Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Key Takeaways A neck lift, medically a platysmaplasty, addresses the platysma muscle, excess neck skin, and submental fat, not the lower face. The right approach depends on anatomy, ranging from a submental-only procedure through to a full anterior and lateral correction, with a deep neck lift reaching the structures beneath the platysma. It is often combined with a facelift when jowling is present. Results typically last five to ten years. Cosmetic surgery in Australia requires a GP referral and two consultations first.
The neck is often the first place where the effects of ageing become hard to ignore, and one of the hardest to address without surgery. Skincare doesn’t tighten a descended platysma muscle. Exercise doesn’t remove excess neck skin. For patients who’ve tried non-surgical options and found them wanting, neck lift surgery is usually the conversation that follows. It is often combined with facelift surgery, particularly deep plane facelift techniques, where the neck and lower face are addressed together.
As a Specialist Plastic Surgeon (FRACS) practising from Bondi Junction and Manly in Sydney, I have specific training in neck lift surgery and broader facial surgery. Surgery is performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
What Is a Neck Lift?
A neck lift, medically termed platysmaplasty, is surgery to address the structural changes of neck ageing. It targets the platysma muscle, excess neck skin, and submental fat to restore definition to the jawline and cervicomental angle (the angle between the jaw and the neck).
It’s worth being clear about what that actually means in practice. The platysma is a broad, thin muscle that runs from the jawline down into the chest. Over time, the muscle can separate at the midline, creating the visible vertical cords running down the front of the neck that most people describe as “neck bands.” The overlying skin loosens and excess fat can accumulate under the chin. The clean angle between the jaw and neck, the defining feature of a well-contoured neck profile, softens and eventually disappears.
A neck lift addresses all of these things surgically. What it can’t do is substitute for facelift surgery where lower face changes such as jowling, marionette lines, or a descending midface are also present. In those cases, combining a neck lift with a facelift typically produces a more balanced result.
Who Gets a Neck Lift?
The short answer: patients whose primary concern is below the jawline.
Most patients presenting for an isolated neck lift have one or more of the following: visible platysma banding (the vertical cords), excess neck skin creating looseness or a “turkey neck” appearance, submental fat creating fullness under the chin and blunting the jawline, or loss of the cervicomental angle.
Age isn’t the determining factor, anatomy is. Some patients in their late 30s to 40s with a genetic predisposition to poor neck contour benefit from neck lift. Patients in their 70s in good health can equally be appropriate candidates. What I assess at consultation is whether the anatomical changes present are sufficient to warrant surgery, and whether the patient’s health supports it.
Types of Neck Lift Surgery
Not all neck lift surgery is the same. The appropriate approach depends on what the anatomy actually requires, and the different types of facelift and neck lift each suit a different pattern of change.
Standard Neck Lift (Platysmaplasty)
The most commonly performed neck procedure. Incisions are placed behind the ears and beneath the chin. The platysma muscle is tightened at the midline, either by suturing the edges together (medial platysmaplasty) or repositioning the muscle laterally toward the sides of the neck (lateral platysmaplasty), or both, depending on the pattern of muscle separation.
Excess neck skin is removed. Where submental fat is also present, this is addressed at the same time. For many patients with mild to moderate neck ageing, this approach provides comprehensive correction with a well-established recovery profile.
Deep Neck Lift
A more advanced technique for patients whose neck concerns originate beneath the platysma, in the deeper anatomical layers that a standard platysmaplasty simply can’t reach.
Where persistent neck fullness is caused by subplatysmal fat deposits, prominent submandibular glands, or prominent digastric muscles, a standard neck lift addresses the wrong layer. The deep neck lift goes beneath the platysma to directly address these structures. I use a 3D Z-platysmaplasty technique as part of this approach, dividing the platysma to reduce the likelihood of band recurrence.
In practice, deep neck lift principles are often incorporated into both anterior-only and full neck lift procedures where the underlying anatomy requires it, rather than being a completely separate operation reserved for a specific patient type.
Full details on deep neck lift
Neck Liposuction
For patients with excess submental fat as the primary concern and good skin elasticity, with no significant laxity and no visible banding, neck liposuction removes the superficial fat through a small cannula.
The important caveat: liposuction doesn’t address skin laxity, platysma banding, or anything beneath the platysma. Patient selection matters here. Liposuction performed on a patient who also has significant skin laxity will not produce the result they’re expecting.
Full details on neck liposuction
How the Surgical Approach Is Chosen
Not all neck lifts involve the same incisions or the same depth of surgery. In practice, neck surgery falls into three categories based on where the problem sits anatomically.
1. Anterior Neck Lift: Submental Approach Only
In younger patients or those with isolated fullness or banding confined to the central neck, surgery can often be performed through a single incision beneath the chin without incisions behind the ears.
