Neck Lift
The neck ages faster than the face and gives age away first. A neck lift tightens the platysma muscle, removes the fat that blunts the jawline, and re-drapes loose skin — often as part of a facelift, sometimes on its own.
What is a neck lift?
A neck lift addresses three separate problems that often occur together: fat under the chin, vertical bands formed by the platysma muscle separating in the midline, and loose skin. Which of the three you have determines what operation you need — and whether a smaller procedure would be enough.
A weak or receding chin makes any neck look worse than it is, because it shortens the distance between chin and neck. Where that is the case, a small chin implant added during the same operation often changes the profile more than tightening alone.
Techniques
Who is a good candidate?
- A blunted jawline, visible vertical bands or loose skin under the chin
- Stable weight — fat removed from the neck does not come back, but weight gain still shows there
- Good general health and well-controlled blood pressure
- Non-smoker, or able to stop four weeks before and after
- Realistic understanding that a weak chin may need addressing at the same time
- Acceptance of a small scar under the chin and, in fuller procedures, behind the ears
Preparation
- Profile photographs and assessment of chin projection, hyoid position and skin quality
- Blood tests, ECG and anaesthetic review; blood pressure optimised beforehand
- Thyroid examination, since an enlarged gland changes what is achievable
- Stopping aspirin, anti-inflammatories, fish oil and vitamin E about ten days before
- Stopping smoking and nicotine at least four weeks before
- A compression garment fitted in advance, and front-fastening clothing for discharge
How the operation is performed
A 3–4 cm incision is made in the natural crease under the chin. Fat above and below the platysma is removed under direct vision, the separated muscle edges are sutured together from chin to thyroid cartilage, and any band lower down is divided so it cannot reform.
If skin needs removing, incisions are extended around and behind the ears so the skin can be lifted upwards and backwards rather than simply cut away. A thin drain is usually left overnight and a compression garment applied.
Anaesthesia, duration and hospital stay
- Anaesthesia: general, or sedation with local anaesthesia for liposuction-only cases
- Operating time: 1–2 hours for liposuction with platysmaplasty; 3–4 hours for a full neck lift
- Hospital stay: same-day discharge for limited cases, one night for a full lift
- Stay in the country: 8–12 days, until sutures are out
- Compression garment: worn continuously for two weeks, then at night for two more
- Time off work: 10–14 days
Recovery, week by week
Results and how long they last
Muscle tightening and fat removal are durable; the fat cells taken out do not return. Skin, however, continues to age, so a neck lift performed in the fifties typically holds well for around a decade before laxity becomes noticeable again.
Significant weight gain after surgery will blur the result, and weight loss after a neck lift can leave skin that is loose again. Operating at a stable weight you can maintain is worth more than any refinement of technique.
Risks and complications
- Haematoma — the most common early complication, closely linked to blood pressure
- Temporary numbness of the skin under the chin and along the jaw
- Injury to the marginal mandibular nerve, causing a temporary asymmetric smile — uncommon, usually recovers
- Contour irregularity or a hollow under the chin if too much fat is removed
- Persistent firmness or a palpable ridge along the muscle repair
- Visible scar under the chin or behind the ears
- Recurrence of bands if the muscle repair was insufficient
- The usual anaesthetic and clotting risks of any operation
Cost and what should be included
A liposuction-only neck is a short procedure and priced accordingly; a full neck lift with platysmaplasty and skin excision is closer to a facelift in time and cost. Most quotes for a neck lift assume it is combined with a facelift — check which you are being offered.
- Named surgeon's fee and which specific technique is planned
- Anaesthesia and the anaesthetist's fee
- Operating theatre and any overnight stay
- Pre-operative tests and ECG
- Compression garment, drains, dressings and medication
- All follow-up visits during your stay, including suture removal
- Whether a chin implant, if recommended, is inside the quoted price
A neck lift will not fix a receding chin
If the chin is set back, the neck angle stays shallow no matter how well the muscle is tightened. Assessing chin projection is part of planning a neck lift — a surgeon who does not look at your profile before quoting is not planning your operation.
