What is the difference between a lower facelift and a neck lift and a lower face lift with a plasma muscle tightening?

Doctor Answers 12

Different names for nearly the same procedure.

If a lower facelift and neck lift is being done, this is virtually the same as a lower face lift with platysmal tightening.  There are some small differences that each surgeon may do for each procedure but not enough to warrant calling them distinct procedures.  Be sure to see a board certified plastic surgeon.

Lower facelift and neck lift

Dear Jane, thank you for your question. A neck lift involves a slightly smaller incision and deals only with the jawline contour/ neck. A lower facelift often involves tightening of the neck too (including platysma tightening) through slightly more extended incisions - the benefit of such an approach is that the jowls can be improved as well as the jawline contour. Most patients who present for a neck lift actually benefit more from a lower facelift and sometimes volume filling too.  Good luck!

Difference between a lower facelift and a neck lift and a lower face lift with a plasma muscle tightening?

 Hi, I have performed many facelifts over the past 30 years and these are basically the same thing.  Once the platysma muscle is plicated, this creates ridges along the neck on either side of the tightened platysma muscle.  The full neck lift is then performed from incisions three inches within the posterior hairline (about 4 inches long) and the tissues are dissected from this point all the way across the neck to the same place on the opposite posterior hairline.  This extensive dissection is required for the tissues ridges, mentioned above, to be pulled backward and upwards allowing redistribution of the sagging neck skin.  Traditional facelifts will often incorporate a full neck lift however this degree of invasive tissue dissection requires drains, pressure dressings and months to recover.  For that reason, the vast majority of my facelift patients have opted for a less invasive, minimally invasive SMAS facelift as described below. I have performed many minimally, invasive type facelifts.  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.

If the chin is weak, this 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 ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • 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.

Hope this helps.

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

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Neck Rejuvenation Options

Thank you for your question.  Tightening the platysma muscle can be an extra procedure which some patients may need to ensure a tight contour neck.  Tightening of the platysma muscle (also know as platysmaplasty) will require a small incision under the chin away from direct view to gain access to the front edge of the muscle on the neck; they are sutured together with permanent stitches.  The muscles of the neck are the foundations and building blocks of the neck are fundamental to achieving a tight and toned result.Not all patients will require having the muscle bands stitches back together, therefore removal of skin which has lost elasticity maybe sufficient to achieve this results.  Alternatively, some patients may need neck liposuction, for those who have excess fat under the chin.  Overall, to obtain the best results a combination of neck rejuvenation procedure maybe needed.Neck Rejuvenation is often used in conjunction with a Concept™ Facelift, in order to provide rejuvenation to the whole area.  This is why it is important to have a comprohensive consultation with a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.Best Wishes 

Amir Nakhdjevani, MBBS, MRCS, FRCS (Plast)
London Plastic Surgeon
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Essentially the same

Your two descriptions are essentially the same; except in certain cases, some doctors may not perform platysmal tightening in a neck lift in someone who is young and does not need it.  Its best to get a consultation from a board certified plastic or facial plastic surgeon who is experienced in this procedure with reliable results.

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

What is the difference between a lower facelift and a neck lift and a lower face lift with a plasma muscle tightening?

The 2 procedures, lower facelift and a neck lift and a lower face lift with a plasma muscle tightening are essentially similar. What is more important than the specific technique is the experience and artistry of the plastic surgeon. 
I would suggest your a plastic surgeon be 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 withwho has all of the modalities of treatment available. 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

Lower Facelift and Platysmaplasty

 As the face ages, looseness in the lower face contributes to the looseness that is seen in the neck. As aging continues, the neck muscles start to separate in the middle of the neck leading to "bands" or " turkey neck" . A lower facelift will help the neck to some degree, but it will not treat the muscle separation in the middle of the neck. This will become visible again within the first 3-6 months unless a neck lift ( platysmaplasty) is performed at the same time. It is possible to do a neck lift without a lower facelift, however, this would be based on what your surgeon sees during your consultation. 

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


In the old days, the facelift consisted of undermining the skin and fat off the muscle fascia, cutting off the excess and pulling back the skin under tension.  During my residency, a new concept was proposed by Dr. Bruce Connell which involved tightening and repositioning the muscular elements of the face and neck. Numerous variations of his concept are now employed.  But his concept of SMAS and platysmaplasty has withstood the test of time.

Most competent plastic surgeons incorporate repair of substructures rather than just pulling the skin. Our understanding of facial aging changes yearly.  3D photo analysis of the aging process by Val Lambros MD FACS has just revealed new findings in the aging process we never appreciated.  The distance from the base of the nose to the lip lengthens with age and the corners of the mouth turn down.  The notch in front of the jowl is actually fat atrophy, not the result of the jowl.  The lower lid rises up the eyeball, not falls.  

Lower face and neck surgery generically includes the mid face and neck. Most of us old timers agree that the SMAS and platysmaplasty have withstood the test of time.   Every patient is different, and surgery should be customized.  There are many inexperienced practitioners attempting short cuts that may be disappointing. 

Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.8 out of 5 stars 9 reviews

Facelift vs necklift

Basically a necklift and facelift are very similar. Check out my you tube video on the subject.  The playsma muscle tightening is usually part of tightening the neck and is performed either by pulling it tight and suturing behind the ear or by sewing it under the chin, and sometimes both.  There are other variations to tightening the muscle depending on the exact goals.  Your surgeon should not have one facelift procedure but should taylor the lift to the specific needs and goals of the patient

Edward J. Ricciardelli, MD
Wilmington Plastic Surgeon
5.0 out of 5 stars 24 reviews

What is the difference between a lower facelift and a neck lift and a lower face lift with a plasma muscle tightening

The 2 procedures, lower facelift , neck lift and a lower face lift with a plasma muscle tightening are essentially similar. Consult with a board certified plastic surgeon for an in person exam  to discuss your options and expectations.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 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.