What Is Neck Liposuction?
Neck liposuction is an operation that removes superficial fat from beneath the chin and the upper neck with a fine cannula, through small incisions in the crease under the chin and sometimes behind the earlobes. “Chin liposuction” describes the area patients notice, “submental liposuction” is the anatomical term, and “neck liposuction” is the broader term. All three describe the same operation in the same layer.
What most patients want from it is a clearer line between the jaw and the neck. The features that create that line were described in the plastic surgery literature decades ago and still hold:
- an uninterrupted line along the lower border of the jaw
- a slight hollow just below the hyoid bone
- a visible bulge at the thyroid cartilage
- a visible front border of the sternocleidomastoid muscle down the side of the neck
- an angle between the chin and the neck (the cervicomental angle) of roughly 105 to 120 degrees
Only one of these depends on superficial fat. The others come from the position of the chin and hyoid, the tone of the platysma, the submandibular glands and the depth of tissue beneath the muscle. That is why neck liposuction can change some necks clearly and others very little, and why the decision starts with which layer is responsible.
The Layers of the Neck and What Each One Needs
The neck is built in layers, and each layer responds to a different operation. Working out which layer is driving the change is the whole of the decision.
Skin. The outer envelope. Elasticity falls with age, sun exposure, weight change and genetics. Skin that has lost the capacity to retract does not tighten when volume is removed from underneath it; it tends to look looser.
Superficial fat, above the platysma. The only layer a liposuction cannula reaches. This layer also does useful work: it gives the smooth, unbroken surface that lets the deeper structures read as contour rather than as separate lumps. Removing too much of it is not a neutral act.
The platysma muscle. A broad, thin sheet running from the collarbone into the lower face. In a substantial proportion of people the two halves do not meet across the midline. With age the muscle slackens and its free edges become visible as vertical bands. Fat removal does not tighten, repair or reposition it.
The deep compartment, below the platysma. Subplatysmal fat, the anterior bellies of the digastric muscles and the submandibular glands. In many patients this compartment contributes as much to neck heaviness as the superficial layer, sometimes more. None of it is reachable by liposuction, and none of it responds to treatments applied from the surface.
The bony platform. Chin projection sets the frame. A neck with normal fat volume looks heavy if the chin sits behind the lower lip in profile, because the angle between jaw and neck is shallow before any soft tissue is considered.
A simple test tells you a good deal. Lift your chin and extend your neck. If the fullness largely disappears, it is likely superficial. If it stays, the volume is probably deep, and liposuction will not change it.
What Neck Liposuction Can and Cannot Change
Liposuction removes superficial fat. In a patient whose excess is confined to that layer, whose skin is elastic enough to redrape and whose chin projection is adequate, it may give a clearer contour beneath the chin. That patient exists, but is less common than enquiries suggest.
For everyone else, the limit is set by the layers above. Liposuction cannot reach the deep compartment, cannot tighten skin, cannot repair the platysma and cannot change chin projection. Where any of those is causing the fullness, removing the fat over them changes the covering rather than the contour.
One further limit is the one patients least expect: liposuction cannot restore what it removes. Fat taken out is gone, and if too much comes out, or it comes out unevenly, revision is difficult and sometimes incomplete. This is what separates it from a treatment that can simply be tried and abandoned.
The before-and-after images below are of a patient of Dr Scott J Turner after neck liposuction, published with the patient’s consent. Individual results vary, and these images do not show the result another patient will have. All surgery carries risk. More results are in the before and after gallery.
Who May Be Suitable for Neck Liposuction Alone?
There is a defined group for whom neck liposuction on its own may be appropriate. It is narrower than most patients expect, and the deciding factors are anatomical rather than a matter of preference.
| More likely to suit liposuction alone | Points away from liposuction alone |
|---|---|
| Fullness resolves with the neck extended | Fullness persists with the neck extended |
| Good skin elasticity | Loose, crepey or hanging neck skin |
| Stable weight | Recent or fluctuating weight change |
| No banding; platysma meets in the midline | Visible bands, or platysma not meeting in the midline |
| No gland or digastric prominence | Palpable gland or digastric fullness |
| Good chin projection, or a chin implant planned | A chin that sits back as the main feature |
| Firm skin, often a younger adult | Jowls and lower-face descent |
| No previous treatment to the area | Repeated injectable or device treatment |
Beyond the anatomy, patients who may be suitable are in good general health and are 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, and fat that is removed cannot be put back.
