I get asked about horizontal lines on the neck and the formation of loose thin wrinkly skin on the neck a fair amount. Botox does not help horizontal lines on the neck.

Some people have horizontal neck lines since they were young. It is just a variant that some people possess. As we age, the skin in our neck becomes thinner and looses its support. This tends to exacerbate these lines as well. This issue is a skin issue, not a muscle issue. Botox affects muscular activity and can be used in the neck for neck bands, which are vertical lines on the neck.

So what can help? Well, a neck lift will pull the neck skin tighter and make the skin seem firmer and with more support, but it might not eliminate the horizontal neck lines completely. Using fillers directly into the lines can help improve them as well. Using lasers or creams might help in making the skin a bit more swollen, and hence appear thicker and more supple. This might improve the appearance of the skin, but will need to be made part of your routine and be done on a regular basis.

I am sorry to hear that you had unsightly scars from your previous operation. If indeed you have enough laxity in your face and neck now, you can have another lift and excise out your old scars. Your ear lobes can also be fixed so they are not pulled down anymore.

That is sometimes the problem with trying too hard to have a tight facelift. It puts excessive tension on the incision lines which can cause excessive thick scars, and can pull down on the ear lobes over time.