Face and Neck Lift Surgery after Weight Loss

By Dr. Scott J Turner, Specialist Plastic Surgeon

Last Updated May 2025

Congratulations on your weight loss journey! While shedding excess kilos is a remarkable achievement for your health, many patients discover an unexpected side effect – facial ageing. At my Sydney plastic surgery practices in Manly and Double Bay, I regularly consult with patients who have experienced weight loss and are seeking solutions for the resulting facial changes.

How Weight Loss Affects Your Face

Have you noticed that after losing weight, your face appears older than before? This is a common and normal phenomenon. Research shows that patients with massive weight loss appear approximately 5 years older than their actual age.

When we lose substantial weight, three key changes occur:

1. Loss of Facial Volume

Think of your face as a balloon slowly deflating. Fat pads beneath the skin that previously provided youthful fullness diminish with weight loss. Clinical studies show that weight loss can cause a dramatic 42-70% reduction in key facial fat pads, creating a gaunt appearance distinct from natural aging. This volume reduction is particularly noticeable in the:

• Cheeks: Creating a hollowed appearance (studies show cheek fat pads can reduce by nearly 70% with weight loss)
• Under-eye area: Forming tear troughs and depletion of the suborbicularis oculi fat (SOOF) pads
• Temples: Causing a skeletal look (temporal fat pad reductions of over 40% have been documented)
• Perioral area: Loss around the mouth and lips leads to fine lines and oral commissure ptosis

Unlike typical aging, where fat is redistributed unevenly, weight loss removes fat relatively evenly throughout the face—including areas where fullness contributes to a youthful appearance. This creates what many plastic surgeons refer to as a “deflated” facial appearance.

2. Increased Skin Laxity

Our skin is remarkably elastic, but there are limits to its ability to contract after being stretched. Following weight fluctuations, excess skin may hang or fold, especially around the:

• Lower face and jawline: Forming jowls (studies show 100% of massive weight loss patients develop ptotic jowls)
• Neck area: Creating what’s often called a “turkey neck” with average skin excess measuring 3.2 cm in the submental region (versus 1.8 cm in age-matched individuals)
• Nasolabial folds: Lines running from nose to mouth become more pronounced
• Platysmal bands: About 82% of weight loss patients exhibit pronounced vertical neck cords from platysma muscle diastasis

This skin laxity is often more pronounced in weight loss patients than in typical aging because the skin was previously stretched to accommodate excess fat. The superficial musculoaponeurotic system (SMAS)—the structural layer beneath the skin—also becomes more lax than in the average aging patient, showing reduced elastic recoil due to prolonged mechanical stress from excess facial adiposity.

3. Reduced Collagen Production

Weight loss accelerates the natural age-related decline in collagen and elastin – the proteins responsible for skin firmness and elasticity. This reduction compounds the effects of skin laxity, creating deeper wrinkles and facial folds. Collagen fragmentation from repetitive skin stretching further compromises skin quality. Without appropriate intervention, these changes can create a disparity between body and facial appearance that may diminish the psychological benefits of your weight loss achievement.

Is Facial Rejuvenation Right for You?

Facial rejuvenation procedures can improve your appearance after weight loss, but not everyone is an ideal candidate. During consultations at my Sydney clinics, I carefully assess several factors:

Ideal Candidates Should Have:

• Stable Weight: You should be at or near your target weight for at least 6 months before undergoing facial procedures. Research indicates this minimum stabilization period allows for metabolic normalization and reduces the risk of further changes that might compromise surgical outcomes.
• Good Physical Health: Optimal healing requires good overall health without medical conditions that could interfere with recovery. For patients with a history of bariatric surgery, we carefully assess nutritional status, as deficiencies in vitamins and minerals can impair wound healing.
• Realistic Expectations: Understanding what can and cannot be achieved is crucial for satisfaction with your results. We’ll discuss how your unique facial structure and skin quality will influence outcomes.
• BMI Considerations: For safety and optimal results, I recommend a BMI below 30 for facial rejuvenation procedures. Research demonstrates that patients with BMI under 28 experience 23% lower complication risks compared to those with BMI over 30. This threshold helps ensure both your safety and optimal aesthetic results.
• Non-Smoking Status: Patients must cease smoking for at least 6 weeks before surgery, as smoking compromises healing and results. This applies equally to vaping and all nicotine products.

