Neck lift surgery corrects loose skin, visible platysma bands, excess fat beneath the chin, and sagging below the jawline. Most patients need one of three approaches: liposuction alone, platysmaplasty to repair the muscle, or a combined lift with skin removal behind the ears.
Which one is right depends on whether your concern comes from fat, muscle laxity, loose skin, or a combination of all three. The procedure is performed on an outpatient basis, usually under local anesthesia with intravenous sedation, and most patients return to work between one and two weeks later.
At our Park Avenue practice, we evaluate neck anatomy, jawline definition, skin quality, and overall facial balance before recommending an approach. Joel Kopelman, MD, FACS, has spent more than 35 years performing facial and oculoplastic rejuvenation across New York, New Jersey, and Palm Beach.
There is no single version of this operation. The technique is matched to the degree of laxity present, and the difference between them is significant in both procedure length and downtime.
In the mildest cases, where excess fat predominates and skin elasticity is still good, liposuction alone through a tiny incision beneath the chin may be enough to restore the contour. Excess neck fat sits in either the pre-platysma or sub-platysma fat pad, and reducing these deposits can sharply improve the neckline on its own.
When the muscle has separated and formed visible vertical bands, platysmaplasty NYC patients typically need muscle repair rather than fat removal alone. The dropping or banded edges of the platysma are released, then retightened toward the midline to rebuild a defined cervicomental angle.
For more advanced laxity, the classical approach adds well-concealed incisions behind the ears so that excess skin can be trimmed and redraped rather than simply tightened. This version is frequently combined with a facelift when mid-facial descent is present alongside the neck concern.
| Technique | Best suited for | Procedure length | Incisions | Back to work | Return to exercise |
|---|---|---|---|---|---|
| Liposuction only | Excess submental fat with good skin elasticity and no muscle banding | About 1 hour | One small incision beneath the chin | 4 to 7 days | Light activity at 7 to 10 days |
| Platysmaplasty, with or without liposuction | Visible vertical neck bands with mild to moderate skin laxity | About 2.5 to 3 hours | Beneath the chin, occasionally behind the ears | 7 to 10 days | Moderate exercise at 3 to 4 weeks |
| Classical lift with skin removal | Significant laxity, jowling, and loose skin that will not redrape on its own | About 3 hours | Beneath the chin and behind both ears | 10 to 14 days | Strenuous exercise at about 6 weeks |
| Combined with facelift or laser | Neck laxity alongside mid-facial descent or surface wrinkling | 4 to 5 hours | Facelift incision pattern | 14 to 21 days | Strenuous exercise at about 6 weeks |
Good candidates are non-smokers in stable general health who are bothered by fullness under the chin, crepey or creased skin, or a neck profile that reads older or heavier than the rest of the face. Weight-loss patients often fall into this group, since skin frequently fails to retract after significant weight loss.
Sometimes the neck ages faster than the rest of the face. In these cases, a targeted procedure addresses the concern without the scope of a full facelift.
Ideal Necklift Candidate
Necklift Benefits
Necklift Techniques
Sometimes the neck ages faster than the rest of the face. In these cases a targeted neck lift will do the trick.
Our approach involves tightening the deeper tissues beneath the platysma rather than pulling on the skin alone. Skin-only tightening is what produces the swept, unnatural look that ages poorly; repositioning the deeper layer is what holds.
By tightening the neck muscles on both sides and at the midline, it is possible to restore a more youthful neck position and a cleaner angle beneath the jaw. This is typically accomplished through two small incisions, one below the chin and one behind the ear.
Incisions are placed within natural creases below the chin and behind the ears. Over several months, they settle and become inconspicuous, which is why placement matters as much as the muscle work itself.
Where the chin is somewhat weak or set back, a chin implant can complement the result by accentuating the jaw and neckline. We will discuss whether that applies to you during your evaluation rather than assuming it does.
“Dr. Kopelman I love my neck and jawline thanks to you. The investment in myself was worth it. I had been so unhappy with my saggy neck and double chin for years. You helped me to restore a sense of confidence in my image! I am so happy I found you on the internet.”
