Deep Plane Neck Lift

The terminology for surgery on the neck can be very vague and confusing. Traditionally, a necklift addressed skin laxity, bands, and excess fat in the neck. A necklift was performed with a small incision under the chin and incisions behind the ears where excess skin could be removed. “Deep plane” or structural necklifts involve similar concepts, but with more thorough contouring of the deep neck structures such as the platysma, subplatysmal fat, submandibular glands, and removal of excess skin. A deep neck lift, in contrast to a “Deep plane” or structural necklift, addresses the deep structures of the neck without removing excess skin. An incision is made only under the chin and incisions are NOT made behind the ears. This allows the surgeon to address the platysma muscle, subplatysmal fat (fat under the platysma muscle), and glands.

The terminology for rejuvenatinve surgery in the neck can be very confusing. The best way to review the terms is during a consult with an experienced surgeon where the surgeon can use your own anatomy to discuss the different procedures and give recommendations tailored to you. The main difference between a deep neck lift and a “traditional” or “deep plane” necklift is skin. Both procedures address deeper structures of the neck such as the platysma, fat under the platysma, and glands. A deep neck lift does not address excess skin in the neck and therefore does not require incisions behind the ears. A “deep plane” necklift requires both incisions under the chin and behind the ears and is used for patients who have excess skin that needs to be removed.

First, you must be healthy and medically able to undergo an elective, cosmetic procedure under general anesthesia. Next, a deep neck lift is most often performed on younger patients, often under the age of 45, who have good skin elasticity and who do not need excess skin removed. Lastly, the anatomy should coincide with the surgical procedure, or in other words, the patient needs to have excess in deeper neck structures that can be contoured to achieve a good outcome.

A deep neck lift addresses deep neck structures such as the muscle, fat under the muscle, and glands to reduce volume and improve neck contour. The jawline can be better defined as well. The deep neck lift does not address structures above the jawline and does not address excess skin in the neck.

Yes, a deep neck lift can correct a double chin. Oftentimes, a double chin is the result of muscle laxity in the neck, excess fat underneath the muscle, and excess gland volume. These can all be contoured and removed during a deep neck lift to decrease volume in the neck and improve the contour associated with a double chin. Sometimes, the chin may also need to be augmented if the double chin is caused by a week chin. This can be done at the same time with a chin augmentation.

A deep neck lift addresses deep structures underneath the jawline and jawline. By definition, a deep neck lift does not tighten the jawline. It does, however, improve contour below the jawline. This, in turn, can allow the jawline to be more prominent and appear improved.

Deep neck procedure take between 1-2 hours.

Most deep neck lifts are performed under general anesthesia. In order to address all the layers of the neck, and to ensure patient comfort, general anesthesia is recommended.

Most patients have bruising a swelling below the chin for 5-7 days after surgery. Sutures are removed 7 days after surgery and swelling slowly subsides over the next 4-6 weeks. Gentle exercise can start 2 weeks after surgery and heavy lifting can be started 4 weeks after surgery. Most patients enjoy their results with little to no swelling at the 6-8 week mark after surgery. It is important to note that these are generalizations based on many patients. Each patient is unique and can have a different post-operative recovery.

Deep neck lifts require 1 incision underneath the chin, which is nicely placed into a small crease between the chin and the neck. In the early stages of healing the scar is still hard to find but can be more noticeable and red as it is slowly healing. This heals very well and after the scar is allowed to mature, is very difficult to notice.

Results from a deep neck lift are permanent. A deep neck lift removes bulky tissue below the skin of the neck to improve the contour. This tissue does not “return” or “reaccumulate.” However, natural changes such as aging and weight gain/loss cannot may change the contour of the neck and these should be discussed with your surgeon prior to the procedure.

Yes, deep neck lfits are safe. They are commonly performed procedures that allow the surgeon to contour and remove excess volume in the neck without having to remove skin. Of course, the patient needs to be a healthy candidate for surgery and should have his/her anatomy reviewed with the surgeon prior to confirming whether or not they are a candidate. As with any surgery, there are risks and benefits, and these should be thoroughly reviewed with the surgeon during the consultation as well.

In the neck, there are important structures that should be avoided. There are nerves, muscles, salivary glands, and swallow structures that should be avoided. Damage to these structure can cause associated dysfunction, such as numbness, movement issues, muscle weakness, salivary leaks, and contour irregularities/asymmetries. However, these complications are rare in experienced hands. Again, all risks and benefits are reviewed during the consultation and pre-operative appointments to ensure transparency and thorough patient education.

Deep neck lifts are not painful procedures. Most people find that the incision under the chin is a little sore after surgery and there is some general tightness as well, but this should not be a significantly painful surgery. Appropriate pain medication prescriptions are given prior to surgery in the event that the patient experiences mild pain.

Yes, a deep neck lift can be combined with a facelift. However, as described above, a deep neck lift is often used for younger patients who want volume improved in the neck without the need to remove skin. For this reason, a deep plane structural necklift is more often performed with a deep plane facelift to remove excess skin, in addition to contouring the neck and reducing volume.

All patients have stitches after a deep neck lift, or surgery of any kind. If an incision is made, sutures or stitches are used to close the suture so that it heals cosmetically. Drains are often used to reduce “dead space” in the neck and ensure no fluid accumulates. This is done on a patient by patient case and should be discussed prior to surgery.

Deep neck lift costs range between $7,000-10,000 depending on length of the surgery and complexity. If additional procedures are performed, costs may increase.

There are alternatives to all surgical procedures. However, not all alternatives produce the same results. Alternatives also heavily depend on patient anatomy. These should be discussed with our team prior to and during your consult. In some cases, liposuction may be better suited and very rarely, some non-surgical injections may help.

No, this would require a deep plane structural necklift with incisions under the chin and behind the ear. In order to remove skin in a cosmetic and discreet fashion, incisions are required behind the ears.

Most patients who are candidates for a deep neck lift to improve volume without skin removal are between the ages of 18 and 45.

A deep neck lift addresses multiple layers under the skin of the chin, including the platysma muscle, fat under the platysma muscle, gland excess, and other muscles in that area. Liposuction only addresses a small amount of fat directly under the skin and leaves the muscle, deep fat, glands, and other structures untouched. This is why a discussion and examination with your surgeon is critical to avoid confusion and to ensure the best procedure is performed.