Drooping neck may be a major concern for many patients seeking a surgical or nonsurgical solution. Young patients may grow a fat, sagging neck due to genetic inheritance, but most neck sagging is due to obesity and ageing.A few things happen to the neck as people age. The skin loses firmness and becomes soft, the fat reduces and the gravity changes, creating traditional jowls and fat under the lip. Muscles often lose their strength and size, or become thinner in bands, platys bands. Skin loses collagen and hyaluronic acid, with sun damage and smoking, pigmentation, fine blood vessels and wrinkles start emerging.