Neck Lift: Platysmaplasty, Neck Bands and Combining It With a Facelift
Key takeaways
- A neck lift addresses the neck: the vertical platysmal bands, under-chin fullness and loose skin below the jawline, usually by tightening the platysma muscle (platysmaplasty) and re-draping the skin.
- It is frequently combined with a facelift, because the two share the same descent of tissue; the neck-lift incision adds a small cut under the chin.
- A combined face and neck lift takes longer, roughly 4 to 6 hours, and combining procedures raises the complication rate to about 3.7% versus about 1.5% for a facelift alone.
- The neck and under-chin are where satisfaction is lowest and results hold least well, so honest expectations matter more here than anywhere else on the face.
- The most common complication remains a haematoma, roughly 1 to 7% and far more common in men and smokers; smoking raises wound-healing problems around 12-fold.
By Paula Winters | Medically reviewed by Mr Alexander Frost, FRCS (Plast)
Published June 12, 2026 · 4 min read
A neck lift is surgery to address the neck: the vertical platysmal bands, under-chin fullness and loose skin below the jawline, usually by tightening the platysma muscle (a platysmaplasty) and re-draping the skin. It is a close relative of the facelift, and the two are so often done together that it helps to understand where one ends and the other begins1.
Of everything about my own surgery, the neck was the part I understood least going in and think about most now. I had assumed a facelift would simply sort the lot, and it took a proper conversation at consultation for me to grasp that the jowls and the neck are separate jobs, even if they descend from the same slow slide of tissue. This is the plain version of what I wish someone had drawn for me on a piece of paper.
What is a neck lift?
A neck lift treats the neck specifically: the two vertical bands that appear when you tense, the fullness under the chin, and the loose skin that blurs the line between jaw and neck. A facelift, by contrast, works on the lower face and jowls; the neck lift is the part that sharpens the angle beneath the jaw2.
The two overlap because they share a cause. The same descent of tissue that drops the cheeks into jowls also loosens the neck, which is why a sagging neck and jowls so often turn up together. A neck lift sits within the wider family of techniques set out in types of facelift, and it is usually described as an addition to, rather than a substitute for, the facial lift.
What is a platysmaplasty?
A platysmaplasty is the muscle part of a neck lift: the paired edges of the platysma muscle, which separate and hang as vertical bands with age, are stitched back together in the midline through a small incision under the chin. Tightening the muscle rather than only the skin is what flattens the bands and defines the angle under the jaw2.
The platysma is a thin sheet across the front of the neck, and it is genuinely the thing that gives those cord-like bands when you look down or speak with emphasis. My reviewer put it simply at consultation: skin alone will not hold a neck; the muscle has to be dealt with, or the bands come back. That is the honest reason the under-chin incision exists, and why a neck lift is more than a skin trim.
Combining a neck lift with a facelift
A neck lift is frequently combined with a facelift, because the two address the same downward drift of tissue; the combination adds a small under-chin incision to the usual facelift cuts and takes longer, roughly 4 to 6 hours rather than 2 to 3. It is done under a general anaesthetic, or local with sedation, in a single sitting1.
The trade-off is real and worth naming. Combining procedures raises the complication rate to about 3.7% versus about 1.5% for a facelift alone3. That does not make it wrong, and for many people one operation with one recovery is preferable to two, but it is a decision to make with a surgeon rather than an automatic upgrade. If you are weighing the neck against the eyes or the brow at the same time, facelift versus blepharoplasty and facelift versus brow lift set out those separate comparisons.
What a neck lift will and will not fix
A neck lift treats laxity: loose muscle, loose skin, and the bands and blurred jawline that laxity creates. It does not on its own resolve fullness from fat, a heavy or receded chin, or the underlying bony and cartilage anatomy of the neck. Those limits are why not every neck can be made into a sharp one4.
This is the part I find people most want softened, and I will not soften it: the neck and under-chin are where satisfaction is lowest across studies and where the result holds least well over time. The cheeks and jawline tend to keep their correction better than the neck does. It is still a worthwhile operation, but it rewards realistic expectations more than any other part of the face. For the wider list of what surgery cannot address, see what a facelift will not fix.
Recovery and risks specific to the neck
Recovery after a neck lift follows the facelift timeline: bruising and swelling are visible for around 2 weeks, most normal activities return at about 2 to 3 weeks, and the deeper swelling and scars settle over about 6 to 9 months. The most common complication is a haematoma, a collection of blood under the skin, at roughly 1 to 7% and much more common in men and in smokers3.
The neck has its own quirks in recovery. The area under the chin can feel tight and oddly numb for weeks, and the swelling there was the slowest part of mine to settle; the jaw looked defined long before the neck caught up. Smoking matters everywhere but especially here: active smokers carry around a 12-fold higher risk of wound-healing problems, and stopping for at least 4 weeks beforehand is standard advice2. The fuller account is in facelift risks and complications, the honest week-by-week in facelift recovery week by week, and the smoking question in facelift and smoking.
References
- Facelift (rhytidectomy), NHS. ↩
- InService Insights: Facelift anatomy, techniques and complications, American Society of Plastic Surgeons. ↩
- A Systematic Review and Comparative Analysis of Rhytidectomy, PMC (systematic review). ↩
- Facelift, American Society of Plastic Surgeons. ↩
Common questions
What is a neck lift?
A neck lift is surgery to address the neck: the vertical platysmal bands that stand out when you tense, under-chin fullness, and loose skin below the jawline. It usually tightens the platysma muscle, a technique called platysmaplasty, and re-drapes the skin. It works on the neck, whereas a facelift works on the lower face and jowls, which is why the two are so often done together.
What is a platysmaplasty?
A platysmaplasty is the muscle part of a neck lift. The platysma is a thin sheet of muscle across the front of the neck; with age its edges separate and hang as two vertical bands. A platysmaplasty stitches those edges back together in the midline, usually through a small incision under the chin, to flatten the bands and sharpen the angle beneath the jaw.
Do you need a facelift and a neck lift together?
Not always, but they overlap. The same descent of tissue that creates jowls also loosens the neck, so many people who want one benefit from the other. A neck lift can be done on its own for a neck problem with a reasonable jawline, but combining it with a facelift is common. Combining does raise the complication rate to about 3.7% versus about 1.5% for a facelift alone, so it is a real decision, not an automatic add-on.
How long does a combined face and neck lift take?
A facelift alone takes roughly 2 to 3 hours; a combined face and neck lift takes about 4 to 6 hours. It is done under a general anaesthetic, or local anaesthetic with sedation, with the usual facelift incisions plus a small extra incision under the chin for the platysmaplasty.
Will a neck lift get rid of my double chin?
It can improve under-chin fullness and a poorly defined jawline, especially where the cause is loose muscle and skin. But a neck lift treats laxity, not everything. Fullness from fat, a heavy or receded chin, or the position of the voice box can limit the result, and the neck is where satisfaction is lowest across studies. A surgeon examining you in person is the only way to know what your neck will actually do.
How long does a neck lift last?
Like a facelift, a neck lift is commonly said to last about 10 years, but that is a range rather than a promise. The neck tends to hold its result least well of all: in longevity studies the jawline and cheek stay corrected better than the neck. A neck lift resets the starting point; it does not stop the neck ageing from there.
Written by Paula Winters. Medically reviewed by Mr Alexander Frost, FRCS (Plast).
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