Do I need neck lift or lower face lift? (photos)

Hi, I hv tried utherapy, PRP, cream, all kinds of things, still see 3 lines on neck. Do I need neck lift, chin lipo, or lower face lift?

Doctor Answers 11

Possible improvement in neck lines.

These neck creases can be treated with a necklift to relaese the skin attachment to the underlying platysmal muscle, but full resolution of them should not be expected.  You have tried an number on non- invasive techniques without success so be wary of other ones offered as a solution.  See a board certified plastic surgeon for a frank discussion about how best to minimize these lines.

Surgery vs Non Surgical

Thank you for your question and photos. It sounds like you gave the non surgical approach the college try and therefore surgery is probably your best bet. That said it should be explained that the three lines you are referring to may not completely resolve and will likely return over time. A neck lift would be most beneficial because your jawline looks refined and without any obvious jowl. Remember surgery is best at re-draping lax skin and tightening deeper tissues. Many of the lines in our face are the result of normal muscular contraction which will persist after surgeryA formal consultation with a board certified plastic surgeon would be your best option to discuss all procedures available to youBest of LuckDrG

Lee A. Gibstein, MD
Miami Plastic Surgeon

Neck lines - what to do?

Thank you for asking about your neck lines.
  • I suspect you will need a neck lift to release skin attachments to underlying platysma
  • That said, a consultation is needed-
  • Sorry your money has been wasted - please see a plastic surgeon if you haven't done so.
  • Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

Lower Facelift or Necklift

Although your pictures are helpful, it is still difficult to adequately see what is creating the wrinkles in your neck. I'm not sure if it's because of your neck being flexed or if it may be due to some irregular fat deposits. Your treatment options may be as simple as injecting filler into the lines, laser liposuction, or combining liposuction and thermitight. Even though Face and Neck lifts are by far my most favorite procedures to perform, my feeling is that a smaller procedure will likely help you achieve your treatment goals. The only way to know for sure is to be seen by an expert in face and neck cosmetic procedures.

Mark Karolak, DO, FAOCO
Bridgewater Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Double Chin Treatment / Laxity-- SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, Kybella, CoolMini

This type of neck really needs skin removal with VASER Hi definition liposuction for neck contouring. Neck lifting can be done as well by an expert for a more aggressive approach. Please see an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

You need surgery

You wasted your money and time on all those things that do not work. You need surgery. Best option can only be recommended after face to face analysis of a patient by the doctor.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Neck lift procedure versus face and neck lift

A full set of facial photographs are required to make a determination about what may need to be performed. In our practice, a neck lift involves removal of fatty deposits above and below the muscle in the neck in addition to a platysma plasty. No skin removal is necessary. When patient's have excess/loose skin in the neck, a lower face and neck lift is necessary. For more information and many examples of both procedures, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Do I need neck lift or lower face lift?

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your cheeks are flat anteriorly (in the front), there is excess fat below the cheeks, jowls are present and the chin is weak.  

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.  It's possible to reduce the amount of excess skin, under the chin, using the same curved incision for chin implant placement (under the chin).  The horizontal creases lower in the neck ar best treated with Botox as these would remain even after a full Neck Lift.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Facelift and neck lift go hand in hand to address the neck and the lower face.

The names of different surgeries and techniques can get confusing. You may hear different definitions from different surgeons. And the procedure is customized to each patient's needs.A facelift typically refers to addressing the lower portion of the face to improve skin laxity and volume loss that caused jowls and an aged appearance. This has a minor affect on the neck.A necklift  focuses on wattles under the chin and bands of the neck muscle to improve the definition of the jawline. The two procedures typically go hand in hand. It is rare to correct one area without making the other area worse. Excessive and aggressive pulling to remove every last wrinkle can make both areas look unnatural.I would recommend a full consultation with a physical examination and photo analysis to determine what treatment options are appropriate and safe for you. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Neck lift or lower face lift?

A necklift only addresses the neck skin laxity. It will not improve the jowls or cheeks.
A minilift also varies significantly in what it entails, depending on the surgeon performing it. It usually performed in patients with minimal laxity and would not improve your neck. The terms facelift and lower facelift mean different things to different patients and vary in their extent from surgeon to surgeon. A facelift or a lower facelift which would include the neck area would have the potential to produce the best cosmetic result of the neck, central cheek and jowl area.

Micro-fat grafts can produce a long term improvement of the areas that have depressions

It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

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.