It seems nothing is simple (or straightforward) when you head south of the face.

Portrait of Tammy Strobel

The green video light on my MacBook Air is my enemy. If you’re on a Zoom call with me, you’ll notice that my chin is always resting strategically on my palm. Same thing on Instagram. I’m actually pulling the skin back in a faux nip-and-tuck to excavate the jawline I seemed to have lost 18 months ago. Prior to this, I’d never really worried about my neck—I have plenty of other issues.

But when you turn 55 or so, your neck (loose skin, jowls, marionette lines, muscle bands, salivary glands) drops one Sunday evening during Big Little Lies. Then it’s all anyone talks about: what to do, who’s done it, how it works and how soon you can book it.

A friend in LA recently had her neck done. I FaceTime her two days after to see the reality. She looks puffy and bruised, and shows me the staples on the back of her head. Staples. She was cavalier about the surgery before but not after, admitting that it was “a much bigger deal” than she had realised, including five hours in the OR. I keep asking, if it was just her neck, why did she have staples on the back of her head? She doesn’t know. I go with her to Pasadena for her post-op appointment to ask her plastic surgeon, Dr Michael Schwartz—and have my own consultation. Dr Schwartz says he performed both a necklift and a facelift, explaining that for most people, a necklift alone does not remedy the disappearing-jawline problem. “A necklift sounds more minimal, but you’re left with the same jawline,” he says.

In Beverly Hills, I visit plastic surgeon Dr Gregory Mueller in the hopes of finding a less invasive way to solve my sagging. His minimally invasive Ellevate procedure creates a permanent suture support for the “bands and glands” that drop as we age. “It’s like a corset,” he says. “The suture is threaded from behind one ear to the other, using a 1mm needle, so there are no incisions, only needle punctures.” Dr Mueller combines this with collagen-stimulating radio frequency FaceTite and lipo (cost: US$8,000 to $14,000, with bruising for up to 10 days). I’m a candidate for Ellevate, but he says I‘ll need actual surgery as well to deal with the excess skin. Total cost: US$24,700, with two weeks of recovery.

Still on my quest for an easier alternative, I meet with Dr Haideh Hirmand, a plastic surgeon in New York. “The neck is the holy grail of facial rejuvenation,” she says. “We don’t have the non-surgical answer to it yet”, meaning that the non-surgical technologies for the face-suture lift, FaceTite, Ultherapy-don’t work as well on the neck, unless it’s at a super-early stage. Creams can be helpful in maintaining skin integrity, but they won’t do what a doctor can do. I’d also heard about Kybella, an injectable that dissolves fat in a double chin, but experts say it wouldn’t fix my neck issues.

For the first signs of ageing, Hirmand offers a face-and-neck suture lift (US$4,500 to $6,500, with “minimal recovery and less bruising than injectables,” she says), or the radio frequency NeckTite, with a seven- to 10-day recovery and visible results after four months (from US$6,500). Ultherapy, an ultrasound treatment that works via heat stimulation, is another buzzy procedure. But doctors say that you’ll see a 20 percent improvement at best (after three months). It costs US$3,500 to $6,500 and needs to be done every year or two. “You’d benefit most from a lower-face and neck lift,” Hirmand says. I’m relieved these doctors have confirmed that I’m not just imagining it: My face and neck are indeed falling.

As it turns out, you can’t really disconnect your neck, jawline and face. My issue isn’t just my neck after all, but my lower face too. If there’s loose skin, jowls and marionette lines, a facelift with a necklift is recommended, but unlike our mothers’ lifts, they’re performed more strategically and look subtler. Three doctors’ visits later, I’m convinced -and planning my return to Instagram.