Procedure dossier
Neck Lift
Also known as platysmaplasty or lower rhytidectomy
A neck lift, medically known as platysmaplasty or lower rhytidectomy, is a surgical procedure that improves the appearance of the neck by addressing excess skin, fat deposits, and muscle banding. The procedure creates a smoother, more defined neck contour and a sharper cervicomental angle (the angle between the chin and neck). A neck lift can dramatically reduce the appearance of a "turkey neck," double chin, visible platysmal bands, and neck skin laxity that creates an aged, heavy appearance.
The neck is one of the most visible areas of aging and is often resistant to non-surgical treatments. Loose, sagging neck skin and prominent muscle bands are common complaints among patients in their 40s and beyond, and these concerns can be particularly bothersome because the neck is difficult to conceal. According to the American Society of Plastic Surgeons, neck lift is frequently performed alongside facelift to achieve comprehensive rejuvenation of the lower face and neck [1].
Average range
$5,000 - $12,000
Recovery
6 weeks
Duration
3 hours
Anesthesia
General
Complexity
Complex
Category
Facial
01 / The brief
What to know first
Neck aging is driven by multiple factors acting simultaneously. The platysma muscle, a thin sheet of muscle that extends from the chest to the lower face, separates with age, creating visible vertical bands in the anterior neck. Skin loses elasticity and begins to sag, forming horizontal neck creases and excess skin along the jawline. Fat accumulates in the submental area (beneath the chin) and in the submandibular region, obscuring the jawline and creating the appearance of a double chin. Bone resorption in the jaw and chin can further contribute to loss of neck definition.
A neck lift addresses all of these issues through a combination of techniques that may include skin excision, platysma muscle tightening, liposuction of submental and submandibular fat, and occasionally removal of the submandibular salivary glands when they contribute to neck fullness [1]. The specific combination of techniques is tailored to each patient's anatomy and concerns.
The neck lift is most commonly performed in conjunction with a facelift, as the lower face and neck age together and achieving an optimal result typically requires addressing both areas. A standalone neck lift is appropriate for patients whose primary concern is isolated to the neck and who have relatively youthful-looking facial features. In younger patients with good skin elasticity, submental liposuction alone or combined with limited platysma tightening may be sufficient.
The procedure has evolved significantly over the past two decades. Modern techniques emphasize platysma muscle repair and tightening as the foundation of the neck lift, rather than relying primarily on skin removal and tension. This approach produces more natural, longer-lasting results and avoids the telltale signs of older surgical techniques such as visible scarring behind the ears and an unnatural "scooped out" neck contour.
02 / Approaches
Techniques and options
The standard neck lift involves incisions behind each ear, extending into the posterior hairline, and a small incision beneath the chin. Through the submental incision, the surgeon accesses the platysma muscle and underlying fat. Submental and submandibular fat is removed via direct excision or liposuction. The separated platysma muscle edges are sutured together in the midline (medial platysma plication or corset platysmaplasty), creating a smooth, taut muscular sling [1]. Through the post-auricular incisions, excess skin is redraped and trimmed.
Corset platysmaplasty is a technique in which the platysma muscle edges are sutured together from the chin to the lower neck, creating a continuous muscular corset that provides robust support and a smooth, defined neck contour. This technique is particularly effective for patients with prominent platysmal bands and significant muscle laxity.
Deep neck lift techniques go beneath the platysma muscle to address deeper structures that contribute to neck fullness. The surgeon may remove or reduce the subplatysmal fat, address the digastric muscles if they contribute to neck fullness, and partially excise or reposition the submandibular glands. These advanced techniques are reserved for patients with substantial neck fullness that cannot be adequately addressed through standard approaches.
For younger patients with good skin elasticity and primarily fat-related concerns, submental liposuction can be performed as an isolated procedure through a single small incision beneath the chin. This minimally invasive approach offers a faster recovery and is effective when skin laxity and muscle banding are not significant. Some surgeons combine liposuction with percutaneous platysma tightening using sutures placed through small puncture incisions.
03 / Candidacy
Who may be a candidate
Often considered
Ideal candidates for neck lift are adults who are bothered by loose or sagging neck skin, visible platysmal bands, excess submental fat, or loss of jawline definition. Most candidates are between 40 and 70 years of age, though younger patients with hereditary neck fullness or premature neck aging may also benefit. Candidates should be in good general health, non-smokers or willing to quit for the required period, and have realistic expectations. Those considering a facelift should discuss whether combining neck lift will achieve a more complete result.
Reasons to pause
Neck lift is not recommended for active smokers who are unwilling to quit, as smoking dramatically increases the risk of skin necrosis and poor wound healing in the thin neck skin. Patients with uncontrolled hypertension face elevated bleeding and hematoma risks. Those with significant medical conditions that increase surgical risk should be carefully evaluated. Patients who have only mild submental fat without skin laxity or muscle banding may be better served by liposuction or non-surgical treatments. Individuals with unrealistic expectations about the degree of neck transformation should be counseled about what is achievable.
04 / Tradeoffs
Potential benefits and risks
Potential benefits
A neck lift provides the most effective and long-lasting improvement for neck aging of any available treatment. The procedure addresses the root causes of neck aging, including muscle laxity, excess fat, and skin redundancy, producing results that non-surgical treatments cannot match. The restoration of a defined jawline and smooth neck contour has a transformative effect on overall appearance, often making patients look significantly younger.
