What Is a Neck Lift?
A neck lift is surgery for changes in the neck and under the chin: loose skin, vertical platysmal bands, fullness beneath the chin and loss of a clear angle between the chin and neck. It is a group of operations rather than one. Repair of the platysma muscle is called a platysmaplasty, removal of neck skin a cervicoplasty, and surgery through an incision under the chin a submentoplasty.
The neck changes in layers, and each layer may need a different operation:
- Skin, which loses elasticity and can become loose.
- Fat above the platysma (supraplatysmal fat), which can collect beneath the chin.
- The platysma, a thin sheet of muscle running down the front of the neck, which can separate in the midline and form two vertical bands.
- Structures beneath the platysma: subplatysmal fat, the anterior bellies of the digastric muscles and the submandibular salivary glands, which can create fullness that surgery on the surface layers does not reach.
- The chin and the hyoid bone, whose position sets where the neck visually begins and how defined the cervicomental angle, the angle between the chin and neck, can be.
The words patients use often describe the appearance rather than its cause. A turkey neck may be loose skin, platysmal bands or both, and a double chin may be fat above the platysma, fullness beneath it, or a chin that sits back. Identifying which layers are involved, and in what proportion, comes before any recommendation.
A neck lift does not lift the jowls or the lower face, which are treated by a facelift. It does not change fine lines, skin texture or sun damage, and it does not stop ageing.
Neck Lift Options Compared
The table below links the changes patients most often notice to the procedures that may be considered. Many patients have more than one, and procedures are often combined. Which is appropriate for you is decided at consultation, after examination.
| What you notice | Usual cause | May be considered |
|---|---|---|
| Vertical bands down the front of the neck | Separation of the platysma muscle in the midline | A standard neck lift with a facelift, or a direct neck lift where the lower face is stable |
| Loose skin on the neck | Skin laxity, often with platysmal bands and descent of the lower face | A neck lift with a deep plane facelift, or a direct neck lift with skin removal where the lower face is stable |
| Fullness under the chin with good skin elasticity | Fat above the platysma | Neck liposuction, on its own or with a chin implant |
| Fullness that persists at a healthy, stable weight | Fat, muscle or salivary glands beneath the platysma | A deep neck lift, on its own or with a facelift |
| A chin that sits behind the lower lip in profile | Low chin projection | A chin implant |
| Jowls together with neck changes | Descent of the lower face and neck together | A deep plane facelift with a standard or deep neck lift |
Neck Surgery on Its Own
| Procedure | What it involves | Theatre time and stay |
|---|---|---|
| Direct neck lift | An incision under the chin to treat fat and central platysmal bands; where skin needs removing, a vertical incision on the front of the neck closed with a Z-plasty; in some patients, incisions around the earlobe and behind the ear | Varies with the incisions needed |
| Deep neck lift | Treatment of the fat, muscle and salivary glands beneath the platysma, which is then repaired | About 3 hours; overnight stay |
| Neck liposuction | Removal of fat above the platysma through small incisions | About 45 minutes; day surgery |
| Chin implant | A shaped implant placed over the front of the lower jaw | About 45 minutes; day surgery |
Neck Surgery With a Facelift
| Option | Neck component | Theatre time and stay |
|---|---|---|
| Short scar facelift | Lateral neck lift, suspending the platysma at the side of the neck | About 4 hours; overnight stay |
| Lower facelift | Lateral neck lift plus a standard neck lift through a small incision under the chin | About 4 hours 30 minutes; overnight stay |
| Deep plane facelift with deep neck lift | Lateral neck lift plus a deep neck lift, which also treats the structures beneath the platysma | About 5 hours; overnight stay |
| Vertical Restore Facelift | Lateral neck lift, with a standard or deep neck lift as assessment indicates, plus brow lift, eyelid surgery, upper lip lift and fat grafting | Up to 7 hours 45 minutes with every component; overnight stay |
Theatre times for the facelift options are for women; surgery for men is scheduled with an additional 30 minutes. Times are indicative, and the procedures that suit you are decided at consultation. All surgery carries risk.
Standard Neck Lift (Platysmaplasty)
The traditional neck lift: the separated edges of the platysma are repaired in the midline through a small incision under the chin. Dr Turner performs it as part of a facelift, where it turns a short scar facelift into a lower facelift, rather than as an isolated operation. Without a facelift, central platysmal bands are treated through a direct neck lift.
