The term “sagging neck” is a broad description that patients use to capture several related but distinct concerns. Understanding which of these applies to you is the first step toward finding the right solution.

Loose or crepey skin: As collagen and elastin break down over time, the skin along the neck and beneath the chin loses its ability to spring back. The result is tissue that hangs loosely and no longer conforms to the underlying structures.
Platysmal banding (“turkey neck”): The platysma is a flat muscle that runs from the chest up through the neck to the jaw. With age, the two halves of this muscle can separate and pull forward, creating the vertical rope-like cords that many patients describe as a turkey neck.
Submental fullness: Excess fat beneath the chin can blur the angle between the neck and jaw, creating the appearance of a double chin or a heavy, undefined lower face.
Loss of jawline definition: When jowls form and skin descends from the lower face onto the neck, the crisp line that once separated the face from the neck becomes indistinct, adding years to the overall appearance.

Patients often present with a combination of these issues rather than just one in isolation. That is why a personalized assessment with Dr. Tregaskiss is so valuable.

What Causes a Sagging Neck?

Several factors contribute to neck laxity, and most patients experience a combination of the following:

Natural aging: Collagen production slows in the mid-thirties and continues to decline each decade. The skin thins, loses elasticity, and gravity does its work over time.
Genetics: Some patients are predisposed to platysmal banding or to accumulating fat beneath the chin, regardless of body weight or lifestyle.
Significant weight changes: Repeated cycles of weight gain and loss, or substantial weight loss in a relatively short period, can leave the skin without enough elasticity to retract, resulting in visible folds and looseness along the neck.
Sun damage: Chronic ultraviolet exposure degrades collagen and elastin fibers in the skin, accelerating the visible signs of aging in the neck area, which is often neglected in daily sun care routines.
Muscle changes: The platysma weakens and spreads with age, and the two sides of the muscle can separate at the midline, producing the banding and cording that defines a turkey neck appearance.

Who is a Good Candidate for Sagging Neck Treatment?

Good candidates for sagging neck treatment in Vancouver, BC include adults of any age who are bothered by one or more of the concerns described above and who are in generally good health. The right treatment, however, depends heavily on the specific anatomy and the degree of change present.

Patients in their thirties and forties who have early skin laxity or isolated submental fat may be excellent candidates for non-surgical or minimally invasive options. Those in their fifties, sixties, and beyond, or anyone with more pronounced sagging, platysmal banding, or significant jowling, typically achieve far more dramatic and lasting results through surgical intervention.

During your consultation, Dr. Tregaskiss will evaluate your skin quality, muscle tone, fat distribution, and overall facial structure to help you understand which path is most likely to deliver the outcome you have in mind.

Sagging Neck Treatment Options at Pacific Plastic Surgery

Pacific Plastic Surgery offers both surgical and non-surgical approaches to neck rejuvenation. Dr. Tregaskiss takes a thorough, individualized approach, often recommending a combination of procedures to address every layer of concern at once and achieve a result that looks balanced, refreshed, and naturally your own.

Surgical

Neck Lift

A neck lift is one of the most effective surgical solutions for patients dealing with significant skin laxity, platysmal banding, or both. Dr. Tregaskiss makes discreet incisions, typically behind the ears and occasionally under the chin, through which the underlying platysma muscle is tightened, excess fat is removed or redistributed, and loose skin is carefully lifted and trimmed. Incisions are positioned in natural creases and hairlines so that scars are essentially invisible once fully healed. Recovery typically involves one to two weeks before returning to social activities, with most swelling resolved within four to six weeks.

Facelift with Neck Lift

Because the face and neck are a continuous unit, patients who have jowling, loose midface skin, or descent of the lower face alongside neck concerns often achieve the most cohesive and harmonious outcome by addressing both in a single procedure. Dr. Tregaskiss frequently combines a facelift with a neck lift to restore the entire lower face and neck in one surgery, reducing overall recovery time compared to staging two separate procedures. This approach is particularly popular among patients seeking neck lift surgery in Vancouver who want a result that avoids the operated look of treating the neck in isolation.

Before & After

This working professional lady in her 70’s underwent a face and necklift to address concerns about her heavy cheeks, jowls and marionette lines.

This 67 year-old lady underwent a browlift, face and neck lift and supplemental fat grafting to the mid-face/lower eyelids

This 63 year-old lady underwent a browlift, face and neck lift, upper and lower blepharoplasty and fat transfer to the midface

This lady in her 70’s who had previously had a facelift underwent a browlift, face and necklift plus fat transfer to the cheeks.

This 56 year-old lady underwent a deep-plane face and necklift with supplemental fat grafting to the mid-face.

This 44 yr old lady had concerns about hollowing of her upper eyelids, dark rings under her eyes, heaviness of her cheeks, heavy nasolabial folds and marionette lines. She underwent a browlift, upper eyelid fat grafting and a full face and necklift. Her post-op photos are taken 1 month after surgery.

This lady in her 60’s had concerns about her ‘square-face.’ She had a face and neck lift, upper blepharoplasty and fat transfer to her cheeks.

View More Before & After

Non-Surgical

Not every patient is ready for, or in need of, surgery. Pacific Plastic Surgery offers non-surgical and minimally invasive treatments that can improve the appearance of the neck with little to no downtime.

Neuromodulators (Botox/Dysport): Injections into the platysma bands can relax the cords that create the turkey neck appearance and provide a subtle lift to the lower face and neck. This approach is temporary and requires repeat treatments to maintain results.
Dermal Fillers: Strategically placed fillers along the jawline can restore definition and reduce the appearance of early jowling, helping to sharpen the boundary between the lower face and the neck.
Skin Tightening Treatments: Energy-based devices such as radiofrequency or ultrasound platforms can stimulate collagen remodeling and produce modest tightening in patients with mild laxity. These treatments require no incisions and minimal downtime, though results are more gradual and less dramatic than surgery.
Fat Reduction Injectables: Injectable deoxycholic acid (Kybella) can dissolve small pockets of submental fat over a series of treatments, reducing chin fullness without surgery. This is best suited to patients with mild to moderate fat and good overlying skin tone.

Contact Us Today

Ready to take the next step? Whether you’re looking to schedule a consultation, ask questions about a procedure, or simply want more information, our expert team at Pacific Plastic Surgery is here to help you feel confident and informed. Reach out today to connect with us — we’d love to start the conversation and support you on your aesthetic journey.

BOOK A CONSULTATION SEE BEFORE & AFTERs

Schedule a Consultation

If a softer jawline, cording along the neck, or loose skin beneath the chin is affecting the way you feel about your appearance, the best next step is a conversation with Dr. Tregaskiss. At Pacific Plastic Surgery, consultations are thorough and unhurried. Dr. Tregaskiss will assess your neck and jawline anatomy in detail, listen to what you hope to achieve, and explain which treatments or combination of treatments are most likely to get you there.

There is no one-size-fits-all approach to sagging neck treatment in Vancouver, BC. Some patients need only a single non-surgical session. Others benefit most from a neck lift. Many find that the right plan involves layering both surgical and non-surgical elements. What matters is that the recommendation is tailored to your anatomy, your goals, and your lifestyle. Contact Pacific Plastic Surgery today to schedule your consultation and take the first step toward an even better you.

DR. ASHLEY TREGASKISS

COSMETIC, PLASTIC, AND RECONSTRUCTIVE SURGEON | BLOG