Quick answers
| Question | Short answer |
|---|---|
| What does deep neck lift treat? | Deep neck fullness arising from subplatysmal fat, bulky anterior digastric muscles, prominent submandibular glands, and tight deep cervical fascia. |
| What does it not treat? | Isolated superficial submental fat, simple platysma bands alone, or a recessed chin (these are better addressed by neck liposuction, platysmaplasty, or chin augmentation respectively). |
| Who performs the surgery? | Dr Scott J Turner, FRACS Specialist Plastic Surgeon, AHPRA registration MED0001654827. |
| Where are consultations held? | Bondi Junction and Manly. |
| Where is surgery performed? | Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why. |
| Operating time and stay | Approximately 3 hours under general anaesthesia, with an overnight hospital stay. |
| Cost | Quoted at consultation. See the face and neck lift cost guide for fee structure. |
| Is a GP referral required? | Yes. A current referral from your usual GP or an independent medical practitioner is required before booking. |
What is a deep neck lift?
A standard neck lift works in the superficial layers of the neck: the skin, the subcutaneous fat sitting above the platysma muscle, and the platysma itself. For most patients with age-related neck change, that is the right depth. The visible bands, the loose skin, and the cervicomental angle loss all sit at or above the platysma, and they all respond to surface work.
For a smaller group of patients, the contour concern is driven by something deeper. The fat sits beneath the platysma rather than above it. The anterior bellies of the digastric muscles are bulky enough to create central neck fullness. The submandibular glands are prominent enough to be visible as bulges along the jawline. In these patients, a surface neck lift will technically succeed at what it set out to do and still leave the neck looking heavy, because the structures producing the fullness have not been touched.
A deep neck lift opens the platysma in the midline and works on the layer beneath. Subplatysmal fat is removed under direct vision rather than blindly with liposuction. Digastric muscles are contoured where they are contributing. Submandibular glands are partially reduced in selected cases. The result is contour correction at the level the problem actually sits.
What structures are treated in a deep neck lift?
| Structure | Why it matters | Relevance to deep neck lift |
|---|---|---|
| Platysma muscle | Separates the superficial and deep layers of the neck. Can form vertical bands with age. | Opened in the midline as part of the deep neck lift, then repaired (often using a 3D Z-platysmaplasty approach). |
| Subplatysmal fat | Fat sitting beneath the platysma. Not accessible to standard liposuction. | Directly excised under vision where it is contributing to fullness. |
| Anterior digastric muscles | Paired muscles running from chin to hyoid. Bulky digastrics create central neck fullness. | Conservatively contoured where they are part of the contour problem. |
| Submandibular glands | Salivary glands sitting beneath the jawline. When enlarged or descended they create visible bulges. | Partially reduced in selected cases, with the portion extending below the mandible removed. |
| Parotid gland tail | Posterior portion of the parotid gland near the angle of the jaw. Can create posterior jawline fullness. | Partially reduced when prominent and contributing to a heavy posterior jawline. |
| Deep cervical fascia | Fascial layer that anchors the deep neck structures. | Transected where it limits platysma mobility. |
| Hyoid bone | Determines how acute the neck angle can become. A low-set hyoid limits the achievable angle. | An anatomical limitation explained at consultation, not surgically altered. |
Which neck procedure is right for you?
Many patients present with overlapping concerns, and combined approaches are common. The table below maps the main contour concern to the procedure most often used to address it.
| Main concern | Most relevant pathway | Why |
|---|---|---|
| Deep central neck fullness, heavy neck contour | Deep neck lift (this page) | Addresses structures beneath the platysma that surface procedures cannot reach. |
| Vertical platysma bands, mild to moderate laxity | Platysmaplasty | Addresses the platysma muscle directly without deeper work. |
| Isolated submental fat with good skin elasticity | Neck liposuction | Removes superficial fat above the platysma. Does not address deep fullness. |
| Significant central neck skin excess in selected older patients | Direct neck lift | A targeted skin-excision approach for narrow indications. |
| Jowls plus neck laxity | Facelift with neck lift | Treats lower face and neck together for a balanced result. |
| Recessed chin contributing to a shallow neck angle | Chin implants | Improves bony projection; can be performed alongside deep neck lift. |
Why some patients need deep neck lift surgery
Deep neck lift is not the default. It is the right operation when the source of the neck fullness sits in a layer that a surface procedure cannot reach. The clinical scenarios most often associated with deep neck lift are:
Inherited anatomical concerns. Some patients are born with prominent submandibular glands, bulky digastric muscles, or excessive subplatysmal fat that creates persistent neck fullness regardless of weight, fitness, or age. These structural features do not respond to non-surgical treatments and cannot be meaningfully changed through superficial dissection.