Deep Neck Lift
Works beneath the platysma, removing subplatysmal fat under direct vision and reducing digastric muscle bulk or submandibular gland prominence where they contribute. It may be performed on its own or with a deep plane facelift, where it adds about an hour of theatre time.
Direct Neck Lift
Treats the neck without a facelift, for patients whose lower face is stable. The incisions follow what needs treating, as set out in the table above. Where skin is removed, the Z-plasty scar on the front of the neck fades over time but does not disappear.
Neck Liposuction
Removes fat through small incisions, usually in the crease under the chin. It does not tighten skin or repair muscle, so on its own it suits a narrow group: fullness beneath the chin with good skin elasticity and no significant banding. More often it is one part of a larger neck or facelift operation.
Chin Implants
A shaped silicone implant, placed through an incision under the chin or inside the lower lip. Where the chin sits back, added projection can give a more defined line between the jaw and the neck, and an implant is sometimes combined with neck liposuction.
Neck Lift With or Without a Facelift
Whether a neck procedure on its own is enough depends on what is causing the change. The platysma is continuous with the SMAS, the supporting layer of the lower face. As the lower face descends with age, the neck loses the support that holds it against the jawline, so in older patients the source of neck laxity is often the lower face rather than the neck itself.
A neck procedure on its own may be appropriate where:
- fullness under the chin is inherited or anatomical, with good skin quality and no meaningful facial descent, often in younger patients;
- the fullness comes from structures beneath the platysma, which is a neck problem at any age;
- platysmal bands are present while the jawline and midface remain well supported;
- a patient prefers a smaller operation and a shorter recovery, having understood that the result may not hold as long if facial descent is contributing.
Where neck laxity is part of age-related facial descent, a deep plane facelift with neck work is usually discussed. Every deep plane facelift includes a lateral neck lift, a standard neck lift makes it a lower facelift, and a deep neck lift can be added where deeper structures contribute. Treating the neck alone in this situation can leave a smoother neck beside unchanged jowls, and the contour may soften sooner, because the support from above has not been restored.
Dr Turner is careful about how strongly this is put: “What I’m describing is a pattern I see in patients who come back sooner than they expected, not a claim that neck-only surgery fails.” The trade-off is a smaller operation with a shorter recovery against a larger one that treats the cause where facial descent is contributing, and his article on having a neck lift without a facelift explains it in more detail.
Who May Be Suitable for a Neck Lift?
Suitability is decided at consultation, after examination. Patients who may be suitable are generally in good health, at or near a stable weight, and non-smokers or willing to stop all nicotine, including vapes, for a defined period before and after surgery. If you are losing weight, including with weight loss medication, surgery is generally deferred until your weight has been stable.
Age alone does not decide suitability. Inherited fullness under the chin can be treated in younger adults, and older patients in good health can also be suitable. A neck lift may not be appropriate where the changes are minor, where medical conditions are not well controlled, or where expectations go beyond what neck surgery can change.
Men. Men more often have thicker skin and a heavier neck, sometimes with skin excess, platysmal laxity and deep fat together, and the beard affects how a scar under the chin or on the neck settles. Planning for men is covered on the male facelift page, and the causes are explained in what causes a heavy neck in men.
Neck Lift Recovery
Recovery depends on the operation performed, general health and individual healing. As a guide:
- Neck liposuction or a chin implant. Day surgery. A compression garment or chin support is worn, bruising settles over the first two weeks, and most patients return to desk-based work within one to two weeks.
- Direct neck lift. Recovery depends on the incisions needed. A compression garment is worn under the chin, and after an incision under the chin alone many patients return to non-strenuous work within one to two weeks; the timeline where skin is removed or further incisions are needed is confirmed at consultation. Scar care continues through the first year.
- Deep neck lift on its own. An overnight stay. Swelling and tightness are more marked than after surgery on the surface layers, a compression garment is worn, and most patients return to desk-based work at two to three weeks. After submandibular gland reduction, a salivary-resting diet is followed for two weeks.
- Neck lift with a facelift. An overnight stay, reviews at day 3 and day 7, and two to three weeks away from desk-based work, or longer after a Vertical Restore Facelift.
Strenuous exercise and heavy lifting are reintroduced gradually over the following weeks, guided by Dr Turner. Most swelling settles over about three months, and scars mature over six to twelve months. The neck lift recovery timeline covers each stage in more detail.
