Neck Lipo or Platysmaplasty or "Neck Lift"? Pros and Cons?

34 y.o. M actor with submental fat. DR 1 said neck lipo. Dr. 2 said that people really platysmaplasty/muscles tightened. Dr 3 said that his "neck lift" removes fat UNDERNEATH the muscle. This sounds best. He warned me against Lipo, said it creates scar tissue, complicates future surgeries. Questions: What are the + and - of neck lipo vs platysmaplasty vs. neck lift? What about 1 surgery that removes fat underneath, tightens muscle, then lipos fat above? Want tightest jawline possible.

Doctor Answers 17

34 yo male actor with submental fat

Platysma bands and submental fat are a major reason for facelift and neck lift surgery. Botox may be a nonsurgical option. Recent studies indicate that a deep plane facelift with separation of the platysma from the SMAS and suspension of the bands have a better result than plication of the bands. Of course, elasticity of the skin, amount of fat to be removed, and quantity of skin are all important considerations. 

San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

How do I remove fat from under my chin?

I would suggest the least invasive procedure if you are an actor and want fat removed from under your chin. You have two alternatives for this, either non-surgical injections with Kybella which will require several injections, costly and sometimes prolonged swelling, or liposculpture with small cut under the chin which I perform under total local anesthetic with no bandage after and usually minimal bruising with usually excellent improvement. Save the more extensive procedures for when and if you need them when you grow older. Minimal is usually better!

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Neck Lipo or Platysmaplasty or "Neck Lift"? Pros and Cons?

 Hi, liposuction removes/reduces fat above the muscle but below the skin.  Going underneath the muscle, under the chin, can lead to muscle injury and abscesses within the mouth and neck.  What's creating the "double" chin depends on the projection of the chin, the amount of excess fat, Platysma laxity (not very common in a 34 year old) and the amount of excess skin. Often, the chin is weak when a double chin develops in the twenties and thirties.

 I have performed many Chin Augmentations using chin implants for over 30 years.  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, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  

 Following the beauty principles outlined in my book on face and body beauty, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  The following procedures would create a more ruggedly handsome face.

  • Cheek augmentation with cheek implants to add angularity to the cheeks and mid face.  This would be combined with liposuction to reduce the excess facial fat to further define the cheek shape.
  • Chin augmentation, using a chin implant, to add projection to the chin creating harmony and balance to the lower face with removal of excess fat/skin as needed.
  • Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.

Hope this helps.

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

Neck lift versus liposuction

In our practice, a neck lift involves making three incisions each approximately 1 inch long, which are placed underneath the chin and behind each ear. This allows access to the neck so that open liposuction can be performed to remove the fat above the platysma muscle. When patients have fatty deposits underneath the muscle, that must be surgically removed through the 1 inch incision underneath the chin. Once the fat is been removed from underneath the chin, a platysma plasty is required.  A platysma- plastyand the fat removal from underneath the muscle will create a significant enhancement of the jawline, which is much better than simple blind liposuction. There is no skin removal. When patients require excess and loose facial skin removal, a lower face and neck lift is usually required on patients over 50 years of age. For more information  and many examples of neck lifts, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Neck rejuvenation options

Thanks for sharing. In general, current neck and lower face rejuvenation treatments include:

  1. Surgical Neck lift* with a Lower Facelift would be the gold standard and gets the best overall results in the jowls and neck and indicated in middle age and older patients
  2. Surgical Neck lift* which involves lifting and removing loose skin would be the next best procedure
  3. Neck Liposuction and/or Laser Lipolysis if only fat removal is required, typically in a younger patient. (A platysmaplasty can be added for further muscle tightening if needed)
  4. Ultherapy is an FDA approved non invasive tightening using ultrasound technology
  5. Kybella is a new FDA approved series of injections that melts fat under the chin
  6. Cool Sculpting is FDA approved energy device to removed fat from under the chin as well. 
  7. Botox to the platysma bands to decrease their activity and show

*It is important the a Neck lift involves some liposuction and importantly a platysmaplasty which is a procedure that tightens the underlying loose neck muscles.  At your age option 3 would likely be the proper choice. Consult with several board certified faciall platic / plastic surgeons experienced in face and neck rejuvenation to discuss your options

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 86 reviews

Best neck options

Thanks for your question.  You could have several choices depending on your specific anatomy.  Some options are liposuction, neck lift with band tightening and kybella.  It sounds as though you have researched this and seen different doctors for their opinions.  Sometimes the most difficult part is deciding which option to take.  Maybe see another doctor to get this final opinion is what you need to do.  Photos would make this easier to determine, but an in person visit to your board certified plastic surgeon is the best.  Good luck to you.

Anna I. Wooten, MD, FACS
Pittsburgh Plastic Surgeon
4.7 out of 5 stars 46 reviews

Neck fat - liposuction, neck lift or neck-lift 'plus'

Thank you for asking about your neck fat.

  • For most men, removing excess fat + platysma tightening gives the best result.
  • There may or may not be excess fat under the platysma.
  • Liposuction does work well - for some people - but the central or 'mini' neck lift with fat removal gives the most predictable results.
  • If your problem is just fat, you can consider Kybella as well - office injections, 6 weeks apart, usually 3
  • If Dr. 2 is planning surgical removal of fat plus muscle tightening, he seems to be more straightforward than Dr. 3 and should give you a better result than Dr. 1's liposuction.
  • But choose the surgeon with whom you have the best rapport and the greatest trust.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Neck lipo vs face/neck lift

Thank you for your question. Without photos it is difficult to give you suggestions. It appears you have done your homework and visited with a few different surgeons. There are several options to address the neck including something like Kybella or Coolsculpting mini which are non-invasive options. Liposuction can be a good procedure as can a face/neck lift with a platysmaplasty depending on the patient. In order to remove the fat underneath the muscle and tighten and/or divide the platysma bands, a face/neck lift is a great option. You had asked about performing lipo in addition to the platysma work. In this case the more superficial fat would be exposed so it can be directly removed so no liposuction would be required. To improve your jaw line and your neck, the face/neck lift is probably your best option, but again this is my opinion based on no photos.

Neck contour

Hello and thank you for your question. There are many options including liposuction, necklift, kybella, etc.  The best option for you truly depends on your individual anatomy.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 122 reviews

Lipo likely not enough

Its difficult to say anything without pictures.  I find that all 3 are necessary if you truly want definition of the neck and your best possible result.  Its the way I've done the majority of my surgeries on patient's who request and need this..  If you want to have a tight jawline, you need to remove the fat, tighten the platysma in the midline as well as the sides, hence, the platysmaplasty with a neck lift and lipo.  Its best to seek an experienced surgeon for a personal consultation.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 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.