Non-Surgical Double Chin Treatments and Their Limits
Fat dissolving injections, fat freezing, focused ultrasound and radiofrequency skin tightening are all marketed for the double chin, and many patients try several before seeking a surgical opinion. They share liposuction’s central limitation, with less control.
They act on the same superficial layer. Injectable fat dissolution and fat freezing target the fat above the platysma. Ultrasound and radiofrequency act on skin and superficial soft tissue. None of them reaches the subplatysmal compartment, the digastric muscles or the submandibular glands. Where the volume is deep, treating the surface leaves the cause untouched.
They do not change structure. No non-surgical treatment repairs a separated platysma, repositions descended tissue or changes chin projection.
Reduction is less controlled. Surgical liposuction is performed under direct control, with the contour assessed as it goes. Injected and applied treatments reduce fat in a distribution that is only loosely predictable, so irregularity is possible.
Results may be modest and may not last. Where these treatments reduce superficial fat, the visible change is often smaller than expected, and the underlying anatomy continues to age.
Repeated treatment may complicate later surgery. This is Dr Turner’s clinical view rather than settled fact, and the same risk described for liposuction below. Repeated injectable, thermal or cold-based treatment can scar the plane beneath the skin and cause the skin to adhere to deeper tissue, which affects both how the neck looks over time and how predictably it can be operated on later.
Surface treatments, surgical or otherwise, treat the surface. If the surface is the cause, that may be enough. In most patients who present with a heavy neck, it is not.
When Another Procedure Is Discussed
Where examination shows the fullness is not confined to superficial fat, the options are structural. Four are discussed most often, and the neck lift guide compares them all.
Chin implant. Where the chin is under-projected, a chin implant lengthens the line from the jaw to the neck, and fullness in front of a recessed chin can look smaller once the chin is brought forward. A measured amount of liposuction is often combined in the same operation, and in that setting the fat removal is more useful, because the chin gives the reduced soft tissue a frame to sit against.
Deep neck lift. Treats the compartment liposuction cannot reach. Through an incision under the chin, subplatysmal fat is reduced under direct vision, the digastric muscles are reduced where they contribute, prominent submandibular glands are managed where indicated, and the platysma is repaired. It is designed for fullness that persists when the neck is extended. On its own it takes about three hours with an overnight stay, or it is performed as part of a facelift.
Direct neck lift. For selected patients, often older men with central skin excess under the chin, the neck is treated through an incision under the chin without the wider undermining of a facelift. Where skin needs to be removed, a vertical incision on the front of the neck is closed with a Z-plasty and leaves a visible scar. In some cases, incisions around the earlobe and behind the ear give access to the platysma at the side of the neck.
Deep plane facelift with neck lift. Where neck changes sit alongside jowls and lower-face descent, treating the neck alone does not lift the jowls. Every facelift Dr Turner performs is a deep plane facelift that includes a lateral neck lift, with a standard or deep neck lift added where indicated. A deep plane facelift with a standard neck lift is the lower facelift.
These are larger operations with longer recoveries and higher fees than liposuction. They are discussed because they treat the structures causing the change. In Dr Turner’s view, a well-chosen larger operation performed once tends to serve a patient better than a smaller one now and a revision later.
Neck Liposuction or a Chin Implant?
