Which Neck Lift Is Right for You?

A neck lift describes a range of aesthetic plastic surgery procedures that improve the contours of the neck. These changes can occur as a result of the ageing process, weight loss, or congenital (hereditary) issues with the underlying anatomy.

Understanding Neck Anatomy

There are several structures across different layers of the neck, and a plastic surgeon must assess each one to determine the most appropriate procedure. There are always pros and cons to any approach, so a detailed consultation is essential to discuss what is surgically achievable and required to get the desired result.

Anatomical features start with the superficial layer, the skin, followed by the underlying platysma muscle, which is a sheet-like muscle that can cause banding or cording in the neck. There is also subcutaneous fat, lying between the skin and platysma. However, deeper structures also need careful evaluation. These include the submandibular salivary glands, deeper fat compartments, and other muscles like the digastric. A thorough examination considers all of these.

You may hear terms like platysmaplasty (reshaping or repositioning the muscle) and cervicoplasty (general neck reshaping), which refer to specific types of surgical interventions.

What Are the Benefits of a Neck Lift?

The benefits extend beyond the aesthetic. Some procedures can improve breathing by supporting weakened structures in the back of the throat, which can be useful for issues like snoring or obstructive sleep apnoea.

Aesthetically, a neck lift aims to restore the appearance of the neck from years earlier or reshape it after weight loss. Psychologically, the transformation can be profound. Patients often go from hiding their neck with clothing or hand gestures to confidently tying their hair back and embracing their appearance post-surgery.

How Is a Neck Lift Done?

Surgery can be superficial, such as a platysmaplasty with or without fat reduction, or more involved, such as a deep neck lift, which addresses deeper structures. People often describe themselves as having a “turkey neck”, visible neck bands, or a double chin despite not gaining weight. Many become self-conscious during social activities or video calls.

When Is an Isolated Neck Lift Appropriate?

Isolated procedures are more suited to younger patients with congenital anatomy such as a small jaw or a hyoid bone that sits far forward or low. These patients often lack neck definition, resulting in a nearly straight chin-to-chest line when viewed from the side. In these cases, the surgeon can often restore the neck’s shape through a discreet 4 cm incision under the chin.

Neck Lift Without a Facelift

The surgeon may remove excess skin through incisions behind the ear, similar to those in a facelift. However, this approach must be carefully considered. A rejuvenated neck paired with an untreated jawline or face can look mismatched. For this reason, neck lifts are more commonly combined with facelifts.

Surgical Approaches

• Under-chin (submental) approach: A small incision under the chin provides access to the platysma muscle and deeper structures.
• Posterior approach: Accesses the back of the platysma muscle via incisions behind the ear, allowing the muscle to be lifted and recontoured.
  

These incisions are placed to minimise visibility and are typically along the hairline, around the earlobe, and near the ear canal.

Types of Neck Lifts

1. Cervicoplasty (Skin-Only Neck Lift)

• What is it? A general term often used online, referring to removing excess skin.
• Best for: People with loose skin and minimal muscle involvement.
• Details: Performed under local or general anaesthetic with incisions under the chin and behind the ears.
• Risks: Infection, bleeding, bruising, swelling, and variable scarring, especially if there is too much tension on the skin.
  

2. Platysmaplasty

• What is it? A muscle-tightening procedure that targets the platysma muscle.
• Best for: Sagging or visible neck bands.
• Details: Incisions under the chin and behind the ears allow access to the muscle. This may be combined with fat removal.
• Risks: Similar to the above, with possible recurrence of banding. Botox can help with maintenance.
  

3. Combined Cervicoplasty and Platysmaplasty

• What is it? A comprehensive rejuvenation targeting both skin and muscle.
• Limitations: This does not address deep neck volume or glands.
  

4. Deep Neck Lift

• What is it? The most comprehensive option, addressing deep anatomical structures.
• Best for: Significant deep volume or gland involvement.
• Details: Submandibular glands may be reduced, not entirely removed. Deep fat or digastric muscles may be tightened.
• Risks: Higher risk of temporary nerve injury, sialoma (saliva collection), and complications from scarring. Botox and a bland diet after surgery can help reduce risks.
  

Liposuction

Now less commonly used. Deeper issues often cause neck fullness, not just superficial fat. Overuse of liposuction can expose muscle bands, leading to poor cosmetic outcomes.

Non-Surgical Options

• Radiofrequency (for example, Morpheus8): Can contract tissue but may increase surgical complexity later due to scar formation.
• Thread lifts and trampoline lifts: Results can vary and these often do not address the underlying structural problems.
• Fat freezing: Limited effectiveness for deep structure issues.
• Botox: Useful for treating bands and maintaining results after surgery.
  

Choosing the Right Approach

As you might now appreciate, the right procedure must be tailored to you. A detailed consultation is needed to assess your skin quality, muscle tone, banding, fat distribution, and deep anatomy.

In my view, surgical options still deliver the most predictable and long-lasting results. While future non-surgical advances may arise, the neck remains an area where surgery leads.

Recovery, Risks and Longevity

Most people can resume daily life after six weeks. Gentle activity is recommended during the first two weeks, and driving is usually possible by week two. Risks vary but include bleeding, infection, scarring, fat necrosis, and contour irregularities.

The Haemostatic Net

This technique, which looks like a net of stitches, helps reduce bleeding by securing lifted skin to the muscle underneath. It prevents haematomas and improves how the skin settles. These stitches are removed within two to five days and rarely leave marks.

Cost of Neck Lift Surgery

With so many techniques available, prices can vary. Typical costs range from £10,000 to over £30,000, especially when combined with a facelift. The most important factor is choosing the approach that best suits your anatomy and goals.

Conclusion

There are many ways to reshape and contour the neck, and the best outcome comes from choosing a tailored approach. To discuss your goals and explore which options are right for you, please fill out our contact form or call us on +44 (0) 1892 536 960. We look forward to hearing from you.

Feel free to get in touch if you would like to find out more about neck lifting surgery. You can also browse results on my Instagram at @marcpacifico.