Q. I just finished reading the book I Feel Bad About my Neck by Nora Ephron, and although I found it funny, I really do feel bad about how my neck is looking. I am 45 years old, attractive, active and I don't want to look older. What can I do to help my neck look better?

A. The neck, in my experience, is a body part most women of a certain age worry about. Many of my patients, wrong or right, feel that the appearance of their neck ages them the most. I tend to disagree with my patients as I feel that the eyes tend to age the most and they're the part of the face that we focus on first. In either case, what can be done to save you from your neck?

I will keep this answer to products and services that can be provided by facial plastic surgeons, plastic surgeons or dermatologists. First, Thermage can tighten your skin with radio frequency waves. Fraxel can tighten your skin with laser treatments. Your personal physician can provide details of these treatments. If all you have is some wrinkles and some muscle bands, Dysport or Botox injections can be used to diminish these unsightly defects, but the use of these drugs for this effect is off-label.

If surgery is necessary, several operations can be provided. If you merely have some mild jowling and a small amount of fat, liposuction may correct that. If, in addition to the above, you have extra skin, you can add excision of the extra skin to the menu. Should you have platysmal bands (the muscle that gives you pleats) you can add platysmaplasty to the surgery. If however, you're really going south, you may need to do a complete face and neck lift. This should give you a reasonable overview of your under view. For further information, you should contact your own physician.

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