The term “turkey neck” is an informal phrase used to describe loose, sagging skin and muscle bands beneath the chin and along the throat. Scientifically, this condition is referred to as cervical laxity or platysmal banding. The visible effect is a loss of the sharp, defined angle between the jawline and the neck, known as the cervicomental angle.
The Key Anatomy of the Lower Face and Neck
The most superficial and relevant muscle in this region is the Platysma muscle. This broad, thin sheet originates in the chest and shoulder area, extending upward to the lower jaw and the skin of the lower face. The Platysma is considered a muscle of facial expression, and its function is to pull down the jaw and lower lip.
Beneath the Platysma muscle and the skin lie distinct pockets of fat, known as the cervical fat pads, which contribute to the neck’s overall shape. These deposits are categorized into superficial (supraplatysmal) fat, located just under the skin, and deep (subplatysmal) fat, located beneath the muscle. The skin itself, composed of the outer epidermis and the structural dermis, acts as the final protective and elastic layer holding these components in place.
The Biological Drivers of Sagging Skin
The visible signs of cervical laxity result from the failure of anatomical structures due to biological aging. A driver is the degradation of the skin’s structural proteins, known as elastin and collagen degradation. Collagen provides tensile strength and firmness, while elastin is responsible for the skin’s ability to snap back after stretching.
With age, the activity of fibroblasts, the cells responsible for producing these proteins, slows down, and existing fibers become fragmented. This loss of structural integrity causes the skin to lose elasticity and resilience. Concurrently, the Platysma muscle thins and weakens over time. This age-related change causes the muscle’s medial edges to separate and stand out, a phenomenon known as platysmal banding.
Some research suggests that these vertical bands are caused by the sustained activity and tension of the muscle as it contracts, rather than just weakening. Changes in the underlying skeletal structure also contribute to the sagging appearance. Bone resorption in the mandible, or jawbone, reduces the bony support structure for the soft tissues of the lower face and neck. This loss of a fixed anchor point allows the overlying fat and muscle to descend, obscuring the sharp angle of the jawline.
External and Genetic Factors That Accelerate Aging
While biological aging is unavoidable, external and inherited factors can significantly accelerate cervical laxity. Photoaging, primarily caused by chronic ultraviolet (UV) radiation exposure, is a damaging extrinsic factor. UV rays generate unstable molecules known as free radicals, which accelerate the breakdown of collagen and elastin fibers. This process leads to disorganized clumps of damaged elastic material in the dermis, a condition termed solar elastosis.
Genetic predisposition plays a substantial role, determining an individual’s natural skin thickness, collagen production rate, and tissue elasticity. People with thinner skin or wider separation of Platysma muscle fibers may notice banding earlier.
Lifestyle Factors
Certain lifestyle factors also place constant mechanical stress on the neck structure. Repetitive neck flexion, such as looking down at a mobile device, has been implicated in the development of wrinkles and laxity, informally called “tech neck”. Additionally, significant or rapid weight fluctuations can overstretch the skin’s supportive network, leaving behind excess tissue that struggles to contract once the fat is lost.
Scientific Approaches to Restoring Neck Structure
Scientific interventions for cervical laxity focus on counteracting lax skin, separated muscle, and excess fat. The goal for skin quality is collagen stimulation. Energy-based devices, such as lasers and radiofrequency, apply controlled heat to the dermis, triggering a wound-healing response that encourages fibroblasts to produce new collagen. Topical treatments, particularly retinoids, also promote fibroblast activity and improve the appearance of the skin’s surface.
Addressing the Platysma muscle often requires either relaxation or mechanical tightening to restore a defined neck angle. Non-surgical approaches use neuromodulators, such as botulinum toxin, which temporarily relax the active muscle bands to smooth the neck contour. Surgical methods, such as platysmaplasty, involve mechanically tightening the muscle by stitching the separated medial edges together in the midline to reinforce the neck structure.
Excess fat is managed through targeted fat reduction. This can be achieved non-surgically with injections of deoxycholic acid, which chemically dissolves localized fat cells. Alternatively, fat can be removed surgically through liposuction to address supraplatysmal deposits.