Note: As of July 2023, Australian regulations require a psychological evaluation before proceeding with cosmetic surgery to ensure patients are emotionally prepared.

Treatment Options: Surgical vs. Non-Surgical

Facial rejuvenation isn’t one-size-fits-all. Depending on your specific concerns, age, and the extent of facial ageing, different approaches may be recommended:

Non-Surgical Options

For patients with only mild concerns, non-surgical treatments are available, though their effectiveness is limited for those with significant weight loss:

• Volume Restoration: Injectable treatments can temporarily add volume to hollow areas but generally don’t address the structural changes after massive weight loss.
• Skin Tightening Treatments: Technologies using radiofrequency or ultrasound may provide minimal improvement for mild skin laxity but rarely deliver meaningful results for post-weight loss patients.
• Thread Treatments: While these can create a subtle temporary lift, they typically fall short for the degree of laxity seen after substantial weight loss.

In my experience, most patients who have experienced massive weight loss find that surgical intervention provides the only truly effective solution for their concerns.

Surgical Solutions for Dramatic Results

For patients with more pronounced facial ageing after weight loss, surgical interventions provide comprehensive, long-lasting correction:

Deep Plane Facelift

The gold standard for addressing significant facial laxity, a deep plane facelift:

• Lifts and repositions deeper facial tissues (not just skin)
• Creates natural-looking results without a “pulled” appearance
• Provides longer-lasting correction than traditional facelifts
• Effectively addresses jowls and mid-face sagging

The deep plane technique is particularly effective for post-weight loss patients because it addresses the structural layer (SMAS) that becomes lax after significant weight loss.
To learn more about this advanced technique, visit our Deep Plane Facelift page.

Neck Lift

Often performed in conjunction with a facelift, a neck lift specifically targets:

• Loose, hanging skin beneath the chin
• Vertical “bands” caused by platysma muscle laxity
• Excess fat deposits under the chin
• Poor definition along the jawline

For patients with significant neck laxity after weight loss, a procedure called Corset Platysmaplasty can be especially effective. This technique directly addresses platysmal bands while removing excess skin to create a more defined jawline.
For more detailed information about neck lift procedures, visit our Neck Lift page.

Facial Fat Grafting

After weight loss, volume restoration is crucial for optimal rejuvenation. Fat grafting:

• Uses your own fat harvested from another body area
• Creates natural-looking volume in cheeks, temples, and under eyes
• Provides lasting results compared to temporary fillers
• Improves skin quality through stem cells in the transferred fat

Post-weight loss patients typically require more fat transfer than traditional facelift patients to restore adequate facial volume. The procedure helps address the hollow appearance that often results from significant weight loss, particularly in the cheeks, temples, and around the mouth.
For more information about this volume-restoring procedure, visit our Facial Fat Transfer page.

Complementary Procedures

Depending on your specific concerns, additional procedures may enhance your results:

• • Brow Lift: Corrects forehead drooping and opens up the eye area, addressing brow sagging that contributes to a tired appearance
  • Eyelid Surgery (Blepharoplasty): Removes excess skin and fat from upper or lower eyelids, addressing sagging lids and under-eye bags that often become more pronounced after weight loss
  • Skin Resurfacing: Improves skin texture and reduces fine lines, enhancing the overall quality of facial skin

For many weight loss patients, a combination of these procedures provides the most comprehensive improvement, addressing multiple aspects of facial aging simultaneously.