~ Rebecca H. ~
Patients go home the same day. A gauze dressing is applied under the chin and behind the ears and removed the following morning, when you are examined by our surgical and nursing staff.
If a drain was placed during surgery, it is typically removed within 24 to 48 hours. A compressive elastic strap is then worn around the neck to control swelling and support the healing tissues, usually for about two weeks.
Expect mild discomfort with some swelling and bruising for roughly two weeks. Most patients need nothing stronger than over-the-counter pain medication. Sutures come out 5 to 7 days after surgery.
Light daily activity resumes in about a week, with a return to work most commonly between 10 and 14 days, depending on the technique used. Final shape and feel are reached approximately two to three months later, as swelling fully resolves and tissues settle.
As with any operation, there are risks. These include reaction to anesthesia, bleeding, infection, and delayed or visible scarring, which is why blood thinners and smoking must be stopped well in advance.
Temporary dry skin, tightness, numbness, and a burning or tingling sensation along the neck are common during healing and typically resolve. There is a small risk of injury to a branch of the facial nerve, which can cause temporary weakness in nearby muscles.
These complications are uncommon, but they are the reason the choice of surgeon matters. We review your specific risk profile against your medical history before scheduling, and we monitor recovery at regularly scheduled intervals rather than at a single follow-up.
Results are long-lasting and continue to serve you as you age, though no surgical procedure stops the aging process itself.
Cost varies considerably because the operation itself varies. A suction-only correction, which takes about an hour, and a classical lift performed alongside a facelift are different procedures with distinct surgical, anesthesia, and facility components.
The main drivers are the required technique, the time spent in the operating room, the type of anesthesia used, and whether complementary procedures are performed during the same session.
Insurance does not generally cover surgery performed purely for cosmetic reasons. We provide a written estimate covering all components of your procedure before anything is scheduled, so there are no surprises afterward.
| Factor | Why it affects your estimate |
|---|---|
| Technique required | Liposuction alone is the least involved option; muscle repair and skin excision each add surgical time and complexity. |
| Operating room time | Procedures range from roughly one hour to four or five hours when combined with a facelift. |
| Anesthesia type | Local anesthesia with intravenous sedation differs in cost from general anesthesia. |
| Combined procedures | Chin implant, eyelid surgery, fat grafting, or laser resurfacing performed in the same session change the total. |
| Post-operative care | Overnight nursing care, garments, and follow-up visits are factored into a full estimate. |
| Insurance coverage | Cosmetic procedures are not typically covered, so the estimate reflects out-of-pocket investment. |
Frequently asked questions
about a Necklift
Dr. Kopelman will review your medical history as well as the prescription and non-prescription medications you may be taking. You must stop all blood thinners (such as aspirin, Motrin, fish oil and Vitamin E) at least two weeks prior to surgery to minimize the potential for bleeding, post-operative bruising and swelling.In addition, if you smoke you must refrain from smoking for two weeks prior to surgery because it may compromise your ability to heal and increase the chances that you will develop scars.
A neck lift is usually performed under local anesthesia with intravenous “twilight’”sedation. The procedure takes approximately three hours. The goal of a neck lift is to elevate and tighten sagging soft tissue through short incisions. Fat below your chin and neck will be re-contoured, underlying sagging muscle will be repositioned and tightened and excess skin will be trimmed behind your ear. The incisions will be hidden within your natural creases below your chin and behind your ears so that over several months these incisions will become inconspicuous.
Following the neck lift procedure, a gauze dressing will be applied under your chin and behind your ears. These dressings will be removed the next day. A drain that was inserted during the procedure will be removed in most cases within 24 to 48 hours after surgery. Most patients typically experience little or no discomfort, but if there is any, it is easily controlled with over-the-counter pain medication. You will be examined by Dr. Kopelman and his nursing staff the next morning. Sutures will be removed in 5 to 7 days following the neck lift surgery. You can resume your daily activities within one week and your exercise routine within two weeks.Incisional scars will be hidden in the natural creases of your face and ears and in time they will be barely visible. To ensure that you have the best possible results Dr. Kopelman will examine you at regularly scheduled intervals to monitor your progress. Most patients return to work about 10 to 14 days after the neck lift surgery.
