Neck Lift Surgery: The Ultimate Guide

Medically reviewed by John Mesa, MDBoard Certified Plastic SurgeonReviewed on June 25, 2023
Written byJolene EdgarUpdated on May 25, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by John Mesa, MDBoard Certified Plastic SurgeonReviewed on June 25, 2023
Written byJolene EdgarUpdated on May 25, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Fast facts


Neck lift surgery (also called a lower rhytidectomy or platysmaplasty) creates a more defined jawline and a slimmer, smoother, and younger-looking neck.

A traditional neck lift involves: 

  • Lifting and smoothing sagging skin
  • Removing excess fat and skin
  • Tightening the platysma muscle (muscle that defines the shape of the neck)

A skillfully performed neck lift targets concerns like skin laxity, wrinkles, a double chin, horizontal neck bands, and “turkey neck,” to give your entire neck and jawline a more sculpted, youthful appearance.

Some plastic surgeons and facial plastic surgeons specialize in what’s known as the deep plane neck lift. During this more complex procedure, surgeons contour the deeper structures of the neck that can lend a bulky look, even after the skin and underlying muscle are tightened. 

“A deep plane neck lift provides the ultimate rejuvenated look to the aged neck” says Dr. John Mesa, a board-certified plastic surgeon in New York City.  A deep neck lift goes beyond the traditional procedure to address:

  • Fat deposits behind the platysma muscle (subplatysmal fat)
  • Enlarged submandibular and parotid salivary glands 
  • The digastric muscles underneath the platysma muscle, which contribute to the angle of the neck

A mini neck lift is a more limited procedure. In this case, the surgeon removes excess fat and skin before tightening the remaining skin, but they don’t usually perform a platysmaplasty (tightening of the neck muscle). A mini neck lift is usually performed under local anesthesia with IV sedation.

Neck lift procedures are frequently combined with a facelift, brow lift, chin implant, or other facial plastic surgery procedures, to create the most balanced result. 

Related: Lower Facelift vs. Neck Lift: What's the Difference?

RealSelf Tip: Unlike nonsurgical neck lifts, which usually require multiple skin-tightening treatment sessions, “getting a neck lift is a one-and-done option,” says Dr. Dilip D. Madnani, a facial plastic surgeon in New York City. This outpatient cosmetic procedure is also a far more effective neck rejuvenation option that offers a dramatic, lasting change.

Interested in a neck lift?

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Pros 

  • The procedure tackles unwanted fat, loose muscles, and sagging, excess skin in one fell swoop. 
  • It offers dramatic results that last for 10 to 15 years. No nonsurgical skin tightening procedure can match it.
  • A well-performed neck lift should leave minimal, discreetly placed scars that will fade over time.  
  • Neck lift patient satisfaction is high: it has a 91% Worth It Rating from reviewers on RealSelf.

Cons

  • You’ll need one to two weeks of downtime, depending on the extent of your procedure and how your body heals.
  • It isn’t cheap, and insurance doesn't cover cosmetic procedures like this one.
  • Like all surgical procedures, it comes with risks like infection, hematoma,  and fluid collection under the skin.
  • In rare cases, facial nerve injury can create temporary facial weakness, which may take up to six months to resolve. 
  • Your neck area will continue to age, though it will still look better than if you didn’t have anything done.

  • Average Cost:
  • $8,675
  • Range:
  • $4,500 - $23,000

The price you pay will depend on your plastic surgeon’s level of experience, their reputation, their location (and overhead costs), what type of anesthesia you have, and a few other key factors.

This procedure is an investment, and it’s not covered by insurance. To help make it more affordable, most providers offer payment plans or accept financing options like CareCredit.

See our complete guide to neck lift costs

Interested in a neck lift?

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As you're picking your plastic surgeon, look for neck lift photos of patients around your age, with a similar degree of sagging skin, neck bands, and other pre-op concerns. Look for before and afters with similar proportions, facial expressions, and lighting.

