Many individuals find that the natural aging process causes their neck muscles to become lax and fatty deposits to build up in the area around the chin, neck, and jaw. Often accompanied by loose skin, these concerns can hide the jaw’s natural angles and make the neck look droopy and aged.
A neck lift can effectively contour the neck region to remove excess skin, tighten lax musculature, eliminate fat, and decrease the appearance of a “double chin.” This treatment is often done in conjunction with facelift surgery, but can also be performed as an isolated procedure. Whether conducted alone or as a complement to other surgeries, the final outcome can be a more youthful neck appearance with improved jawline contour and definition.
Benefits of a Neck Lift
Both women and men can typically enjoy a rejuvenated appearance in their neck following this aesthetic procedure. More specifically, patients can often achieve favorable cosmetic results such as:
- A more distinctly defined jawline
- Smoothed and tightened skin around the neck
- A more prominent chin
- Decreased, if not eliminated, neck folds
Sometimes, if excess skin is less of an issue than a buildup of neck fat, patients can opt to undergo liposuction in the neck, rather than a full neck lift. Facial plastic surgeon John Hilinski, MD can help you decide which procedure would be more beneficial depending on your unique needs.
Candidates for Neck Lift Surgery
This procedure is typically designed for individuals seeking to target excess fat and loose skin around the neck for a tighter neck appearance and improved jawline contour. Patients with neck folds and deep creases generally find success in rejuvenating their neck, under-chin, and jawline with a neck lift procedure. Ideally, candidates should be in relatively good health and not smoke. If you do use tobacco products, Dr. Hilinski may recommend you abstain for at least a month before and after treatment, so as not to impede the healing process. For more information about candidacy, please visit our neck lift FAQ page.
The Neck Lift Procedure
In many cases, neck lift surgery can be done on an outpatient basis. Usually, a hidden incision is made beneath the chin, through which the muscles are tightened and fatty deposits are removed. In some cases, an additional hidden incision is required around the bottom of the ear to remove excess skin.
When the neck lift is performed on its own, it may be done so as an office-based procedure using local anesthesia. When performed in conjunction with a lower facelift, it is usually done in an outpatient surgery center under deep sedation or general anesthesia. Depending on the approach being used and how much work is being done, the surgery can take anywhere from one and a half to three hours to perform.
Neck Lift Risks
All surgical procedures have an inherent risk of complication; however, a neck lift is typically safe and successful when performed by a highly trained and experienced facial plastic surgeon. Individuals may experience temporary swelling or numbness around the ear, but these symptoms generally dissipate with time. Due to the anatomy of the treatment area, there is a small chance of damaging the nerve responsible for movement of the mouth region during the operation. Nevertheless, the risk of this area being affected by surgery is greatly minimized by knowing where the nerve is located.
Recovery from Neck Lift Surgery
Recovery after the neck lift procedure takes place over a few weeks, during which time a compressive bandage is worn around the neck. Any pain that patients experience is well controlled with low-dose prescription medication. Swelling and bruising may be noticeable for up to ten days after the procedure. Patients are typically able to return to work within seven to ten days, or sooner for those not bothered by residual swelling.
Neck Lift FAQs
Q – What is a neck lift?
The neck lift, also known as submentoplasty, is a procedure that lifts and rejuvenates a sagging and/or full neck and jawline.
Q – Who is a good candidate for a neck lift?
The best candidates for a neck lift include healthy men and women who are bothered by unwanted sagging of the neck and/or jawline. Most patients complain that they look prematurely aged due to excess laxity that drapes down below the jaw and/or undesirable fullness below the chin. These changes are usually the result of a combination of three different components that need consideration – loose skin, muscle sagging (termed platysmal banding), and excess fat. Loose skin is a result of the aging process, which causes excess laxity and gravitational pull. Muscle sagging reflects what the aging process does to the thin wide muscle sheet (the platysma) that extends all the way across the neck. Each side has a platysma muscle that normally does not meet in the middle and, as the aging process advances, the edge of the muscle on each side begins to sag downward leading to two visible bands the extend from just below the chin toward the collarbone. This contributes to what is often described as a ‘turkey gobbler’ deformity (combined sagging skin and muscle). Patients with excess fat have unwanted fullness below the chin that contributes to a poorly defined jawline. All three components can coexist in the same patient and lead to the appearance of a premature aging neck.
Patients with all three components of an aging neck usually undergo a neck lift with or without a combined facelift. If there is excess fat present under the chin, the neck lift can be combined with liposuction (liposculpture) performed through a short incision under the chin. In rare cases a slightly wider incision is used to remove the fat directly, termed an open lipectomy. If platysmal banding is present, these should be tightened through a hidden incision made below the chin. The edges of the two sides of the muscle are quilted together much like a corset to create a sharp new neckline (like a hammock), termed a platysmaplasty. Inevitably there is excess skin laxity noted after the platysmaplasty, which requires an incision behind the ear to further lift and tighten the neck line. In some cases of skin laxity, muscle banding and fat excess involving a male neck, a ‘direct neck lift’ may be performed. Because this involves the placement of a slightly longer incision under the chin, it is usually reserved for male patients whose skin tends to hide the incision in a more favorable fashion.