This approach is frequently misunderstood as minor. In reality, it often involves substantial structural work. Depending on the anatomy, it may include removal of submental and subplatysmal fat, medial platysmaplasty (tightening the platysma at the midline), partial reduction of submandibular gland prominence where relevant, and digastric muscle contouring. This is effectively a targeted deep neck lift performed through an anterior approach.
It is most appropriate where skin elasticity is good, excess skin is minimal, and the primary concern is central neck fullness or banding. The limitation is that it does not address loose skin along the jawline or sides of the neck, which becomes more relevant as ageing advances.
2. Isolated Neck Lift: Anterior and Lateral Approach
Where both skin laxity and muscle banding are present, a more complete neck lift is required.
This involves a submental incision for access to the platysma and deeper structures, plus additional incisions behind the ears and into the occipital hairline to address excess skin. It allows redraping and removal of excess neck skin, a combination of medial and lateral platysmaplasty, and a more complete definition of the jawline and cervicomental angle.
Many patients in this group also require deep neck principles, including subplatysmal fat contouring, submandibular gland management, and digastric refinement. This is not a skin-tightening procedure. It is a multi-layer correction combining superficial and deep anatomy in a single operation.
3. Neck Lift Combined with Facelift
For many patients, the neck does not age in isolation. Where jowling, jawline descent, or lower face changes are also present, a neck lift alone produces an incomplete or unbalanced result, because the boundary between the lower face and neck is continuous and surgical planning tends to reflect that.
In these cases, the neck component is integrated into the facelift rather than treated as a separate procedure. Common combinations include SMAS facelift with neck lift, extended deep plane facelift with integrated neck work, and vertical restore facelift with deep neck contouring. The specific combination is determined by individual anatomy and is not a fixed formula.
This integrated approach allows continuity from face to neck, smoother jawline transitions, and more durable structural correction than treating each area in isolation.
Neck Lift vs Facelift: What’s the Difference?
This question comes up constantly, and the answer is fairly straightforward.
A facelift addresses the midface and lower face, including jowling along the jawline, midface descent, and loss of facial contours, as well as the neck when a neck lift component is included. A neck lift addresses the neck only.
Many patients have both facial and neck concerns, and the two are typically addressed together. A common misconception is that the neck can be fully corrected in isolation. In reality, the boundary between the lower face and neck is continuous, and surgical planning often reflects that rather than treating the two as separate regions.
Some patients, though, have genuinely isolated neck concerns with minimal facial ageing. For them, a standalone neck lift is the right conversation. Whether a standalone approach adequately addresses the concerns, or whether lower face involvement makes facelift more appropriate, is something I assess at consultation.
What Neck Lift Can and Can’t Address
What it can address:
- Platysma banding, the vertical cords running down the front of the neck
- Excess neck skin, loose skin, and the “turkey neck” appearance
- Submental fat creating a double chin and loss of jawline definition
- Loss of the cervicomental angle, the clean jaw-to-neck transition
- Deep structural neck fullness from subplatysmal fat, gland prominence, or muscle bulk where deep neck lift is incorporated
What it cannot address:
- Jowling or lower face descent, which require facelift surgery
- Superficial skin quality changes such as fine lines or texture, since neck lift changes the underlying structure, not the skin surface
- Salivary gland enlargement from causes unrelated to anatomy
- Changes requiring upper or midface correction
The Procedure
Neck lift surgery is performed under general anaesthetic at an accredited private hospital, with a specialist anaesthetist managing care throughout. The exact operating time depends on whether the procedure is limited to the central neck, includes skin redraping through incisions behind the ears, or is combined with facelift surgery.
In some patients, typically those with good skin elasticity and isolated central fullness or banding, the procedure is performed through a submental incision alone. In others, additional incisions behind the ears and into the occipital hairline are required to address excess skin and allow more complete jawline contouring. Where deeper structures are contributing to neck fullness or poor definition, deep neck lift components are incorporated into the same operation.
An overnight stay is standard for most neck lift procedures.
Recovery
Most patients return to desk work within two to three weeks. Visible bruising typically resolves over two to three weeks. A compression garment is worn for the first few weeks to support healing and minimise swelling.
Deep neck lift involves a somewhat longer recovery than standard platysmaplasty, reflecting the depth of the procedure. Return to light activities at two to three weeks, exercise at four to six weeks, and the final result in three to six months.
For a full week-by-week guide, see recovery after facelift surgery, as the recovery principles and timeline overlap significantly with neck lift.
Cost
| Procedure | All-inclusive cost |
|---|---|
| Anterior neck lift (standalone) | $18,000 to $26,000 |
| Combined face and neck lift | See facelift cost guide |
| Consultation | $450 |
All-inclusive covers surgeon, hospital, anaesthesia, and all follow-up visits. Most neck lifts are performed as part of a facelift procedure.
