By Dr Scott J Turner, Specialist Plastic Surgeon | Published: October 2025
A Question I Hear Every Week
“Dr Turner, my neck really bothers me, but my face is fine. Can’t we just fix the neck?”
This is genuinely one of the most common questions I hear during consultations at my Sydney, Brisbane, and Canberra clinics. I completely understand why patients feel this way. When something bothers us, that’s where our attention naturally goes. If you’re looking in the mirror and noticing a loose, sagging neck or what some patients call a “waddle” under the chin, it’s understandable that you want to address that specific concern directly.
So let me share with you what I wish every patient understood before considering a standalone neck lift procedure.
The Hidden Truth About Neck Aging
Here’s what many patients don’t realise about the anatomy: when you’re aging and you’re in your late 40s, 50s, and beyond, the source of your neck laxity isn’t actually the neck itself—it’s the face.
Let me explain why this matters.
The platysma muscle is a thin sheet of muscle that covers your neck and extends up into the lower face, where it continues as the SMAS (superficial musculoaponeurotic system). Think of it like a hammock that needs to be secured at both ends to work properly. As we age, the facial tissues that provide the upper anchor point for this muscle begin to descend. When the platysma muscle loses its upper support as the face starts to sag, the neck naturally begins to sag with it. Nothing is holding it up against the jawline and redraping it into that beautiful youthful neck contour you remember having.
Why I’m Cautious About Standalone Neck Lifts
Many surgeons still perform and advocate for isolated neck lift procedures. However, based on my experience and training, I have concerns about this approach for aging patients.
When we go into the neck and try to directly address the problem—whether that’s snipping the platysma muscle or plicating it—without elevating and supporting the platysma muscle up top in the face, what I’ve observed is that as the months and years go by, the neck often starts to sag again. Sometimes it can even leave an unusual or unnatural appearance.
My strong professional opinion is that the aging neck needs to be treated by vertical elevation of the SMAS (superficial musculoaponeurotic system), which is attached to the platysma muscle and holds the neck up. This is the practice I have seen work consistently, providing durable, long-lasting results. This approach is used in procedures like the deep plane facelift and vertical facelift.
If I’m being completely honest with you, I’d rate an isolated neck lift for aging patients about a 1 or 2 out of 10. It might give you temporary improvement, but in the long run, my experience suggests it’s likely to fail you, and you may find yourself disappointed with the outcome.
When IS a Neck Lift by Itself the Right Answer?
Now, I don’t want you to think that isolated neck procedures are never appropriate—they absolutely can be.
If you’re on the younger side—perhaps in your 20s or 30s—and you have absolutely no skin laxity but just have fullness under your neck, then an isolated neck lift or neck liposuction can be an excellent solution. This is particularly true for patients with genetic fullness under the chin. I have performed these procedures for many patients, and I believe there’s nothing wrong with this approach when it’s the right indication. It removes that heaviness from the tissue and helps achieve a slender, more defined neck.
But if you’re experiencing age-related changes? A neck lift by itself isn’t going to get you where you want to be. You may find yourself back considering additional surgery before you know it, wanting to restore that neck contour again.
Understanding the Comprehensive Approach
When I evaluate a patient who tells me “my neck bothers me but my face is fine,” I always take time during the consultation to show them what I’m seeing from an anatomical perspective.
Often, once we look together at the relationship between the brow, the face and neck, patients begin to notice things they hadn’t consciously registered—perhaps some jowling along the jawline, or subtle descent in the mid-face. These changes are actually contributing to the neck concerns, even if the neck is where your attention has been focused.
The modern approach to addressing age-related neck laxity involves facelift techniques that restore the vertical support system. By elevating the SMAS layer in the face, we restore that upper anchor point for the platysma muscle. This provides comprehensive support to both the lower face and neck.
The benefits I see with this approach include:
Anatomically Sound Treatment: We’re addressing the underlying cause, not just the symptom.
Natural-Looking Results: By restoring proper anatomical relationships, results typically appear more harmonious with your facial features.
Better Longevity: When we address the support structure properly, I find the outcomes tend to last significantly longer.
