Fix tech neck: Surgical and nonsurgical treatment options

In today's digital age, many of us are quickly discovering an unexpected side effect of constant device use – tech neck. This term describes the creases, sagging skin and early signs of aging that can occur in the neck and lower face from repeatedly looking down at phones, tablets, laptops and other devices. Beyond wrinkles, years of downturned gaze and poor posture can also contribute to skin laxity, muscle strain and fat redistribution, creating a prematurely aged appearance that drags down an otherwise youthful face.

As awareness of tech neck has grown, so has the range of treatment options available to treat it. From preventative skincare and injectables to advanced surgical approaches, board-certified plastic surgeons are helping patients restore the definition that's disappeared.

What are the best treatment options for tech neck, and how effective are they really? Will this issue remain pervasive in the coming years as technology continues to evolve? To gather more insights into the fascinating topic of tech neck and how to treat it, we reached out to ASPS Member Surgeon Darrick Antell, MD.

ASPS: What is tech neck, and what causes it?

Dr. Antell: Tech neck is related to the constant use of technology devices, such as smartphones and tablets, or looking at other devices, which can cause neck laxity, neck pain and horizontal neck creases.

ASPS: How does tech neck affect both the skin and underlying facial and neck structures over time?

Dr. Antell: Over time, tech neck can affect both the skin and the underlying structures. The skin can develop creases, like the number 11s, between the eyebrows. You can get horizontal creases in the neck from keeping it bent down. It can also lead to cervical neck problems, which can wear out the vertebral neck joints over time.

ASPS: What nonsurgical treatments are available for tech neck? Are they effective?

Dr. Antell: Nonsurgical treatments might include fillers for the horizontal necklace lines. It does cause improvement, although it's for a finite period of time. Fillers can be a great first step because they can be repeated and are also reversible. Microneedling can also be done for fine lines as a nonsurgical alternative.

ASPS: What surgical options are available for treating tech neck? Are they effective?

Dr. Antell: Surgical options are the gold standard and may include micro liposuction to remove a double chin that can be obvious on Zoom calls. It may include a neck lift to tighten the skin and/or a platysmaplasty to tighten the underlying neck muscles.

ASPS: Are there combination approaches – using both surgical and nonsurgical methods – that provide better outcomes for patients?

Dr. Antell: There are combined approaches in which surgery and fillers complement each other. Surgery can minimize excess skin and fat, whereas fillers can address fine horizontal lines. Another approach to improving the neck is microneedling, which can significantly reduce fine wrinkles.

ASPS: Who is the ideal candidate for tech neck treatments, and what factors influence treatment choice?

Dr. Antell: An ideal candidate for tech neck treatment is someone who has excess fat under their chin or the beginnings of loose skin and wrinkles. Early intervention can prevent it from getting worse and forestall the aging process.

ASPS: How do you manage patient expectations regarding the results of these procedures?

Dr. Antell: Managing patient expectations is a large part of choosing appropriate candidates for plastic surgery. It's important to make sure the patient is aware that improvement can be achieved, but "gone" is almost never going to happen.

ASPS: Are there lifestyle or ergonomic modifications patients should implement alongside medical treatments to maintain results?

Dr. Antell: I think it's important to look up from your screen or tech device and stretch your neck and get up and walk around periodically. It's also important to avoid excess sun exposure, which can cause superficial wrinkles. In our age of technology, we frequently use smartphones and tablets, which often cause us to look down constantly. Either try to lift the tablet or device up to a more horizontal position or get up periodically and stretch your neck.

ASPS: Have there been recent innovations in treating tech neck that make procedures more effective, less invasive or with a faster recovery?

Dr. Antell: There are recent innovations such as microneedling, which can help improve the quality and texture of the skin on the neck and address fine wrinkles as they're beginning. In addition, using sunblock is important to protect the neck from sun damage. Also, fillers are a great choice for the horizontal "necklace lines" that people periodically get.

ASPS: What trends do you foresee in treating tech neck in the next 10 or so years, particularly as screen time and device usage continue to rise?

Dr. Antell: People are now becoming more aware of tech neck, and we realize that you wear your résumé on your face! I think there are ways that we can address it at an earlier age, and science is always exploring new frontiers. Whether it's to improve a double chin you're now aware of on Zoom calls, to treat horizontal necklace lines or to improve the quality of the skin, including fine wrinkles. Faster healing techniques are also available, and we can perform a neck lift as an isolated procedure rather than a face and neck lift.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.