Hollowing under chin after neck lift - is it possible to avoid this? (Photos)

Hello, hope you are doing well. A central hollowing/depression in the neck after neck lift surgery is sometimes referred to as a 'cobra neck deformity'. This generally occurs when contouring of the soft tissue under the chin is done too aggressively. It is not expected to happen, and it can be avoided. I advise you to ask your surgeon what they plan to do in your central neck to achieve the best result (contour) while balancing your concern about having this complication.

Best,
Dr. Tower

Some patients notice a hollowed appearance under the chin or around the throat after a neck lift. This isn’t always a sign of something gone wrong — it often comes down to individual anatomy.
When excess skin is removed, and if the underlying fat or muscle is naturally thin (which is especially common in lean individuals), the area can look more sunken or tight than expected. It’s not necessarily about the surgery being too aggressive — sometimes it’s just how your body is structured.
This look can sometimes be softened with surgical techniques like careful platysma muscle handling or even a small amount of fat grafting — but whether this is needed depends entirely on your anatomy.
The best step you can take is to mention this specific concern during your pre-op consultation. Your surgeon can evaluate whether you're likely to experience this effect and adjust the approach if needed. The goal is always a natural, balanced result that works with your facial and neck structure.

Hollowing after a Neck lift is a risk most commonly with a deep neck lift. When removing the sub-platysmal fat, resection of digastric muscle and excision of part of submandibular gland, the neck may appear skeletonized afterwards.

If you are getting a lower face/neck lift, then don't worry since it is rare to get that hollowing effect. Your doc will remove the fat and suture the muscles and skin together nicely so it should be just fine.

This generally occurs if the surgeon is too aggressive in "deep neck" maneuvers such as removing too much fat under the platysma muscle. Whether or not deep neck work is needed is highly dependent on anatomy- there are many patients that do not require this, as they have little or no excess fat under this muscle. However if sub-platysmal fat is excised for contouring, it should be done very judiciously to avoid hollowing.
Sean Fisher, MDAesthetic Plastic SurgeonSeattle, WA

The hollow can be too aggressive removal of fat or anatomy. Your anatomy should be fine with the facelift.