Both are discussed for a soft jawline and a full area under the chin, but they change different things: liposuction removes fat, and a chin implant adds projection to the bony platform. Many patients who ask about one have a neck that would be changed more by the other, or by both.
| Neck liposuction | Chin implant | |
|---|---|---|
| What it changes | Removes superficial fat under the chin and along the upper neck | Brings a recessed chin forward |
| May suit | Soft fullness that resolves with the neck extended, with good skin elasticity | A chin that sits behind the lower lip in profile |
| Incision | Two to three millimetres under the chin, sometimes behind the earlobes | Under the chin or inside the lower lip |
| Theatre time and stay | About 45 minutes, general anaesthesia, day surgery | About 45 minutes, general anaesthesia, day surgery |
| Desk-based work | Usually one to two weeks | Usually one to two weeks |
Should both be done together? Where a recessed chin and superficial fullness are both present, the two can be performed in one operation with one recovery. Bringing the chin forward reduces how much fat needs to come out, which suits the restraint that neck liposuction calls for. Whether a chin implant is appropriate is assessed in profile at consultation, and the chin implant page explains the operation.
How Neck Liposuction Is Performed
Dr Turner performs neck liposuction only in hospital: under general anaesthesia at an accredited Sydney private hospital, with a specialist anaesthetist. It is not performed in consulting rooms under local anaesthetic. On its own it takes about 45 minutes and is day surgery. As part of a chin implant, neck lift or facelift, it is incorporated into the larger operation.
A tumescent solution of saline, local anaesthetic and adrenaline is infiltrated first, which reduces bleeding and gives pain relief afterwards. Access is through incisions of two to three millimetres, usually in the natural crease beneath the chin and sometimes behind the earlobes. A fine cannula is passed into the layer above the platysma and fat is removed in controlled passes.
Restraint is the operating principle. Removal is kept even between the midline and the areas either side, and deliberately conservative in total volume, because the deformities that follow over-resection under the chin are among the more difficult problems in facial surgery to revise. Skin redraping is assessed throughout, and a chin strap or compression garment is fitted before you leave theatre.
Neck Liposuction Recovery
Recovery from neck liposuction on its own is generally shorter than after neck lift surgery. When it is combined with another operation, recovery follows the larger operation.
- First 48 hours. Mild to moderate discomfort, swelling, bruising and tightness. Sleep with your head elevated; light walking is encouraged from day one.
- Week 1. The compression garment is worn continuously except for showering. Bruising peaks around days two to three. You are reviewed in clinic in this period.
- Weeks 1 to 2. Most patients return to desk-based work.
- Weeks 2 to 6. The garment moves to night wear. Strenuous exercise and impact activity are avoided, with activity increased gradually.
- Months 3 to 6. Residual swelling settles and the contour becomes apparent. Skin retraction continues across this period.
Numbness is common early and usually settles over weeks to months. Some contour changes continue beyond six months, which is why the final assessment is not made early. Individual healing varies.
Patients from outside Sydney. Dr Turner also consults in Newcastle and Canberra, and surgery is performed in Sydney. How long to stay in Sydney after surgery is confirmed at consultation, and the out-of-town patients page explains the arrangements.
Neck Liposuction Risks and Complications
All surgery carries risk. The information below is general, and the risks that apply to you are discussed in detail at consultation. Neck liposuction is not a low-consequence treatment that can simply be tried: the area under the chin tolerates over-treatment poorly, and several recognised problems appear months or years afterwards. This is the reason Dr Turner is conservative about the operation.
General surgical risks
- Bleeding or haematoma requiring drainage
- Infection
- Poor wound healing or unfavourable scarring
- Anaesthetic side effects or reactions to medications
- Blood clots, including deep vein thrombosis and pulmonary embolism, rare with this operation
Early risks specific to neck and chin liposuction
- Contour irregularity, including lumpiness, dimpling, asymmetry or localised depressions
- Injury to the marginal mandibular nerve, causing temporary or, very rarely, permanent weakness of the lower lip
- Numbness or altered sensation, usually temporary but occasionally permanent
- Seroma, a fluid collection that may need drainage
- Prolonged bruising and swelling, and skin discolouration, usually temporary
- Skin necrosis, extremely rare but serious
Delayed and long-term risks
- Platysmal bands appearing after surgery. Published series identify bands at the front of the neck as a specific pitfall of submental liposuction, more likely in heavier necks and where the platysma does not meet in the midline. Fat that concealed the free muscle edges is removed, and bands can appear, sometimes not until the muscle slackens further with age. The platysmal bands article explains why they form.