AHPRA Regulatory Requirements
Under AHPRA cosmetic surgery guidelines (effective 1 July 2023), the following apply before neck lift surgery can proceed:
- A referral from your GP or a specialist physician
- A minimum of two consultations with Dr Turner before surgery is booked
- A psychological evaluation to confirm suitability
- A mandatory cooling-off period before formal consent is given
Why Modern Neck Lift Surgery Involves More Than Skin Tightening
Modern neck lift surgery is more anatomically detailed than many patients realise. While facelift techniques often receive more public attention, some of the most meaningful refinements in facial surgery over the past five years have involved how surgeons assess and treat the neck.
A traditional neck lift essentially meant tightening the platysma muscle and removing skin. Results were reasonable in the short term, but the limitations became apparent over time: band recurrence was common, deep structural fullness often persisted, and jawline definition fell short of what the anatomy could allow. What has changed is the understanding of what actually creates a poorly defined neck, and the availability of techniques to address each contributing factor directly.
Submandibular gland management. In some patients, prominent submandibular glands contribute to fullness beneath the jawline. Skin tightening or platysma work alone will not change this. Where appropriate, careful gland reduction can improve jawline definition in selected cases.
Digastric muscle contouring. Deep central neck fullness sometimes comes not from fat but from prominent digastric muscles beneath the platysma. Contouring these directly produces cervicomental definition that superficial techniques leave unchanged.
3D platysmaplasty. Traditional platysma plication sutures the muscle without dividing it, and band recurrence is a known consequence. The 3D Z-platysmaplasty technique divides the platysma horizontally, addressing cranial and caudal segments independently and suspending them to stable structures. The result is more durable than standard plication.
Subplatysmal fat contouring. Deep fat deposits beneath the platysma contribute to neck fullness in many patients. Direct excision addresses the anatomical cause rather than the surface appearance.
This is also why neck lift results vary between patients and surgeons. When a procedure focuses on skin tightening alone, the underlying cause remains and the skin loosens again. When prominent glands or subplatysmal fat are the real contributors, surface-level surgery leaves the main problem untouched. When the platysma is plicated rather than divided, bands tend to recur. And when significant jowling is present but the lower face is left out of the plan, the neck improves while the lower face still draws the eye downward, so the result reads as incomplete. The operation is tailored to the structures actually contributing to neck fullness, banding, and loss of definition, which varies considerably from one patient to the next.
Frequently Asked Questions
Can neck liposuction replace a neck lift?
Only in selected patients. Neck liposuction can improve fullness beneath the chin, what many patients call a double chin, where skin elasticity is good and platysma banding is absent. It does not tighten loose or turkey neck skin, correct platysma separation, or address deeper structures such as subplatysmal fat or submandibular gland prominence. Where these are present, liposuction alone is usually insufficient and a formal neck lift is the more appropriate conversation.
Do I need a deep neck lift?
Not necessarily. A deep neck lift is indicated where the primary contributors to neck fullness or poor definition sit beneath the platysma, specifically subplatysmal fat, prominent submandibular glands, or digastric muscle bulk. For many patients, standard platysmaplasty comprehensively addresses the concern. For others, deep neck principles are incorporated into the procedure as part of the same operation without it being a categorically different surgery. Whether deeper dissection is required is determined at consultation through assessment of the specific anatomy present.
Is a neck lift the same as a facelift?
No. A facelift addresses the midface, lower face, and jawline, and typically includes a neck lift component. A standalone neck lift addresses the neck only. Some patients have isolated neck concerns that can be addressed without facelift. Others have both facial and neck concerns that are better treated together. Dr Turner assesses which approach is appropriate at consultation.
How long does a neck lift last?
Neck lift results typically last five to ten years, varying with individual anatomy, skin quality, and lifestyle factors. The ageing process continues after surgery. For patients who had platysma banding as a primary concern, the correction tends to be long-lasting because the muscle has been surgically tightened rather than simply treated.
How much does a neck lift cost in Sydney?
A standalone anterior neck lift with Dr Turner costs $18,000 to $26,000 all-inclusive, covering surgeon, hospital, anaesthesia, and all follow-up visits. Most neck lifts are performed as part of a facelift procedure, and combined pricing is covered in the facelift cost guide. A consultation fee of $450 applies.
Consult with Dr Scott J Turner
Dr Turner consults for neck lift surgery in Sydney at Bondi Junction and Manly. Surgery is performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why. Contact the practice to arrange a consultation.
About Your Surgeon
Dr Scott J Turner is an AHPRA-registered Specialist Plastic Surgeon (FRACS) consulting in Sydney (Manly and Bondi Junction), Brisbane and Canberra. His practice focuses on facial aesthetic surgery, rhinoplasty and cosmetic breast surgery, performed at accredited private hospitals in Sydney. Dr Turner emphasises individual patient assessment, surgical planning and clear information on risks, recovery and costs, holds Fellowship of the Royal Australasian College of Surgeons.
