It used to mean you were in a tough spot.
That is, if you found yourself wanting to address the loose or saggy skin in your neck – something that is going to happen to all of us eventually as we age – but hated the idea of surgery… you were in a lose-lose situation. No surgery? Fine. But that meant simply living with whatever change in appearance your neck went through. Want to improve the way your neck looks? Fine. That meant surgery.