Neck lift — its characteristic problem is not the result but the border

A neck lift tightens loose neck skin and the muscle layer beneath it (the platysma).

First, what this operation addresses has to be separated out. A neck looks loose for several reasons, and different causes need different things.

• loose skin — the tightening side
• platysmal bands standing out as two cords — the muscle is gathered in the midline and sutured
• fat under the chin — overlaps with liposuction and deoxycholic acid
• large salivary glands making the area below the jawline stand out — tightening does not solve this
• a chin set back, making the neck look short — the territory of genioplasty or orthognathic surgery

That list is the most practical part of this page. Decide by looking at the neck alone and you miss the cause.

And now this operation's characteristic problem — the border.

The neck does not age separately from the face. But tighten the neck alone and above and below the jawline fall out of step. The neck is taut while the cheeks and the area around the mouth are as they were, so two ages end up in one face.

That is why this operation is often done together with a facelift. This site keeps the two pages apart because the option of doing the neck only genuinely exists, and it spends much of this page on whether to do them together because that option can create a border.

It cannot be undone. Skin removed does not come back, and a sutured muscle layer does not return to where it was.

This site does not deal in prices, clinics or reviews.

A great deal passes through the neck. This is the heaviest section of this operation.

The marginal mandibular branch of the facial nerve runs near the jawline. Damage can change how the lower lip moves, so that one side looks to droop when you smile. It usually recovers, but not always.

The great auricular nerve runs below the ear. Damage leaves the earlobe and around it numb, and it can persist.

Salivary glands and large vessels lie beneath.

Collected blood (haematoma) is the most urgent complication here. The neck is where the airway runs. If one side swells quickly after surgery, if breathing is uncomfortable, or if your voice changes, report it immediately — at night too.

Scars remain behind the ear and under the chin. They usually hide substantially in the hair and the shadow of the jaw, but the scar behind the ear can widen. That is a place under tension.

The shape of the earlobe can change. A look of being pulled down and attached has been described. Once it happens it is hard to correct.

Platysmal bands can reappear. A gathered, sutured muscle can loosen over time, or what remains can stand out.

Sensation is dull for a while, around the neck and ear.

Smoking is especially dangerous in this operation. Skin is lifted over a wide area, so blood supply matters. Skin loss is a reported complication.

Swelling and firmness linger. The area under the chin can feel hard for months. Judging the final shape takes six months to a year.

Separate the causes first. Go through the list above one by one in a consultation — skin, muscle bands, fat, salivary glands, chin. What tightening solves and what it does not are mixed together.

Discuss whether to do it with the face. It is the most important question on this page. Doing the neck alone means a lighter recovery but can create a border. Doing both gives an even result but makes the operation bigger. Which suits you depends on how loose things are and on your age.

Look at side and three-quarter photographs. The neck is the area least visible from the front. Look at 45 degrees, the profile, and with your head down.

Have the scar drawn on you. Check whether the line behind the ear shows when your hair is tied back.

Not smoking matters especially here. From weeks beforehand. Get the period from your clinician.

If your blood pressure is high, check how well it is controlled. It bears directly on the risk of haematoma.

Bending and turning the neck are restricted afterwards. Get instructions on sleeping position too.

Have it at a stable weight. The neck and under the chin are sensitive to weight.

The result of this operation depends less on 'how much was tightened' than on 'how far it went together with the face'. That is why this site spends half the page on the border.

It cannot be undone. Skin removed does not come back, and a sutured muscle layer does not return. Loosening again over time is a separate matter, covered under cautions. This operation too is of the 'cannot be undone but can undo itself' kind — the same structure as the lateral canthoplasty page.

Age keeps going. This operation does not turn back a clock; it changes the state at one point in time. The neck goes on ageing afterwards. Some people have a second operation.

The neck is also an area that is easy to hide. Collars and angles cover a lot of it. Before surgery, look honestly at how much it actually bothers you. This site does not make that judgement for you.

The result is hard to agree from photographs. The shape of the neck changes a great deal with the angle of the head. Setting expectations from one angle leads you astray.

Whether to have it done is settled with a doctor, and it is better not to settle it on one consultation alone.