Q – Where is the neck lift procedure performed?
Neck lift surgery is usually performed in an outpatient surgery center, often times in conjunction with a lower facelift. Many direct neck lifts can be performed as an office-based procedure.
Q – What type of anesthesia is used for a neck lift?
Most neck lifts involve deep sedation or general anesthesia. A straight local anesthesia can be used if a direct neck lift is being performed in the office setting.
Q – How is the neck lift procedure performed?
The neck lift involves incisions hidden predominantly behind the ear with only a short extension needed along the front of the ear. The skin is separated from the underlying tissue and the platysma muscle is identified below the jawline. The back border of the muscle is mobilized then lifted upward and the muscle is secured to the bone just behind the ear with multiple sutures. By pulling the back edge of the muscle upward, the front and side of the neck are effectively tightened. The incision is then closed carefully with fine sutures.
If the front of the neck requires liposuction or platysmaplasty, this is typically performed prior to the remainder of the neck lift. For liposuction, a short incision is made under the chin and a narrow suction device is used to remove the excess fat, thereby sculpturing and reshaping the neck. In rare cases, a slightly wider incision is required to remove the fat directly, and this is termed an open lipectomy. For platysmaplasty, an incision is made below the chin and the edges of the two sides of the muscle are quilted together much like a corset, creating a sharp new neckline. There is inevitably excess skin laxity noted after the platysmaplasty and this requires an incision behind the ear to further lift and tighten the neck line.
For a direct neck lift to treat skin laxity, muscle banding and fat excess in the male neck, an intentionally irregular-shaped incision (termed a W-plasty or Z-plasty) is made under the chin. This shape helps to fool the human eye as the eye tends to notice straight, linear scars more easily. A certain amount of excess skin is excised directly under the neck. The muscle can then be tightened under direct vision if necessary and excess fat removed as needed through the open incision. The skin edges are then brought together carefully and closed in meticulous fashion with fine sutures.
Q – How long does the neck lift take to perform?
A neck lift can take between one and a half to three hours to complete depending on what approach is being used and how much work is being done.
Q – Where are the incisions made for the neck lift?
The incisions for the neck lift are hidden behind the ears with a very short extension around the front of the bottom of the ear (the lobule). If liposuction or platysmaplasty are being done as well, a short incision is also made just below the chin. Incisions for a direct neck lift are placed entirely under the chin along the front of the neck.
Q – Are there scars after a neck lift?
Though the incisions made for the neck lift will result in scars, they tend to be well-concealed as they are mainly located behind the ear and sometimes beneath the chin.
Q – Is the neck lift a painful procedure?
Patients may experience some discomfort which is well controlled with low dose prescription narcotic medication.
Q – What is the recovery like after a neck lift?
During the first few days after the neck lift, patients should sleep with the head slightly elevated at a 30 degree angle to minimize swelling. Patients are also encouraged to minimize rotation of the neck. Any pain or discomfort that patients experience is well controlled with low dose prescription narcotic medication. Patients will be seen within one to two days after surgery for bandage dressing change and then within four to seven days after surgery to have the sutures removed. Swelling and bruising may still be noticeable for up to ten days after surgery. In most cases, patients will note a sensation of feeling ‘tight’ for several weeks, though they will not appear tight. This is an expected feeling that will slowly fade away as your neck becomes more familiar with its new contour and position.
Q – When will I be able to return to work after undergoing a neck lift?
Most patients are able to return to work within seven to ten days after the neck lift, sometimes sooner for those patients not bothered by residual swelling.
Q – When will I be able to exercise after my neck lift?
Aerobic activity (reconditioning) may be resumed within ten to fourteen days after the neck lift and more strenuous activity (resistance workouts) within three to four weeks.
Q – When are the stitches removed after the neck lift?
The stitches are removed within four to seven days after the neck lift.
Q – Are there risks or complications with the neck lift?
As with all types of surgery there are potential risks associated with the neck lift. By virtue of the anatomy in the area, there is a potential risk of damaging the nerve that controls movement of the mouth region. However, knowledge of where this nerve runs essentially minimizes the chances of this complication occurring. Some patients may note temporary numbness around the ear due to swelling near the sensory nerve in this area, though permanent numbness is very rare following neck lift surgery.
Q – Does insurance cover the neck lift procedure?
Neck lift procedure which are performed for cosmetic purposes are typically not covered by insurance, though patients will need to check with their own insurer.
Read more about the neck lift procedure.
Dr. John Hilinski has either authored or reviewed and approved this content.