Persistent fullness after previous surgery. Patients who have had a traditional neck lift or neck liposuction and were left with disappointing or short-lived results often have underlying deep structural causes that were not identified or addressed at the time. Deep neck lift can provide correction where previous surgery has not.
Central fullness that does not respond to weight change. Persistent fullness beneath the chin and along the jawline that does not change with diet, exercise, or non-surgical treatments typically reflects deep tissue involvement.
Disproportion between face and neck. When facial procedures have produced good results but the neck looks disproportionately heavy in comparison, deep neck lift can restore overall facial balance.
Visible glandular structures. Enlarged submandibular or parotid gland tails that create bulges along the jawline cannot be improved through surface techniques.
Are you a suitable candidate?
Deep neck lift is more complex than standard platysmaplasty and carries a different risk profile, so patient selection matters. Suitable candidates typically present with one or more of the following:
- Prominent submandibular glands creating visible jawline fullness
- Excessive subplatysmal fat not accessible to liposuction
- Bulky anterior digastric muscles causing central neck fullness
- Enlarged parotid gland tails affecting posterior jawline contour
- Inherited heavy neck contour despite good weight and skin quality
- Persistent fullness following previous neck procedures
Beyond the anatomy, candidates need to be in good general health, suitable for a longer procedure under general anaesthesia, at or near stable weight, and non-smoking for a minimum of six weeks before and after surgery. The risk of wound healing complications with deeper dissection is significantly higher in smokers.
Realistic expectations are part of suitability. The procedure has a specific role and specific limitations. Body dysmorphic concerns are screened for during the consultation process. Where a psychological assessment is indicated under the Medical Board’s cosmetic surgery requirements, it forms part of the pre-operative pathway.
Who may not be suitable
Deep neck lift is not appropriate for every patient with a neck concern. It is generally not the right operation when:
- The concern arises only from superficial skin laxity or platysma banding (platysmaplasty is the more appropriate and less complex option)
- General health does not support a longer procedure under general anaesthesia
- Smoking has not been ceased well before surgery
- Expectations exceed what the surgery can deliver
- The patient is unable to commit to post-operative care, particularly the salivary-resting diet required after submandibular gland reduction
At consultation, Dr Turner will recommend the most anatomically appropriate procedure, not the most extensive one. A patient with surface-level changes does not need a deep operation, and recommending one would not be in the patient’s interest.
How is deep neck lift performed?
Deep neck lift is performed under general anaesthesia at an accredited Sydney private hospital, with a specialist anaesthetist managing care throughout. The procedure takes approximately 3 hours, longer if combined with facelift components. An overnight hospital stay is standard, with discharge the following day.
Incisions are placed around and behind the ears in the natural skin creases, similar to a facelift pattern, with an additional small incision in the natural crease beneath the chin to access the deeper structures. In selected younger patients with minimal lateral concerns, a limited submental-only approach may be appropriate.
The defining feature of the operation is that it works at two anatomical levels in the same procedure. Three technical elements characterise the approach.
Dual-plane dissection
Dissection occurs at both the superficial and deep levels of the neck, which allows independent treatment of surface and deep structures.
In the submandibular segment (the region above the hyoid bone), both planes are opened. The platysma is separated from the overlying skin in the superficial plane, and the subplatysmal space is entered in the deep plane to access the structures sitting beneath the muscle. Three anatomical zones are systematically assessed:
- Zone I (submental): the central region beneath the chin. Excess subplatysmal fat is excised under direct vision. Digastric muscles are contoured if bulky. A patch of subplatysmal fat is preserved at the hyoid level to maintain natural contour.
- Zone II (body of the mandible): the region along the jawline. Submandibular glands are carefully exposed. Where enlarged or descended, the portion extending below the mandible is reduced.
- Zone III (angle of the mandible): the posterior region. Where the parotid gland tail is creating fullness, the SMAS/platysma is elevated to allow partial reduction.
In the cervical segment (below the hyoid bone), only deep dissection is performed. The skin and platysma remain attached as a composite layer, which preserves natural skin adherence in this region and reduces the risk of surface irregularities.