Patients from outside Sydney. Dr Turner also consults in Canberra, Newcastle and Brisbane, and surgery is performed in Sydney. Patients having a neck lift with a facelift are advised to stay in Sydney for 7 to 10 days after surgery, which covers the day 3 and day 7 reviews; for neck surgery on its own, the length of stay is confirmed at consultation. Travel planning is covered on the out-of-town patients page.
Neck Lift Cost in Sydney
The fee for neck surgery depends on the operation planned and the time it takes in theatre. It has three parts:
- The surgeon’s fee, which reflects the operation, its complexity and its length.
- The specialist anaesthetist’s fee, which also follows theatre time.
- The private hospital fee, covering the operating theatre and, where needed, an overnight stay.
Neck procedures performed on their own, including a deep neck lift, direct neck lift, neck liposuction and chin implant, are quoted after consultation, once the operation has been planned. The written, itemised quote covers all three parts, the LigaSure device used in a deep neck lift, and the scheduled post-operative reviews.
When neck surgery is part of a facelift, the fee for each combination, including a standard or deep neck lift, is set out on the facelift cost page, with a fee calculator.
Neck surgery performed for cosmetic reasons is not covered by Medicare or private health insurance. The $450 consultation fee, travel and accommodation are separate.
Neck Lift Risks and Complications
All surgery carries risk. Complications discussed at consultation include:
- Haematoma. A collection of blood under the skin, which may need a return to theatre.
- Nerve injury. Injury to the marginal mandibular branch of the facial nerve can weaken the lower lip. It is usually temporary; permanent weakness is rare.
- Seroma and infection. A collection of fluid that may need drainage, and infection, which is uncommon.
- Scarring. Incisions are placed in skin creases under the chin and behind the ear where possible, but scars vary between patients. Where skin is removed on the front of the neck, the Z-plasty scar remains visible. Hypertrophic scarring is possible, particularly on the front of the neck.
- Contour irregularity and asymmetry. This includes central hollowing beneath the chin (cobra neck deformity) if too much fat is removed.
- Sialocele. A collection of saliva after submandibular gland reduction in a deep neck lift, usually managed in clinic.
- Chin implant complications. Infection or extrusion of the implant, which may need removal.
- Sensory changes. Numbness and tightness are expected early and usually lessen over weeks to months.
- Recurrence or revision. Fullness or bands may recur, or the result may not meet expectations, which may lead to further surgery.
The general risks of anaesthesia are also discussed. Risk is reduced by stopping smoking and all nicotine, including vapes, optimising general health, operating in an accredited hospital and structured follow-up. Further information is on the risks and complications page, and the neck lift scars guide covers how incisions heal.
Choosing a Neck Lift Surgeon in Sydney
The title now means something. Since the National Law was amended, only a medical practitioner with specialist registration in surgery, obstetrics and gynaecology, or ophthalmology may use the title “surgeon”, including “cosmetic surgeon”.
Check the register. Any practitioner’s registration and specialty can be confirmed at no cost on the AHPRA register at ahpra.gov.au. Look for specialist registration in surgery with a field of specialty practice of plastic surgery.
Dr Scott J Turner is a Specialist Plastic Surgeon, AHPRA registration MED0001654827. He was awarded Fellowship of the Royal Australasian College of Surgeons (FRACS) in 2013, and completed his MBBS and Master of Surgery at the University of Sydney.
Ask where the surgery is performed. Neck surgery should be carried out in an accredited hospital, where credentialling independently checks a surgeon’s qualifications and scope of practice. Dr Turner holds privileges at Bondi Junction Private Hospital, Delmar Private Hospital in Dee Why, and East Sydney Private Hospital.
Questions worth asking at consultation. Which layers of my neck are involved, and does the planned operation reach them? Is a facelift part of the recommendation, and why? Where will the incisions and scars be? Who provides after-hours care if a complication arises?
Understand the pathway. A referral from your GP or another registered medical practitioner is required before your first consultation. Two consultations with Dr Turner are required before surgery, the first of which can be by video and the second in person, and a seven-day cooling-off period applies before surgery can be booked or a deposit paid. Dr Turner screens for psychological factors such as body dysmorphic disorder and refers for further assessment where indicated.
Further guidance on assessing a surgeon is set out in choosing your surgeon.