Pay special attention to profile views with a level chin (the most telling position), and note whether there’s a visible shadow below the chin and jawline. Along with a well-contoured neck, you want to see a sculpted jaw. Any scars you detect should be thin and inconspicuous, tucked under the jaw or behind ears. 

The neck lift before and after pictures in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Good candidates for a neck lift are healthy nonsmokers with excess neck skin and platysma muscle laxity, with or without excess neck fat.

Neck fullness can, in some cases, be due to protruding glands and muscles, which can also be addressed during surgery.

You could be a good candidate for what’s called a micro or mini neck lift if you:

  • Have a small amount of extra skin and/or fat where your neck meets your jawline 
  • Have relatively elastic skin, without severe sagging 
  • Don’t have prominent neck bands  

A mini neck lift is usually performed under local anesthesia with IV sedation. The surgeon removes excess fat and skin before tightening the remaining skin, but they don’t usually perform a platysmaplasty.

Usually, a mini neck lift costs several thousand dollars less than a full neck lift. It also comes with a shorter recovery period. 

While reduced cost and downtime sound appealing, the mini neck lift is really only appropriate for those with minimal signs of laxity, fullness, or droop in the neck.

See our complete guide to a mini neck lift

This outpatient surgery is performed under either local anesthesia with IV sedation or general anesthesia, depending on surgeon and patient preferences. Some surgeons, like Dr. Mesa, perform traditional or deep plane neck lifts with the patient awake, under local anesthesia (without any IV sedation or general anesthesia). If you and your surgeon are comfortable with this approach, it’s well worth considering to lower your cost and avoid the risks associated with general anesthesia.

Based on the extent of your procedure, it will take one to three hours.

The three common issues targeted by the procedure are excess fat, muscle laxity (loose platysma muscles), and sagging neck skin. Not all surgeons define or perform a neck lift in the same way, so have a detailed conversation about your goals and your surgeon's technique during your initial consultation. 

Also ask where they’ll place your incisions, so you’ll know what kind of neck lift scars to expect. “A skilled surgeon usually can disguise your incisions by placing them behind your ears or along your lower hairline, so you should expect minimal visible scarring from a neck lift,” says Seattle facial plastic surgeon Dr. William Portuese

For patients with minimal excess skin, the neck anatomy can often be accessed through a small incision hidden under the chin (the submental area). 

If excess skin needs to be removed, however, surgeons typically need to make incisions around the ears, sometimes in addition to the submental incision. When a neck lift is performed alone (not combined with a facelift), those incisions can usually be limited to the backside of the ears, to make the subsequent neck lift scars less visible.

Once the incisions are made, here’s how a neck lift is done. 

Fat removal 

Surgeons can use a few different methods to remove the excess fat that creates a heavy-looking neck, double chin, or jowls. 

  • When there’s fat only above the platysma muscle, attached to the skin, liposuction can remove it through three small incisions—one below the chin and one behind each ear. 
  • Most patients have fat both above and below the platysma muscle. In this situation, the surgeon removes the deeper fat manually, using direct visualization (usually with a lighted retractor). They then remove the excess fat above the platysma with liposuction.

Platysmaplasty

The platysma muscle separates and loosens with age, which creates thin vertical bands (generally two). As the muscle ages, it presses and stretches against the skin, making these ropey neck bands more obvious and softening the jawline. Platysma muscle cords also contribute to turkey neck. 

To address these bands, a surgeon performs a platysmaplasty. This involves:

  • Sewing the two sides of the platysma muscle in the front of the neck and under the chin together like a corset (in fact, it’s often called a corset platysmaplasty). 
  • Possibly removing some excess platysma, to further tighten it. 
  • Attaching it more tightly to other neck muscles or structures.

Cervicoplasty

Aging or weight loss (or gain) can create loose skin, so most neck lifts involve this procedure, which entails:

  • Removing excess skin.
  • Tightening the remaining skin, to smooth wrinkles and create a more youthful contour. 