Throughout the dissection, subcutaneous fat is conservatively contoured. Aggressive fat removal is avoided so the neck does not look skeletonised.
3D Z-platysmaplasty
Rather than simply suturing the platysma edges together, a 3D Z-platysmaplasty divides the muscle horizontally into cranial and caudal segments along a predetermined line at the submandibular-cervical junction. The cranial segment is secured to the digastric muscles and hyoid bone centrally, with the lateral edges suspended to the mastoid. The caudal segment is suspended to the mastoid as a composite skin-fat-muscle layer. The three-dimensional separation is designed to reduce the likelihood of platysma band recurrence compared to standard plication, where the muscle is sutured but not divided.
Haemostatic net closure
Rather than rely on high-tension skin closure, a haemostatic net is applied at the end of the operation to distribute tension evenly across the skin flap. This reduces haematoma risk and supports natural skin redistribution. The net remains in place for 48 to 72 hours. Incisions are closed in layers beneath the net.
Recovery after deep neck lift
Recovery from deep neck lift follows a similar overall arc to a standard neck lift, but initial swelling is typically more pronounced because of the depth of dissection. The general pattern is as follows.
| Timeframe | What to expect |
|---|---|
| Days 1 to 2 | Haemostatic net in place. Head elevated 30 to 45 degrees. Minimal activity. |
| Days 3 to 7 | Net removed. Compression garment worn continuously. Sutures behind the ears removed at 5 to 7 days. |
| Weeks 1 to 2 | Compression garment worn at night. Short gentle walks encouraged. |
| Weeks 2 to 3 | Sutures under the chin removed at 10 to 14 days. Most patients return to office-based work. |
| Weeks 4 to 6 | Social recovery for most patients. Gradual return to light exercise under Dr Turner’s guidance. |
| Months 3 to 6 | Residual swelling fully resolves. Final result becomes apparent. |
For patients who have had submandibular gland reduction, a salivary-resting diet is recommended for two weeks after surgery. This means avoiding salty, sour, spicy, and sweet foods that stimulate saliva production, in order to reduce the risk of sialocele.
Strenuous activity and heavy lifting are restricted for 4 to 6 weeks. Sun protection over incision sites is important throughout the healing period. Follow-up appointments are scheduled at defined intervals, and Dr Turner’s team remains available throughout recovery.
Combining deep neck lift with facelift surgery
Deep neck lift is frequently performed alongside facelift procedures. The dual-plane dissection used for deep neck lift is technically compatible with the deeper dissection layers of advanced facelift techniques, and treating the neck and lower face together generally produces a more proportionate result than treating one in isolation.
Dr Turner performs a range of facelift approaches that can be combined with deep neck lift:
- Deep plane facelift, with structural repositioning of the midface, jawline, and neck through ligament release
- Vertical Restore facelift, with vertical repositioning of facial tissues
- Short scar facelift, a less extensive approach for patients with mild to moderate lower face concerns alongside significant neck involvement
Whether a combined approach is appropriate depends on individual anatomy and is determined at consultation.
Risks and safety
Deep neck lift is a safe procedure in experienced hands, but it is more complex than standard neck lift and carries additional risks related to the deeper dissection. All risks are discussed in detail at consultation.
Common temporary effects
- Swelling and bruising. Moderate to significant swelling, particularly in the first week. Bruising typically resolves over two to three weeks. Initial swelling may be more pronounced than after standard neck lift due to the depth of dissection.
- Numbness and altered sensation. Temporary reduced sensation in the neck and lower face, typically resolving over three to six months as nerves recover.
- Tightness. The neck will feel tight for several weeks, improving as tissues settle. Mild tightness may persist for two to three months.
- Asymmetry during healing. Some variation during the healing phase is normal as swelling resolves at different rates on each side. Persistent asymmetry is uncommon.
Risks specific to deep dissection
- Sialocele. A collection of salivary fluid that can develop after submandibular gland reduction, occurring in approximately 2 percent of patients. Managed with serial aspiration in clinic, a salivary-resting diet, temporary compression, and where indicated an injection into the gland. Usually resolves within two to four weeks.
- Temporary lower lip weakness. Occurs in up to 4 percent of patients due to the proximity of the marginal mandibular branch of the facial nerve to the surgical field. Usually resolves within 6 to 12 weeks. Permanent weakness is rare (less than 1 percent).