Sometimes it is not necessary to have a more extensive “full” facelift because most of your facial cosmetic concerns revolve around loose neck skin, sagging neck muscles and bulging fat. Many patients do not show a significant loss of mid-facial fullness or the descent of upper facial soft tissue. Therefore, a more limited procedure, a limited neck lift, is a good alternative to having a traditional full facelift. Neck lifts can be performed with shorter incisions which can restore smooth contours to your neck. On the other hand, a “full” facelift , a more extensive procedure, is the ideal treatment option for patients with moderate to severe signs of aging including jowls,extensive muscle and skin laxity, and mid-facial volume loss. At the time of your initial consultation Dr. Kopelman will review your unique characteristics and concerns. You will have an opportunity to discuss your goals and expectations and ask any relevant questions you may have. Dr. Kopelman will determine if you are an ideal candidate for an isolated neck lift or for a traditional facelift.
Yes, depending upon your cosmetic concerns, Dr. Kopelman may recommend other complimentary cosmetic procedures such as cosmetic eyelid surgery (blepharoplasty), fat grafting, endoscopic brow lifts, and laser skin rejuvenation to enhance the overall appearance of your face.
Dr. Kopelman will review your medical history as well as the prescription and non-prescription medications you may be taking. You must stop all blood thinners (such as aspirin, Motrin, fish oil and Vitamin E) at least two weeks prior to surgery to minimize the potential for bleeding, post-operative bruising and swelling.In addition, if you smoke you must refrain from smoking for two weeks prior to surgery because it may compromise your ability to heal and increase the chances that you will develop scars.
A neck lift is usually performed under local anesthesia with intravenous “twilight’”sedation. The procedure takes approximately three hours. The goal of a neck lift is to elevate and tighten sagging soft tissue through short incisions. Fat below your chin and neck will be re-contoured, underlying sagging muscle will be repositioned and tightened and excess skin will be trimmed behind your ear. The incisions will be hidden within your natural creases below your chin and behind your ears so that over several months these incisions will become inconspicuous.
Following the neck lift procedure, a gauze dressing will be applied under your chin and behind your ears. These dressings will be removed the next day. A drain that was inserted during the procedure will be removed in most cases within 24 to 48 hours after surgery. Most patients typically experience little or no discomfort, but if there is any, it is easily controlled with over-the-counter pain medication. You will be examined by Dr. Kopelman and his nursing staff the next morning. Sutures will be removed in 5 to 7 days following the neck lift surgery. You can resume your daily activities within one week and your exercise routine within two weeks.Incisional scars will be hidden in the natural creases of your face and ears and in time they will be barely visible. To ensure that you have the best possible results Dr. Kopelman will examine you at regularly scheduled intervals to monitor your progress. Most patients return to work about 10 to 14 days after the neck lift surgery.
Sometimes it is not necessary to have a more extensive “full” facelift because most of your facial cosmetic concerns revolve around loose neck skin, sagging neck muscles and bulging fat. Many patients do not show a significant loss of mid-facial fullness or the descent of upper facial soft tissue. Therefore, a more limited procedure, a limited neck lift, is a good alternative to having a traditional full facelift. Neck lifts can be performed with shorter incisions which can restore smooth contours to your neck. On the other hand, a “full” facelift , a more extensive procedure, is the ideal treatment option for patients with moderate to severe signs of aging including jowls,extensive muscle and skin laxity, and mid-facial volume loss. At the time of your initial consultation Dr. Kopelman will review your unique characteristics and concerns. You will have an opportunity to discuss your goals and expectations and ask any relevant questions you may have. Dr. Kopelman will determine if you are an ideal candidate for an isolated neck lift or for a traditional facelift.
Yes, depending upon your cosmetic concerns, Dr. Kopelman may recommend other complimentary cosmetic procedures such as cosmetic eyelid surgery (blepharoplasty), fat grafting, endoscopic brow lifts, and laser skin rejuvenation to enhance the overall appearance of your face.
Schedule a Consultation
For a Necklift
To schedule a private consultation with Dr. Kopelman, please call the office or request an appointment online.
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