Some surgeons also use a technique called a "short scar neck lift," to improve contours without removing excess skin. They make a small incision under the chin to modify the underlying neck structure, creating more surface area for the skin. The result is a sharper jawline and smoother neck.

Once the procedure is complete, incisions are closed with tiny, dissolvable sutures.

You'll need 1 to 2 weeks of recovery time after a neck lift, depending on the extent of your procedure and how quickly your body heals.

Some people take just one week off and then camouflage incisions or swelling with makeup, scarves, or turtlenecks when they return to work. Others take more time off, to give bruises and swollen tissue extra time to look normal—especially if they also had a facelift.

Proper post-op care can help minimize discomfort and help you heal safely. Follow your provider's advice when it comes to keeping your incisions clean and caring for your neck area during your recovery.

Here’s what you can expect during neck lift recovery:

  • Patients usually wear a chin strap or pressure dressing that wraps around their head and underneath their chin for at least the first 24 hours post-procedure, to help reduce swelling and bruising. 
  • Some also have small surgical drains (especially when a deep neck lift is performed). These stay in place for one to two days, to collect excess blood and fluid while helping prevent build-up. 
  • Most doctors will want to see you for your first checkup the day after surgery, to ensure that your healing is off to a good start.
  • If they didn’t use dissolvable sutures, you’ll also return after 7 days to have the stitches removed. 
  • Don’t bend over or lift anything heavy for a week after surgery.
  • Avoid vigorous exercise for two weeks. 
  • Most swelling and bruising should be resolved within 12 to 14 days, and the scar tissue will have started to soften and fade.  

If your neck lift scars are a major concern for you, talk with your provider about scar treatment options, including silicone scar gels you can use during your recovery.

RealSelf Tip: Post-surgical lymphatic drainage massages or other post-op massages are recommended by some surgeons, including Dr. Mesa. “Post-surgical lymphatic drainage massage significantly speeds up the healing and recovery process after a neck lift,” he explains. Post-surgical lymphatic drainage massages should only be performed by a licensed massage therapist. 

Neck lift surgery itself isn't painful at all, thanks to the anesthesia. Deep plane neck lifts can involve some discomfort, due to the involvement of deeper neck structures.

Your neck will feel tight and sore as the anesthesia wears off, and you’ll have some discomfort for 24–48 hours after surgery. This should be well-managed by oral prescription pain medication.

Numbness is also very common, due to the temporary disruption of nerve endings. According to RealSelf reviewers, numbness can linger for months (or even more than a year).

Gently massaging the area can help "wake up" the nerves as you heal. You may feel some tingling, itchiness, or occasional little zings of pain while you're regaining normal sensation.

You’ll notice a contour difference right away, but swelling and bruising will prevent you from seeing the full result for several weeks, until the swelling subsides. 

You should see most of your final result within a month of your procedure, and it will continue to improve over the coming months.

Neck lift results can last for 10 to 15 years. That said, you will continue to age—and so will your neck. 

As Dr. Madnani says, “we don’t stop the aging process, so inevitably, your neck will drop some over time. However, it typically never sags to the extent it did before surgery.” 

To prolong results, Dr. Madnani suggests maintaining a healthy weight, not smoking, and using strong sun protection; UV damage damages the elastin in skin and kickstarts the signs of aging.

Nonsurgical skin tightening treatments, like radiofrequency or ultrasound energy treatments, can also help extend the longevity of results by stimulating new collagen production.

A neck lift is a relatively safe cosmetic surgery. “A neck lift procedure performed while the patient is awake under local anesthesia is quite safe,” says Dr. Mesa. “This approach completely eliminates the risk of both IV sedation and general anesthesia, making it particularly appealing to patients with well-managed medical comorbidities or those of advanced age.”

During your consultation, your provider should talk you through these potential risks.

