What is the newest method for performing a neck lift?

Most doctors suggest an incision under the chin and sewing the platysma muscle together. However, one doctor said this is unnatural and does not do that anymore. Instead he tightens the muscle on each side behind the ear and does a little liposuction under the chin. It seems that the more doctors I see the more confused I get. I do not want to feel like I'm choking from having my platysma muscle sewed together too tightly. And I would prefer it not be sewed together at all it it's unnatural.

Doctor Answers 17

Newest Techniques for Neck Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Newer techniques are important and will be covered in my answer below. Most important is finding the best plastic surgeon possible.
The best recommendations to improve your neck appearance depend on your needs, desires, and most importantly an examination to determine the best procedure for you. Your plastic surgeon will evaluate you for five main features that will determine your best options for neck line improvement:
  1. Amount of excess fat typically found beneath the chin, and in the upper neck. This requires liposuction with small cannulas or direct removal especially if the fat is beneath the platysma muscle.
  2. Presence of Significant (Platysmal) Banding – this requires bringing the muscles together in the upper/mid neck to a more youthful position and occasionally their release. This procedure is called a platysmaplasty or platysma plication. Mild banding can be treated non- surgically with Botox or Dysport but this requires injections 3-4 times a year for maintenance.
  3. Amount of excess/redundant skin (cutis laxa) and condition of your skin. In advanced stages this is called a Turkey Waddle or Gobble deformity. For example, younger age, darker skin colors and no large weight loss history most likely means there will be better elasticity and therefore better post-surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. Mild to minimal skin tightening using non-surgical means like the Sciton Laser SkinTyte procedure, Ultherapy or Thermage could also be considered. My personal preference for non-surgical skin tightening of the neck is the Sciton Laser BBL SkinTyte® procedure as there is no down time, more comfortable procdure, is effective and is a more targeted treatment. For redundant upper and mid excess neck skin: I prefer the LiteLift® (lower facelift ) procedure or MACS for skin re-draping for mild to moderate excess skin management as there are minimal scars and the skin is lifted vertically allowing for minimal hidden scars resulting in a natural appearance “non pulled” appearance. However: for moderate to severe skin redundancy , a neck lift or traditional lower facelift (e.g.Lite Lift®, MACS and others) is needed with or without lipo for best results. For advanced Turkey Waddle correction wither a traditional facelift or posterior neck lift often with a platysmaplasty is required with more extensive scars that extend at the hairline behind your ears. The advantage of a facelift procedure rather than a posterior neck lift is that your lower jawline (e.g. jowls and marionette lines) are also improved at the same time.
  4. Chin deficiency. If you have a weak chin then you will not have adequate chin support to your neckline skin which affects your entire neck line. Sometimes especially in younger individuals this is all that is required and this can be done in the office under local anesthesia. There are a number of different sizes and shapes and your plastic surgeon will pick the optimal one for you.
  5. Presence of prominent Digastric Muscles or Submandibular gland fullness from laxity or enlargement. Although not a major concern for most patients, if present then partial resection is usually the best solution.


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This is a great question, but photos would be need to be specific to you. One of the most requested procedures is about  improving the neck. But what you must understand; what is causing the neck sagging and the bands? The tissues that were above the jawline are now below the jawline, and to correct the problem we must put things back to where they use to be (anatomically). Because of this, an isolated neck lift is not usually recommended or appropriate. The best correction is with lower facelift or a cevical-facial lift.

As for dealing with the bands I have found that the lateral tightening (on the side) is more effective and lasts longer than the mid-line plication, which is not an anatomical procedure. The liposuction is usually used to contour the neck and define the jawline. However every patient is different. That is why we have different techniques and why the surgical procedure is not the some for everyone.

Consult with a qualified facial plastic surgeon. Look at their results and you need to feel comfortable with the surgeon. Please look at my gallery of before and after photos below. Best wishes.

James Shire, MD
Chattanooga Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

How Neck Lifts Are Performed

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The type of necklift incision will depend upon your gender, your hairline and preferred hairstyles, any scars from previous surgeries, and a variety of other factors.  As a general rule, a #necklift #incision starts right in front of or within the hairline on the temple, follows the curve of the front of the ear, travels underneath the earlobe, and ends at the hairline behind the ear.  There are also shorter #scar techniques preferred by many patients, which do not have incisions in the hairline.  Some patients who wish to have liposuction or tightening of their neck will need an additional incision under their #chin, which can be hidden in a natural skin fold.