Before and After Photos
Photographs of Dr Turner’s own Sydney facelift patients, including patients who had neck surgery as part of their facelift, can be viewed in the facelift before and after gallery. They are taken under consistent lighting, angle and framing and published with patient consent. Photographs of neck surgery performed on its own are not published. Results shown are individual and are not a prediction of outcome.
Frequently Asked Questions
How much does a neck lift cost in Sydney?
The fee depends on the operation planned and the time it takes in theatre, and is made up of the surgeon’s fee, the specialist anaesthetist’s fee and the private hospital fee. Neck procedures performed on their own are quoted after consultation. When a neck lift is part of a facelift, the fee for each combination is on the facelift cost page. There is no Medicare rebate or private health insurance benefit for cosmetic neck surgery.
Can I have a neck lift without a facelift?
Sometimes. A neck procedure on its own may suit inherited fullness under the chin with good skin and no facial descent, fullness from structures beneath the platysma, or platysmal bands with a well-supported jawline. Where neck laxity is part of age-related descent of the lower face, a neck lift alone does not lift the jowls, and a deep plane facelift with neck work is usually discussed. The assessment is made at consultation.
What is the average age for a neck lift?
There is no set age. Younger adults with inherited fullness under the chin may be suitable for neck liposuction or a deep neck lift, while age-related laxity, for which a facelift is usually discussed, tends to appear later. Anatomy, skin quality and general health decide suitability rather than age alone.
Can a turkey neck be treated without surgery?
A turkey neck is usually loose skin, platysmal bands or both. These are structural changes: non-surgical treatments may change skin quality, but they do not remove loose skin or repair a separated muscle. Which layers are involved, and whether surgery would change them, is assessed at consultation. The turkey neck article explains the causes in more detail.
Which neck procedure is right for me?
That depends on which layer is causing the change. Fullness under the chin with good skin elasticity may suit neck liposuction; fullness beneath the platysma may need a deep neck lift; central bands or loose skin with a stable lower face may suit a direct neck lift; and a chin that sits back may suit a chin implant. Where the jowls and neck have changed together, a deep plane facelift with a standard or deep neck lift is usually discussed. The procedure is confirmed after examination.
Can neck liposuction tighten loose neck skin?
No. Neck liposuction removes fat above the platysma but does not tighten skin or repair the muscle. Where loose skin or platysmal bands are part of the change, liposuction alone will not treat them, and removing too much fat can leave a hollow beneath the chin. A procedure that treats the skin and muscle, often with a facelift, is discussed instead.
Where are neck lift incisions placed?
That depends on the operation. Neck liposuction and a direct neck lift use a small incision in the crease under the chin, and a chin implant is placed either through that crease or through the inside of the lower lip. Where skin is removed in a direct neck lift, a vertical incision on the front of the neck is closed with a Z-plasty and leaves a visible scar. In most deep neck lifts and some direct neck lifts, incisions around the earlobe and behind the ear give access to the platysma at the side of the neck, and a facelift incision runs in front of and behind the ear along the temporal and occipital hairlines. The neck lift scars guide covers how they heal.
What is the recovery time after a neck lift?
It depends on the operation. After neck liposuction or a chin implant, both day surgery, most patients return to desk-based work within one to two weeks. After a deep neck lift, or a neck lift with a facelift, an overnight stay is followed by two to three weeks away from desk-based work, or longer after a Vertical Restore Facelift. Swelling continues to settle over several months, and individual healing varies.
Do I need a GP referral before a neck lift consultation?
Yes. A referral from your GP or another registered medical practitioner is required before a cosmetic surgery consultation. The referral requirement exists so that your doctor is aware of the procedure you are considering and can raise any relevant medical or psychological factors.
Related Guides
- Neck surgery with a facelift: Facelift, Lower Facelift, Short Scar Facelift, Deep Plane Facelift and Facelift Cost
- Understanding the neck: Turkey Neck: Causes and Treatment, Platysmal Bands: Causes and Treatment, Traditional vs Deep Neck Lift and Can You Have a Neck Lift Without a Facelift?
- Recovery and scars: Neck Lift Recovery: Week-by-Week Timeline and Neck Lift Scars
- For men: What Causes a Heavy Neck in Men? and Male Neck Lift Recovery
- About: Dr Scott J Turner, Specialist Plastic Surgeon