  • “The most common adverse event following a neck lift is slight asymmetry or undercorrection,” says Dr. Jaime Perez, a plastic surgeon in Tampa, Florida. “These issues can often be addressed during an additional procedure, performed under local anesthesia in an office setting.”
  • Blood or fluid can collect under the skin (hematoma and seroma) during recovery. Your plastic surgeon may try to minimize that risk by inserting small surgical drains or recommend compression.
  • Rarely, facial nerves can be injured during a neck lift, creating temporary weakness of one side of the lower face. This usually resolves on its own within three to six months, but it can be distressing in the meantime.
  • Occasionally, patients claiming to have suffered a botched neck lift will have what’s known as a cobra neck deformity. The complication presents as a depression in the midline of the neck and occurs due to overly aggressive fat removal, which causes the skin of the neck to scar down to the muscle. Revision surgery is needed to correct it.

To minimize your risk of complications after a neck lift, find an experienced, board-certified plastic surgeon or facial plastic surgeon perform your procedure.

Botox (Page Image)Botox

nonsurgical

Dermal Fillers (Page Image)Dermal Fillers

nonsurgical

CoolSculpting (Page Image)CoolSculpting

nonsurgical

Ultherapy (Page Image)Ultherapy

nonsurgical

Worth It Rating96%90%93%86%68%49%79%
Average Cost$553$1300$7525$2125$2275$2650$3175
DowntimeNo downtimeMinimal or no downtime1 week of downtime1–12 days of downtime (depending on intensity)Minimal downtimeNo downtimeMinimal downtime
AnesthesiaNo anesthesiaTopical or no anesthesiaLocal anesthesiaTopical anesthesiaNo anesthesiaNo anesthesiaLocal, topical, or no anesthesia

A mini facelift can eliminate jowls or sagging skin on your lower face and jawline. This facial rejuvenation procedure delivers less dramatic results than a full facelift, but you’ll have a shorter scar and need less recovery time, while still achieving a well-contoured transition between the lower face and neck.

If you’d be happy with more subtle, temporary results, you could consider a nonsurgical neck lift. Every doctor who offers them has a favorite technique, but they usually combine several of these rejuvenation techniques:

  • Botox injections into the platysma along the underside of the jawline and down each band relaxes the muscles that pull the mouth and neck down and smooths out the appearance of the neck. In a 2017 study on the use of Botox for neck rejuvenation, sometimes referred to as a “Nefertiti lift,” 96.6% of patients were satisfied with their results.
  • Dermal fillers can help fill in horizontal neck lines, giving the neck a more youthful look. This anti-aging effect should last about a year.
  • Laser resurfacing and radiofrequency (RF) microneedling can be good choices if you’re looking to smooth fine lines and crepey skin along the neck area. They create microdamage along the superficial and/or lower layers of the skin, which then triggers the body’s healing response for smoother, firmer skin.
  • CoolSculpting is also worth considering, if a double chin is your only concern, though you’ll see results much more quickly with chin liposuction. (Both of these methods target only superficial fat, not deeper deposits.)
  • Ultherapy, Sofwave, and other energy-based treatments can also be used to smooth or tighten the appearance of your neck. The device heats the tissue below the surface of the skin and stimulates your natural collagen production to tighten the area.
  • FaceTite and NeckTite are minimally invasive procedures that use RF energy to melt fat and modestly tighten the skin of the lower face and neck, for a slightly more contoured look.

Related: The Treatments & Products Dermatologists Use to Anti-Age Their Own Necks

Neck thread lifts with PDO threads are not a reliable solution for neck laxity because they can’t support the (substantial) deeper tissues. Since the skin of the neck is thin and fragile, these superficially placed threads can often be seen or felt under the skin. There’s also the risk of extrusion (threads popping through the skin), puckering, and scarring. 

Dr. Mesa says, “When a patient asks me what my opinion is about thread lifts as a replacement for a neck lift, I tell them it is the best way to waste your money since the results are minimal and usually only last approximately six months.” 

A better option for some patients (those with minimal skin laxity and submental fat) may be the MyEllevate procedure, which suspends the deeper tissues of the neck with an internal suture support system. The minimally invasive neck-contouring procedure is reported to have a low risk of complications.

Interested in a neck lift?

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Updated May 25, 2023

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