Local anesthetic is usually used in combination with #intravenous #anesthesia during a necklift operation, allowing you to sleep peacefully through the procedure. Though general anesthesia may be requested, it is not necessary in most cases.  A necklift and any additional procedures you may add are #outpatient procedures usually performed in a surgery center. In some cases, your surgeon may advise you to stay in a post-op care facility for a single night. 

It is important to be realistic with your desired results. Necklifts are designed to remove only deep grooves and #wrinkles, not fine ones. Smoothing out every tiny line in your face would leave you with an eerie, unnatural, and undesirable result. The goal should be to make your necklift look as natural as possible, simply turning back the clock a few years.  

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Neck Lift Options and Techniques

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The question of what approach to the neck is best is debated among surgeons regularly.  While there are no truly new techniques for performing a neck lift, there are twists on the procedure that are mostly marketing ploys rather than truly new. 

The question of which approach is best, under the chin or up by the ears, is also debated.  If you perform the age old finger lift, it is always up.  After years of doing both techniques and sometimes combined techniques, I have abandoned the submental or under the chin approach as I find the complication rate to be less and the results and the satisfaction rates to be so much better.  In addition, this approach will deal with other issues like the jowls and wrinkled cheek skin as an added bonus.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

The newest necklift not widely practiced by most plastic surgeons is the "New Necklift"

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The New Necklift is the result of over 8 years of development and over 2000 procedures performed. It permits patients to have significant improvement in the areas under the chin as well as the jowels. It is a combination or hybrid procedure of minimal incision necklifting combined with thermoplastic/laser/radiofrequency techniques pioneered by our clininc. It can be performed in under an hour. Not all patients are candidates for the "New Necklift". The MIA center or Minimally Invasive Aesthetic Center specializes in technology aided and minimal incsion techniques.

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 45 reviews

Neck Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. There are no real "new" surgical methods for perfoming a neck lift. Generally speaking, there are lateral and medial platysmaplasties. Surgeons have different opinions about whether to pull the platsyma bands (neck muscle edges) laterally as part of a facelift or suturing them medially via a submental incision. I hope this helps!

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Newest Neck Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
There is no "newest" neck lift, but there are lot of solutions to the problem, depending upon what the problem is.  Without photos, of course, we don't know.  And remember, plastic surgery is an art more than a science.  So it's easy to become confused when talking to several surgeons.  We all do it differently.  But if you express your specific concerns with your doctor (neck too tight, unnatural look) he/she can better avoid those issues.  I almost always carefully remove at least some fat, though it's important to leave an adequate amount under the skin to avoid irregularities and unnatural skin tone.  Additionally, I tighten the muscle from under the neck in most patients, and from the sides in others.  In some, I tighten from BOTH the front and sides in order to get a better sling effect.  However, I am most careful in preventing anything that begins to look or feel artificial.  After all, not looking natural after plastic surgery is the most common fear I hear from my patients.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 42 reviews

Neck lift surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
First I do all my necklifts with simple oral sedation ( Valium, Ambien ) and local anesthesia injections.. This removes 95% of the surgical risk which is inherent in the anesthesia process. With local anesthesia as the surgical method, operative and post-operative bleeding are almost completely eliminated. Except for a few needle sticks the process is  painless. A good necklift that will last years takes me 1 hour this way in the office operating room.
    I tend to agree with the surgeon who tightens the muscles behind the ear and does only a little liposuction under the chin. In most patient this gets a fabulous and natural looking result.  I agree also that sewing the platysma muscle together is usually uncomfortable for most patients and receives a lot of complaints.
    On ocassion some patients have very prominent platysma bands, and these must be cut from an incision under the chin to reduce the " Cobra " appearence they can produce. But even if this needs to be done the bands should not be sewn together.

Neck lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
There are several ways to perform neck lifts depending on the problem.  Without a picture or an examination, it is difficult to advise you with any accuracy.  An incision under the chin can help tighten muscles and reduce banding of the neck.  Suspension stitches from behind the ear can also help tighten the neck muscles by pulling them tight from the sides.  Again, each patient must be approached individually.  It sounds like you have had several consultations and just need to decide which doctor you think will do the best job for you. 

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Newest Method of Neck Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I agree with the doctor that said that neck lifts are unnatural. The problems in the neck are caused by descent of tissues from the face. There is, therefore, nothing you can do solely in the neck to correct these problems. Once this was realized, together with understanding that the costs and recovery from a neck lift is as great as a facelift, have led to doing neck lifts only with a facelift. This corrects all the problems, especially if the procedure is based on the MACS Lift and elevates the tissues back to their natural position instead of artificially backward. The neck is tightened by reconstructing the stretched ligament below the angle of the jaw, recreating the natural contour. Other ancillary procedures such as liposuction are used as needed to obtain the best result. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.