Comprehensive Improvement: Patients often tell me they notice improvements in areas they hadn’t even identified as concerns initially.
What This Means for Your Decision
I understand that when you come to a consultation focused on your neck, it might be surprising to hear me discuss other facial procedures, like a brow lift or deep plane facelift. My role isn’t to talk you into more extensive surgery—it’s to give you my honest professional assessment of what will actually address your concerns effectively.
Some patients, after understanding the anatomy, choose to proceed with comprehensive facial rejuvenation. Others may decide to wait or pursue non-surgical options. Some younger patients are indeed perfect candidates for isolated neck procedures.
What’s important is that you understand the anatomical realities so you can make an informed decision about your treatment.
Questions to Consider During Your Consultation
When you’re evaluating your options for neck rejuvenation, here are some important points we’ll discuss:
Your Age and Skin Quality: This significantly impacts which approach is most likely to give you satisfactory long-term results.
The Big Picture: We need to assess not just the neck in isolation, but the relationship between your neck, jawline, jowls, and lower face.
Your Goals and Expectations: Understanding what you hope to achieve and over what timeframe helps us determine the most appropriate approach.
Realistic Outcomes: I believe in being transparent about what different procedures can and cannot achieve.
Your Overall Health: Your medical history, any previous surgeries, and your healing capacity all factor into treatment planning.
Why Specialist Training Matters
As a Fellow of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery, I’ve completed extensive specialist training in facial anatomy and surgical techniques. This training gives me a deep understanding of the complex anatomical relationships between the face and neck.
I share this information with patients not to discourage them from seeking treatment, but to empower them to make decisions based on sound anatomical principles rather than simply addressing the area that bothers them most visually.
My Recommendation
If you’re noticing changes in your neck and considering your options, I encourage you to schedule a consultation where we can evaluate your specific anatomy. I’ll show you what I’m seeing, explain the relationship between your facial structures and your neck concerns, and discuss which approaches are most likely to give you the natural, long-lasting results you deserve.
Remember, there’s no one-size-fits-all answer. Some patients are indeed excellent candidates for isolated neck procedures. Others benefit from comprehensive facial rejuvenation. The key is understanding your unique anatomy and making an informed decision based on realistic expectations.
You can learn more about my approach to facial rejuvenation surgery and my qualifications here.
About Dr Scott J Turner
Dr Scott J Turner is a specialist plastic surgeon practising from three convenient locations across Australia—Sydney, Brisbane, and Canberra. He specialises in facial procedures, rhinoplasty, and breast surgery, and provides evidence-based care with personalised treatment plans to optimise surgical outcomes.
Qualifications & Memberships
Dr Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery. He holds a Master of Surgery (Plastic Surgery) and an MBBS with Honours from the University of Sydney, and is a member of ASAPS, ISAPS, ASPS, The Aesthetic Society, and the AMA.
Surgical Philosophy
His approach strikes a balance between technical precision and an artistic eye, focusing on natural-looking results that work with each patient’s features while maintaining harmony and individuality.
Clinic Locations
Sydney
- Manly Clinic: Suite 504, Level 5, 39 East Esplanade, Manly NSW 2095
- Bondi Junction Clinic: 39 Grosvenor St, Bondi Junction NSW 2022
Brisbane
- Spring Hill Clinic: Herstellen Clinic, 490 Boundary St, Spring Hill QLD
Canberra
- Campbell Clinic: G24/6 Provan St, Campbell ACT 2612 (consultations from Fridays)
For more on Dr Turner’s expertise and approach, visit Dr Scott J Turner – Sydney Plastic Surgeon.
To schedule a consultation, contact our practice.
Important Medical Disclaimers: This information is for educational purposes only and does not replace professional medical advice. All surgical procedures carry risks and potential complications. Results vary significantly from person to person, depending on individual factors such as age, skin quality, healing response, and lifestyle. Dr Scott J Turner is a specialist plastic surgeon registered with AHPRA. Patients should seek multiple opinions when considering cosmetic surgery and carefully weigh the benefits and risks before proceeding with any surgical procedure.