- Frey’s syndrome. A rare complication following parotid gland reduction, causing flushing or sweating in the cheek during eating. Prevented through adequate tissue coverage during surgery and treatable with injections if it occurs.
- Dry mouth (xerostomia). Does not occur with partial submandibular gland reduction as performed in aesthetic surgery. Xerostomia is associated only with complete removal of both submandibular glands combined with radiation treatment, neither of which is performed here.
General surgical risks
Haematoma (1 to 3 percent of patients), infection, scarring (incisions placed in natural creases generally heal well, but hypertrophic scarring is possible), nerve injury (most are temporary and resolve over months; permanent injury is rare), and skin contour irregularities. Full risks are set out in the facelift risks and complications page.
Deep neck lift cost in Sydney
The cost of deep neck lift surgery in Sydney depends on the specific work performed, whether the procedure is combined with facelift surgery, the surgical and anaesthetic time required, and the hospital facility used. Deep neck lift typically sits at the upper end of the neck-lift range because of the longer operating time and the technical complexity of the deep dissection.
A detailed breakdown of surgical fees, anaesthetic fees, hospital fees, and Medicare considerations is set out in the face and neck lift cost guide. A formal itemised quote is provided after consultation, once the specific procedure has been confirmed.
Medical Board and AHPRA requirements for cosmetic surgery
Cosmetic surgery in Australia is regulated by the Medical Board of Australia and the Australian Health Practitioner Regulation Agency (AHPRA). Patients seeking cosmetic deep neck lift must meet the following requirements before surgery proceeds.
A current referral from your usual general practitioner, or from an independent medical practitioner, is required. Two consultations are conducted before booking surgery, with the first consultation held in person. A cooling-off period of at least seven days applies between consenting to surgery and the surgery date for adult patients. Patients under 18 are subject to a longer cooling-off period of three months and require psychological assessment. Adult patients are screened for body dysmorphic concerns, with referral for psychological assessment where indicated.
Dr Turner’s practice follows the Medical Board’s cosmetic surgery guidelines in full.
Before and after photos
Before and after photographs of deep neck lift and facelift patients are available to view in person during consultation, in accordance with the Medical Board’s restrictions on the public display of cosmetic surgery results. The consultation also includes a review of the patient-specific factors (skin quality, skeletal structure, hyoid position, gland prominence, previous surgery, and healing) that influence the result.
Choosing a deep neck lift surgeon in Sydney
Deep neck lift is one of the more demanding operations in neck surgery. The structures sitting beneath the platysma are close to the marginal mandibular nerve, the major salivary glands, and the deep vasculature of the neck. The planning and the assessment matter as much as the technique. The most useful things to assess when choosing a surgeon are:
- Specialist qualifications. Specialist Plastic Surgeons in Australia hold a Fellowship of the Royal Australasian College of Surgeons (FRACS) in plastic surgery and are registered with AHPRA. Dr Turner’s FRACS qualification (2013) and AHPRA registration (MED0001654827) can be verified independently.
- Operating environment. Deep neck lift should be performed in an accredited private hospital with a specialist anaesthetist, not in a clinic-based theatre. Dr Turner operates at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
- Assessment depth. A consultation that examines the platysma alongside the subplatysmal layer, digastric muscle bulk, submandibular gland position, parotid gland tail, hyoid position, jowls, and chin projection will produce a more reliable plan than one focused only on the surface.
- Honesty about indication. A surgeon who recommends deep neck lift only when the anatomy supports it, and standard platysmaplasty when it does not, is giving you better information than one who applies the same operation to every patient.
- Risk transparency. Sialocele, marginal mandibular nerve weakness, and Frey’s syndrome are specific risks of the procedure that should be raised openly and explained, not glossed over.
- AHPRA pathway. Two consultations, a GP referral, a cooling-off period, and screening for body dysmorphic concerns are mandatory under the Medical Board’s cosmetic surgery guidelines.
More about Dr Turner’s background is available on the Dr Scott J Turner page.
Frequently Asked Questions
What is a deep neck lift?
A deep neck lift is a surgical procedure that addresses neck fullness arising from structures sitting beneath the platysma muscle. These structures include subplatysmal fat, the anterior bellies of the digastric muscles, and in selected cases the submandibular glands or parotid gland tails. A standard neck lift works only in the superficial layers above and at the level of the platysma. A deep neck lift opens the platysma in the midline and treats the layer beneath, which is the right approach when the source of the contour problem sits below the muscle rather than above it.