- Central hollowing (cobra neck deformity). Where central fat is over-resected relative to the areas either side, the midline sinks while the side of the neck stays full. Repair generally needs a formal platysmaplasty with redraping rather than a minor revision.
- Skin adhering to the muscle beneath. When too much superficial fat is removed, the skin can adhere to the platysma or digastric muscles, so it moves with the muscle instead of gliding over it, with rippling and tethering on movement. This is one of the harder problems in facial surgery to repair, because the plane that would be used to release it has gone.
- Submandibular gland prominence. A prominent gland is often hidden by fat before surgery and easy to miss on examination. Once the neck is reduced, it can show as a new bulge below the jaw.
- A gaunt appearance. Over-resection can leave a neck that looks thin rather than defined, and this tends to become more noticeable with age.
- Poor skin retraction, leaving looseness where fat previously gave volume, or a smaller change than expected where the volume was deep rather than superficial.
- A harder operation later. In Dr Turner’s view, previous liposuction leaves scarring in the plane a neck lift or facelift needs to lift, which makes the later operation less predictable and can limit what it achieves.
- The need for revision surgery, which under the chin is often more difficult than the first operation, and dissatisfaction with the outcome.
None of this means neck liposuction should never be performed. It means it should be performed for the patients it suits, in measured quantity, with the long-term picture explained beforehand rather than discovered afterwards. More information is on the risks and complications page.
Neck Liposuction Cost in Sydney
The fee for neck liposuction depends on whether it is performed on its own or with a chin implant, neck lift or facelift, on the time the operation takes in theatre, and on its complexity. It is made up of the surgeon’s fee, the specialist anaesthetist’s fee and the private hospital fee.
Because Dr Turner performs neck liposuction only in hospital, the fee includes the hospital and specialist anaesthetist as well as the surgeon. For neck liposuction on its own the fee varies and is around $9,000. Other neck procedures performed on their own are quoted after consultation. Every fee is confirmed in an itemised written quote after consultation. When neck surgery is part of a facelift, the fee for each combination is shown on the facelift cost page. There is no Medicare rebate or private health insurance benefit for cosmetic neck surgery.
The fee is worth weighing against durability. In Dr Turner’s view, a smaller operation that does not treat the cause, followed later by the one that does, generally costs more in total, and the second operation is performed on tissue the first one altered.
Choosing a Surgeon for Neck Liposuction
Neck liposuction is surgery, and the problems that follow over-resection under the chin are difficult to revise. It is reasonable to check that your surgeon is a Specialist Plastic Surgeon on the public AHPRA register, operates in accredited hospitals with a specialist anaesthetist, and examines the deeper layers of your neck as well as the fat. The guide to choosing your plastic surgeon covers what to ask.
Dr Scott J Turner is a Specialist Plastic Surgeon who was awarded FRACS in 2013 and holds AHPRA registration MED0001654827, both independently verifiable. He is a member of the Australian and New Zealand Board of Cosmetic Plastic Surgery. Surgery is performed at accredited Sydney private hospitals with a specialist anaesthetist.
A referral from your GP or another registered medical practitioner is required before a cosmetic surgery consultation. Two pre-operative consultations are held, the first of which may 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. At consultation, the examination looks at which layer of your neck is producing the fullness, what fat removal would and would not change, and what the alternatives involve. To arrange a consultation, contact us.
Frequently asked questions
Is neck liposuction the same as chin liposuction or submental liposuction?
Yes. The three terms describe one operation: removing superficial fat from beneath the chin and along the upper neck, through the same incisions and in the same layer. “Chin liposuction” describes the area patients notice, “submental liposuction” is the anatomical term, and “neck liposuction” is the broader term.
How much does chin or neck liposuction cost in Sydney?
