The concept of doing a necklift as an isolated procedure is a relatively new concept.  Necklifts are traditionally part of a standard full facelift and involve tightening and repositioning the skin of the neck and lower face to give a tighter look, better jawline, and reduce or eliminate the jowls.

However, we saw several patients in the early years of our practice who were troubled by the appearance of their neck but satisfied with the appearance of their face.  As one of our patients put it (and this became the title of a talk we gave at a national meeting) “My face is OK, but my neck looks like Grandma!”  She was interested in correcting her neck but did not want a facelift.  We continue to see more patients with these feelings for three reasons:

  • As more patients are pursuing non-invasive procedures for the face (Botox, fillers, laser treatment, microdermabrasion, chemical peel, etc.) we are keeping the faces looking better but are really doing little for the neck, where many of these treatments are ineffective
  • Many patients are worried about the outcome of a facelift, as they have seen patients, even celebrities, who have ended up with an unnatural appearance after surgery.  They are less concerned about a bad outcome in the neck where it really is almost impossible to have an “overdone” appearance.
  • They feel a facelift is a bigger, more extensive procedure than they desire.

Faced with these requests, we began performing necklifts as an isolated procedure over 18 years ago.  Since that time, other plastic surgeons have also noted this trend and the first textbook on necklifts was written only a few years ago.

Necklift vs facelift- which do you need?

This really depends on where you have the greatest problem.  Patients who have a fairly youthful face with minimal sagging but their problem is confined to the jawline, jowls, and excess skin the neck are excellent candidates for a necklift.  However, if these changes involve the entire face, we may suggest a necklift.

One operation is not “better” than the other.  However, one may be better for you than the other.  It is important to select the right operation that fits your problem and your needs.

The Consultation

At your initial consultation we will evaluate your face, review your photographs, and discuss ways we can achieve the look you want.  We will review the procedure, showing photographs and diagrams on how it is performed, and come up with an operative plan that suits your needs.  Of course, we will ask you about your overall health history and medications to make sure we can do the operation safely.  If you have certain medical conditions we may need to contact your primary physician prior to surgery for medical clearance.

The Operation

The procedure is performed in the operating room at the Lawrence Surgery Center under either a general anesthetic or local anesthesia with sedation.  It typically takes around three hours, but may take longer if other procedures are added (blepharoplasty, etc.).  During the procedure we typically perform liposuction of the jowls, tighten the platysma muscles in the neck to eliminate prominent bands, and redistribute the skin, removing the excess.  After the procedure, you are placed in a head wrap type dressing that will remain in place until the following day when we exchange it for a lighter dressing.  Patients usually stay at the surgery center for 1-2 hours after surgery then are discharged home.  Pain afterward is mild to moderate and is controlled by oral pain medication.


Pain is generally mild to moderate after the operation, requiring patients to take pain pills for 1-3 days.  Nearly all patients experience swelling or bruising after the surgery, which may take a few weeks to resolve.  Most of this is not in the face but extends down the front of the neck, sometimes into the upper chest area.  Skin sutures are removed after 7-14 days.  Makeup may be worn shortly after surgery to cover any bruising.  Most patients wait 7-14 days before returning to work and vigorous exercise.

The direct excision necklift

Sometimes patients are candidates for a less extensive procedure, the direct excision necklift.  In this office procedure, we simply cut out the excess skin in the area on the front of your neck.  This procedure can be done in the office in about 1 hour and requires only a local anesthetic. Pain after the procedure is minimal and recovery time is short.

As inviting as it sounds, this procedure has one significant drawback- it places the scar directly in the front of the neck.  Therefore, we use this procedure only in very carefully selected patients where we know the scar has the best chance of fading.  This tends to be older men with ruddy, thick skin.  In these patients, the scar tends to fade and blend with the surrounding skin and become scarcely visible.  In a female with fairly good skin, we feel the scar would be unacceptable and do not recommend this procedure.

Other procedures

Necklifts address one of the most obvious features of aging- sagging tissue.  However, they don’t address two other important aspects of aging- a deterioration of skin quality (elasticity, pigmentation, thickness,etc) and volume loss in the face.  We will discuss with you the importance of a good skin care regimen and arrange for a complimentary consultation with one of our aestheticians, our experts in skin care.  You may also benefit from other procedures at the time of surgery that will help enhance your overall result of your necklift.

Fast fact

We gave our first presentation on this topic at the national meeting of the American Society of Plastic Surgery Nurses in Chicago in 2005. Over 50,000 necklift procedures were performed last year.

5 Reasons why you should have your necklift performed at Lawrence Plastic Surgery:

  • Experience– We have been performing and perfecting this procedure for over 20 years and have the happy patients to prove it
  • Accredited facilities–  We perform our facelifts at the Lawrence Surgery Center, an accredited facility with an experienced, knowledgeable and friendly staff
  • Safety– We place your safety above all else.  We have given educational talks at national conferences the avoidance of significant complications associated with plastic surgery and place your safety above all else
  • Surgeon certified by the American Board of Plastic Surgery
  • Great staff and office environment–  Our experienced staff, including a Certified Plastic Surgery nurse, and experienced aestheticians, work alongside your surgeon every step of the way to give you not just a great operation but a great experience

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