Frequently asked questions
Can I have a neck lift without a facelift?
Yes, and it is the right choice when the face itself is still holding well — typically in the forties and early fifties. Past that point, tightening only the neck can leave a visible mismatch at the jawline, so the surgeon should tell you honestly if a neck-only approach will look incomplete on you.
Will liposuction alone be enough?
Only if fat is the sole problem and your skin still retracts well — mostly younger patients. If you have visible bands, liposuction will not touch them, and if the skin is lax, removing the fat underneath can make it hang more. The honest test is whether the skin snaps back when pinched.
How visible is the scar under the chin?
It sits in the natural crease and is not visible when facing someone; it can be seen if you tilt your head right back. It fades to a fine pale line over about a year. Scars behind the ears, when needed, are hidden by the ear and hairline.
Do the bands come back?
A properly performed platysmaplasty, in which the muscle edges are sutured together and any lower band divided, is durable. Bands that return early usually indicate an incomplete repair rather than unusual ageing. Ask specifically whether the muscle will be repaired or only the skin tightened.
Do I need a neck lift or just liposuction under the chin?
Skin elasticity decides it. If you are under about forty-five with good skin tone and the problem is purely fat, liposuction alone gives an excellent result through two tiny incisions. If the skin no longer retracts, removing the fat underneath leaves it hanging and makes things worse. The pinch test at consultation answers this in seconds — ask your surgeon to do it and to explain what they feel.
What actually causes a double chin?
Four different things, and they need different treatments. Fat above the platysma muscle responds to liposuction; fat below it must be removed surgically; a lax platysma muscle needs stitching in the midline; and a small or receding chin creates the illusion of fullness that no amount of fat removal fixes. Slim people with a double chin usually have the third or fourth problem, not the first.
Will the neck lift scars show?
There are usually two: a three-centimetre line in the crease under the chin, and scars around and behind the ears if skin needs redraping. The under-chin scar sits in a shadow and is essentially invisible when standing. The ear scars follow the same path as a facelift. Liposuction alone leaves only two four-millimetre marks. Ask to see photographs of scars at six months, not just before-and-after shots.
Can a neck lift fix vertical bands and turkey neck?
Yes, and this is exactly what the operation is designed for. Those bands are the front edges of the platysma muscle, which separate and become visible with age. The surgeon opens the skin under the chin, joins the two muscle edges in the midline and tightens them — a step called platysmaplasty. Botox softens the bands temporarily, but only surgery reconnects the muscle and gives a lasting jawline.
How long does a neck lift last?
Around ten years when the platysma muscle is repaired, and about five when only skin and fat are treated. The neck ages faster than the face because the skin is thinner and there is less underlying support, so results here are slightly less durable than a facelift. Sun protection matters more on the neck than almost anywhere, and weight fluctuation is the fastest way to lose the result.
How long is the recovery?
Ten to fourteen days before you look normal, with a compression garment worn around the neck for the first week and at night for a month. Swelling under the chin lasts longer than you expect — the area stays slightly full for two to three months, which is why early photographs can be discouraging. Avoid turning your head sharply and sleeping on your side for two weeks.
Would a chin implant improve my result?
Often, if your chin is small or set back. A weak chin shortens the distance between jaw and neck, so the area looks full even after fat is removed and muscle is tightened. Adding projection with an implant or a bone advancement creates the angle that defines a jawline. Look at yourself in profile rather than face-on: that view shows whether the problem is the neck or the chin behind it.
Related reading
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Get a FREE Second OpinionThis page provides general information about this procedure; it is not medical advice, a diagnosis, or a treatment recommendation. Capital Oncology Group is a care-coordination service and not a medical provider. All procedures are performed by independent, accredited hospitals and licensed physicians, and the decision to operate must be made by a qualified surgeon after examining you individually.