What is the difference between deep neck lift and platysmaplasty?
Platysmaplasty repairs the platysma muscle itself, addressing vertical bands and muscle laxity at the surface level of the neck. Deep neck lift includes a platysmaplasty as part of the operation, but also opens the platysma to work on structures beneath it. The two procedures address different anatomical layers and are indicated for different patient presentations. Platysmaplasty is the right operation when the concern is bands and surface laxity. Deep neck lift is the right operation when the concern is fullness from subplatysmal fat, digastric muscle bulk, or gland prominence.
What is the difference between deep neck lift and neck liposuction?
Neck liposuction removes superficial fat sitting above the platysma muscle through a small incision under the chin. It is appropriate for patients with isolated submental fat and good skin elasticity. Deep neck lift treats fat sitting beneath the platysma, which is not accessible to liposuction. The two procedures address different fat compartments. Patients whose fullness is from supra-platysmal fat with good skin tone are candidates for liposuction. Patients whose fullness is from subplatysmal fat, often combined with other deep structures, are candidates for deep neck lift.
What is sialocele and how is it treated?
A sialocele is a collection of saliva that can develop beneath the skin after submandibular gland reduction, occurring in approximately 2 percent of patients. It typically presents as a soft swelling under the jaw in the first one to two weeks after surgery. Management involves serial aspiration in the clinic, a salivary-resting diet that avoids salty, sour, spicy, and sweet foods that stimulate saliva production, temporary compression, and in some cases an injection to reduce gland activity. Sialocele almost always resolves within two to four weeks without permanent consequence.
Will I have dry mouth after submandibular gland reduction?
No. Partial submandibular gland reduction as performed in aesthetic surgery does not cause dry mouth. Xerostomia is associated only with complete removal of both submandibular glands combined with radiation treatment, a combination used in head and neck cancer management and not in cosmetic surgery. The remaining gland tissue and the other salivary glands (the parotid glands and the sublingual glands) maintain normal saliva production. This is a common concern that Dr Turner addresses directly at consultation.
Can deep neck lift be combined with facelift surgery?
Yes. In fact, this is one of the most common scenarios for deep neck lift. The dual-plane dissection of deep neck lift is technically compatible with the deeper dissection layers used in advanced facelift techniques, and addressing the neck and lower face in the same operation generally produces a more proportionate result than treating either in isolation. Whether a combined approach is appropriate depends on individual anatomy and the extent of lower face change present. The decision is made at consultation.
I had previous neck liposuction or neck lift with poor results, can deep neck lift help?
Patients who have had previous neck procedures with limited or short-lived results are among the most common presentations for deep neck lift. A disappointing outcome from a standard neck lift or from neck liposuction often indicates that the problem involved deeper structures (subplatysmal fat, digastric muscles, or gland prominence) that were not addressed at the time. Deep neck lift can provide meaningful correction in these cases. Previous surgery does alter the tissue planes, and this is factored into the surgical plan at consultation.
Do I need a GP referral before deep neck lift in Australia?
Yes. Under the Medical Board’s cosmetic surgery guidelines, a current referral from your usual general practitioner, or from an independent medical practitioner, is required before booking cosmetic surgery. The referral is part of the broader patient safety framework, which also includes two consultations, a cooling-off period of at least seven days for adult patients, and screening for body dysmorphic concerns.
Related procedures and resources
Related procedures
- Neck Lift Sydney
- Platysmaplasty Sydney
- Direct Neck Lift Sydney
- Neck Liposuction Sydney
- Chin Implants Sydney
- Facelift Sydney
- Deep Plane Facelift Sydney
- Vertical Restore Facelift
Helpful guides
Consultation with Dr Scott J Turner
Dr Scott J Turner consults for deep neck lift in Sydney from Bondi Junction (39 Grosvenor Street, Bondi Junction NSW 2022) and Manly (Suite 504, Level 5, 39 East Esplanade, Manly NSW 2095). For patients based interstate, consulting rooms in Brisbane (Herstellen Clinic, Spring Hill) and Canberra (Campbell) are available, with surgery performed at Dr Turner’s Sydney hospitals.
Phone: 1300 437 758 Email: [email protected]