The neck is one of the most visible aging indicators, and its improvement has an outsized impact on perceived youthfulness. Many patients report that neck lift results give them renewed confidence in wearing open-neckline clothing, having profile photographs taken, and presenting themselves in professional and social settings. The durability of results, typically lasting over a decade, makes neck lift a worthwhile long-term investment in appearance.
Risks to discuss
Neck lift risks include bleeding, infection, hematoma, nerve injury, and adverse reaction to anesthesia. Hematoma is the most common complication, occurring in approximately 1 to 3 percent of cases, and requires prompt drainage [1]. Injury to the marginal mandibular branch of the facial nerve can cause temporary or, rarely, permanent weakness of the lower lip, affecting facial expression [1]. Injury to the great auricular nerve can cause earlobe numbness.
Skin necrosis is a risk, particularly in smokers and patients with vascular disease, and can lead to visible scarring [2]. Asymmetry, contour irregularities, and cobra neck deformity (an unnatural central depression with lateral fullness) are potential complications that may require revision. Over-resection of fat or aggressive platysma tightening can produce an overly hollowed or "skeletonized" appearance. Visible or widened scars, particularly behind the ears, can occur. The overall complication rate is low in experienced hands, but patients should be informed of all potential risks.
05 / Planning
Preparation and recovery
Before the procedure
Preparation for neck lift includes a thorough assessment of neck anatomy, including skin quality, degree of platysma banding, submental fat volume, jawline definition, and chin projection. The surgeon determines whether a standalone neck lift or combined facelift and neck lift is most appropriate. Assessment of chin projection is important, as chin augmentation can significantly enhance neck lift results in patients with a receding chin.
Blood-thinning medications and supplements must be discontinued at least two weeks before surgery. Smoking cessation is required at least four to six weeks before and after the procedure [2]. Pre-operative testing, including blood work and medical clearance, is obtained as appropriate. Patients should arrange for transportation home, post-operative assistance for the first 24 to 48 hours, and a recovery area with extra pillows and button-front shirts.
Aftercare
After surgery, a compression dressing or chin strap is applied to support the neck and minimize swelling. This garment is typically worn continuously for the first week and then at night for an additional two to four weeks. Drains may be placed and are usually removed within one to two days. Cold compresses applied during the first 48 hours help reduce swelling.
Patients should sleep with their head elevated at 30 to 45 degrees for the first two to three weeks. Gentle walking is encouraged within the first day or two to promote circulation. Strenuous physical activity, heavy lifting, and vigorous exercise should be avoided for four to six weeks. Sutures are removed in stages over one to two weeks. Sun exposure to healing incisions should be minimized, and broad-spectrum sunscreen should be applied once the skin has healed. Follow-up appointments are scheduled at regular intervals over the first year.
Moderate swelling and bruising, compression garment in place, drains may be present
Drains removed, swelling beginning to subside, mild discomfort
Sutures removed, bruising fading, able to return to light activities
Most patients comfortable returning to work and social activities
Significant improvement in swelling, light exercise permitted
Most restrictions lifted, moderate exercise resumed
Majority of swelling resolved, results becoming clear
Near-final result visible
Final result achieved, scars well-healed and fading
Expected results
A neck lift produces a more defined jawline, a smoother neck contour, elimination of visible platysmal bands, and a sharper cervicomental angle. The improvement is visible once initial swelling subsides, typically within two to three weeks, with the final result becoming apparent at three to six months as tissues settle and swelling fully resolves.
Results typically last 10 to 15 years, though continued aging, weight fluctuations, and lifestyle factors influence longevity [2]. Patients who maintain a stable weight, protect their skin from sun damage, and follow a healthy lifestyle tend to enjoy the longest-lasting results. The procedure does not prevent continued aging, but patients generally maintain a more youthful neck appearance than they would have without surgery.
Patient satisfaction with neck lift surgery is high, particularly when performed in conjunction with facelift. Patients frequently report that the neck lift was the component of their facial rejuvenation that made the most dramatic difference in their overall appearance and confidence.
06 / Common questions
Frequently asked
Can a neck lift be done without a facelift?
Yes, a standalone neck lift is appropriate for patients whose aging concerns are primarily limited to the neck area and who have relatively youthful-looking facial features. However, the lower face and neck age together, and most patients achieve the best results when neck lift is combined with a facelift for comprehensive rejuvenation. During consultation, your surgeon will evaluate whether a standalone neck lift or a combined approach will produce the most harmonious result for your specific anatomy and goals.
How long do neck lift results last?
Neck lift results typically last 10 to 15 years, depending on the techniques used, individual genetics, skin quality, and lifestyle factors. Maintaining a stable weight, protecting the skin from sun damage, avoiding smoking, and following a consistent skincare routine help extend the longevity of results. The aging process continues after surgery, but patients generally maintain a more youthful neck appearance than they would have without the procedure. Some patients choose additional non-surgical maintenance treatments over time.
What is the difference between a neck lift and liposuction of the neck?
Neck liposuction removes excess fat from beneath the chin and along the neck but does not address loose skin or platysma muscle banding. It is best for younger patients with good skin elasticity whose concern is primarily excess fat. A neck lift is a more comprehensive procedure that addresses fat, loose skin, and muscle laxity. For patients with significant skin sagging or visible muscle bands, liposuction alone will not produce an optimal result, and a neck lift is recommended. Your surgeon will determine which approach is most appropriate for your anatomy.
07 / Community desk
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