What to Expect: The Facelift Surgery Journey

At my Sydney practice, I specialize in the advanced deep plane facelift technique, which is particularly effective for post-weight loss patients:

Before Surgery: Thorough Planning

• Comprehensive Consultation: We’ll discuss your goals, examine your facial anatomy, and develop a personalized treatment plan. For weight loss patients, I’ll carefully assess areas with skin excess and identify fat loss patterns to guide our surgical approach.
• Pre-Surgical Preparation: You’ll receive detailed instructions for the weeks leading up to surgery, including medications to avoid. For patients with a history of bariatric surgery, we’ll address any nutritional deficiencies that might affect healing. In some cases, I may recommend specific supplements:
  • Vitamin D3 supplements to correct deficiencies common in bariatric patients
  • L-arginine supplements, which can improve wound healing
  • A comprehensive multivitamin regimen to support recovery
• Surgical Marking: On the day of surgery, I’ll meticulously mark incision locations, deep plane entry points, and areas for volume restoration. For post-weight loss patients, this includes:
  • Strategic incision planning that accommodates greater skin resection
  • Careful mapping of facial nerve pathways to ensure safe dissection
  • Precise marking of volume restoration zones

During Surgery: Precise Technique

Performed under general anaesthesia in a fully accredited hospital, the procedure typically takes about 4 hours and involves:

1. Strategic Incisions: Carefully placed along the hairline and around the ears to remain well-concealed. For patients with significant skin excess, I may use:
   • Superior extensions into the temporal hairline to accommodate additional skin resection
   • Postauricular incisions that allow for greater posterior lift vectors
   • Specialized techniques to prevent earlobe distortion
2. Deep Plane Dissection: Working beneath the SMAS (Superficial Musculoaponeurotic System) within specific facial spaces. The SMAS, skin, and subcutaneous tissues are elevated together as a composite flap, allowing for greater correction of sagging and facial contouring. Retaining ligaments, which contribute to skin laxity, are carefully released to facilitate repositioning.
3. SMAS Repositioning: The SMAS layer is lifted and repositioned vertically, addressing midface and jowl laxity. For weight loss patients, I often employ:
   • SMAS stacking plication techniques that provide 38% greater suspension strength
   • Horizontal mattress sutures that create optimal lifting vectors
   • Advanced fixation methods that ensure long-term results
4. Neck Rejuvenation: The neck is frequently addressed during the deep plane facelift to ensure a seamless transition between the face and neck:
   • Liposuction: Excess fat deposits in the neck are removed to enhance contour
   • Platysmaplasty: A formal neck lift is performed to correct deep neck laxity and improve the definition of the jawline
5. Fat Transfer: For significant weight loss patients, strategic placement of harvested fat to restore volume in depleted areas is essential. This addresses the volume depletion in areas like the cheeks, temples, and under the eyes using precise injection techniques for optimal fat survival.

Recovery: What to Anticipate

• Hospital Stay: An overnight stay ensures optimal monitoring and comfort
• Initial Recovery: Expect swelling and bruising for 10-14 days
• Return to Activities: Most patients return to light activities within 2 weeks
• Final Results: While immediate improvement is visible, final results continue to refine over 3-6 months

Why Choose Dr. Turner for Your Facial Rejuvenation

As a Specialist Plastic Surgeon with extensive experience in post-weight loss body contouring, I understand the unique challenges faced by weight loss patients. My approach combines:

• Advanced surgical techniques focused on natural-looking results
• Comprehensive assessment of your facial anatomy and ageing patterns
• Customised treatment plans addressing your specific concerns
• Meticulous attention to detail for optimal outcomes

Take the First Step

If you’ve experienced weight loss and are concerned about facial ageing, I invite you to schedule a consultation at either my Manly or Double Bay clinic. Together, we’ll develop a personalised plan to help you achieve facial harmony that complements your weight loss success.

Ready to learn more? Contact us today to schedule your consultation.

Note: This information is of a general nature only. All procedures involve risks and potential complications. Please consult with Dr. Turner to determine whether facial rejuvenation is suitable for you.