The fee depends on whether liposuction is performed on its own or with another operation, and on the time it takes in theatre. It is made up of the surgeon’s fee, the specialist anaesthetist’s fee and the private hospital fee, and is confirmed in an itemised quote after consultation. Dr Turner performs neck liposuction only in hospital, and on its own the fee varies and is around $9,000. When it is part of a facelift, the fee for each combination is on the facelift cost page. There is no Medicare rebate for cosmetic neck surgery.
Is chin liposuction worth it?
It may be for patients whose fullness is confined to the fat above the platysma, whose skin is elastic and whose chin is well projected. For most people assessed for it, some of the fullness comes from deeper fat, the platysma, the glands or a recessed chin, and liposuction alone gives a limited change and can make the neck less predictable over time. This is why neck liposuction has a limited role on its own: Dr Turner most often uses it as an adjunct within a direct or deep neck lift or a lower facelift, where the structural changes are treated as well.
How long do the results of chin liposuction last?
Fat cells that are removed do not grow back, but the fat that remains can enlarge with weight gain, and the skin, platysma and deeper structures of the neck continue to age. How the neck looks years later depends on weight stability, skin quality and how conservatively the fat was removed. Liposuction does not stop ageing changes in the layers it does not treat.
How do I know whether my neck fullness is superficial or deep?
The simplest indicator is to lift your chin and extend your neck. If the fullness largely disappears, it is likely superficial. If it stays, or if it feels firm rather than soft under the chin, the volume is probably in the deep compartment. This is an approximation rather than a diagnosis: assessment includes feeling the gland and digastric region and examining the platysma at consultation.
Can neck liposuction make my neck look worse?
It can, and the mechanisms are recognised. Removing fat over a slack platysma can reveal bands that were hidden. Taking more from the midline than from either side causes central hollowing. Removing too much overall can let the skin adhere to the muscle beneath or leave the neck looking gaunt, and a gland hidden by fat can become obvious afterwards. These are the reasons the operation calls for restraint and careful patient selection.
Can neck liposuction tighten loose skin?
No. Liposuction removes fat. Skin retraction afterwards is passive and depends on the elasticity you already have. Where elasticity is poor, removing fat can leave loose skin where volume used to be. In that situation a neck lift, often with a facelift, is discussed instead.
What is the difference between neck liposuction and a deep neck lift?
Liposuction removes fat from above the platysma through a fine cannula and relies on skin retraction. A deep neck lift opens the area under the chin to treat what sits beneath the platysma, including subplatysmal fat, the digastric muscles and prominent submandibular glands, and repairs the platysma itself. They treat different layers. If your fullness persists when you lift your chin and extend your neck, a deep neck lift is designed for it and liposuction is not.
Can neck liposuction be combined with a chin implant?
Yes, and it is one of the more useful combinations. Where a recessed chin makes the angle between the jaw and neck shallow, fullness in front of it looks larger than it is. Bringing the chin forward while removing a measured amount of superficial fat treats both the platform and the volume in one operation, and reduces how much fat needs to come out. Whether a chin implant is appropriate is assessed in profile at consultation.
Is neck liposuction suitable for men?
In selected cases, yes, and the same criteria apply. Beard growth affects how a scar under the chin matures, and the skin is generally thicker. Men more often have a combination of skin excess, platysmal laxity and deep fat, which is usually better treated with a direct neck lift or a male facelift with neck work.
What if I have already had liposuction or non-surgical treatment?
Tell Dr Turner at consultation, including how many sessions and when. Previous treatment can alter the tissue planes, and where it has caused scarring or made the skin adhere, it affects both the surgical approach and what is realistic to achieve. It does not rule surgery out, but it changes the planning, and it is better known beforehand than found during the operation.
Do I need a GP referral for neck liposuction?
Yes. A referral from your GP or another registered medical practitioner is required before a cosmetic surgery consultation. The referral means your doctor is aware of the operation you are considering and can raise any relevant medical or psychological factors.
Related Guides
- Neck lift surgery: every neck option compared, with and without a facelift
- Turkey neck: causes and treatment options
- What causes a heavy neck in men?
- Platysmal bands: why they form
- Can you have a neck lift without a facelift?
- Neck lift recovery timeline
- Facelift and neck before and after gallery
