Deep Neck Lift

Deep neck lift describes an advanced surgical technique where the surgeon operates under the muscle layer in the neck. This enables the surgeon to better release the muscle and reposition it as well as remove any fat under that muscle. It provides a more complete, natural rejuvenation and definition of the neck without a stretched unnatural look.

It is performed by very few surgeons as it is more technically difficult and requires surgery to be performed in layers most plastic surgeons are not trained to operate in. Dr. Samaha’s specialized training in head and neck surgery means that he was extensively trained to routinely operate in those layers and has a detailed understanding of the neck’s anatomy.

Choose a Facial Rejuvenation Specialist

Dr. Samaha specializes exclusively in face and neck surgery and does not perform breast and body surgery. All his professional time is therefore spent evaluating, diagnosing, and operating on faces and necks. He has performed over 600 rejuvenation surgeries (facelifts and neck lifts, eyelid rejuvenation, and others) at his Montreal Centre for Facial Plastic Surgery.

Neck Anatomy

Under the skin is a layer of fat. Under this fat layer is a muscle layer, called the platysma muscle, that covers the neck on each side like a sheet. It is similar to the SMAS sheet of muscle in the face. There is a platysma on each side and the two sides meet in the middle.

Under this platysma muscle layer, we find fat, muscles, glands and other structures. There is frequently excess fat in this layer that needs to be removed to create natural and long-lasting definition in the neck.

Who is an ideal candidate for a deep neck lift?

Patients who have looseness of their neck tissues, vertical bands (called platysmal banding), or fullness under the chin are excellent candidates for a neck lift. In older patients, these changes can be advanced, and some may have a “turkey neck”. Other patients may have loosening or fullness of the neck area at a younger age.

What is the best age to have a deep neck lift?

Deep neck lift is performed for both young patients in their 30s and early 40s and older patients in their late 40s onward.

Some young patients have fuller necks due to genetics or heredity. This fullness usually exists under the chin, sometimes encompassing the entire neck, giving them a “double chin” appearance and poor definition of the chin and jawline, despite having young, firm, smooth skin. These patients greatly benefit from a neck lift, which is usually performed alone without a facelift as the face is still firm and youthful. The result is a more defined, youthful neck with enhanced definition of the jawline and elimination of the “double chin”.

Older patients often have the hallmarks of aging, such as wrinkled skin, drooping of the neck tissues, and vertical bands in the neck. They may also have some areas of fat collection in the neck as a result of aging. The deep neck lift addresses all these aging changes for a more youthful, well-defined neck. In these older patients, aging has also affected the face, so a neck lift is usually performed in conjunction with a facelift for better overall results.

How does a deep neck lift work and how does it differ from a traditional neck lift?

Traditional neck lift surgery consists of getting under the skin layer only and just suturing the edges of the platysma muscle together, called platysmaplasty (see illustration).

Deep neck lift illustration

Edges of the platysma muscle that have sagged and formed bands are sutured.

The muscle layer is not lifted, released or repositioned. This can create a stretched, unnatural look. In addition, any fat collections under the platysma are not accessed nor removed. Since the skin only is tightened, these fat collections become more apparent as bulges or areas of fullness.

With the deep neck lift surgical technique, Dr. Samaha releases the muscle from the layers underneath, allowing them to be repositioned. This enables him to move the muscle to a more youthful position, creating a more natural-looking and long-lasting definition. Because the muscle is released from the deeper layers, excess fat collections in these layers can then be accessed and removed for a much more natural, smooth neck with markedly enhanced definition.

This technique is also important in treating patients with full and heavy necks.

Some patients have a very full “fat” neck. Achieving any meaningful result in these patients requires removal of the deep neck fat collections to create neck definition (see illustrations). Without accessing the deep layers and removing the excess fat, very little improvement can be expected.

This patient had a full heavy neck with no definition. The deeper layer was accesses through a deep neck lift and the fat deposits removed in a uniform fashion to sculpt a neck contour for her that did she did not have before surgery.

What advantages does deep neck lift surgery have over a regular neck lift?

  • Avoids the tension, stretch, or tightness that’s sometimes associated with the regular technique.
  • As the platysma muscle is completely released, a more natural and longer-lasting result can be obtained.
  • Access to the deeper layers and removal of fat collections from these layers provides a superior result with better neck definition.
  • For patients with a heavy, full neck, this technique is necessary to see any significant improvement.

What about jowls?

For most people, aging in the neck, with “turkey neck” and bands is accompanied by aging in the face, with sagging and jowls. Consequently, most patients in Dr. Samaha’s practice undergo a facelift and neck lift together. However, a small number of patients will have bands and wrinkling in their neck without jowls. For these patients, an isolated neck lift is the best solution as they do not need a facelift.

What about facial liposuction?

Under the skin is a fat layer. This layer of fat is above the platysma muscle (between the skin and the muscle). A minimum amount of fat is essential in this layer as it helps keep the skin surface smooth.

In patients who have excess fat in this layer, liposuction can enhance the result when performed as an accessory to the neck lift. However, if performed for the wrong reasons, liposuction can have very poor outcomes. Dr. Samaha frequently sees patients who were mistakenly advised to have liposuction under the chin with unsightly results.

Common facial liposuction mistakes that lead to poor results

Deep neck lift

Patient who underwent liposuction elsewhere. She was a candidate for face and neck lift but was erroneously recommended liposuction.

  • Many patients do have excess fat. However, this fat is under the muscle layer, which requires a deep neck lift to remove. The fat layer under the skin is normal and necessary to maintain a smooth surface to the skin. So, when liposuction is done in those patients, it is done on the wrong layer. Not only does it not improve neck definition, but it also causes irregularities of the skin.
  • Most patients do not have excess fat under the skin but rather loose, sagging muscles and skin which are not improved with liposuction. Liposuction will remove the little fat that is under the skin, causing the same effect mentioned above.
  • Some patients do have excess fat under the skin and can benefit from liposuction to complement their neck lift. However, if liposuction alone is performed, it can worsen or create a “turkey neck”. It is akin to a bag full of groceries. The bag represents the skin and the groceries the fat layer under it. When the bag is emptied, it wrinkles more.

How much does a neck lift cost in Montreal?

There are many factors that determine the cost of neck lift surgery, some include:

  • The complexity of the procedure: a traditional neck lift is less costly than a deep neck lift because of the complexity, surgical skill, and time required for the latter.
  • The degree of specialization of the surgeon: the more specialized a surgeon is in a certain region or procedure, the higher the fees. Dr. Samaha specializes exclusively in facial surgery.
  • The patient’s unique anatomy: Dr. Samaha tailors each procedure according to the patient’s needs and the extent of aging of her/his neck. The surgical fee will therefore reflect the amount of work and time required to achieve the best possible result.

How long does neck lift surgery take?

A neck lift is often performed with a facelift. A skilled, experienced surgeon takes 3 to 4 hours for the two procedures together. In the occasional patient who is a candidate for a neck lift alone, the procedure takes about 1.5 hours.

Is there more scarring with this surgical method?

No. A neck lift is performed through a scar under the chin, hidden in the natural crease that everyone has between the chin and the neck. Scars hidden behind the ears allow access to the sides of the neck. The scars for a deep neck lift and a traditional neck lift are identical.

How long does it take to recover from a neck lift?

Typically, most patients recover in about a week, whereas the usual recovery from a classic neck lift procedure is about 2 weeks, mainly to allow for the bruising to resolve. The majority of patients undergoing a deep neck lift at our Montreal facial plastic surgery centre are able to resume their normal daily activities within one week. This shorter recovery time is due to Dr. Samaha’s Maximum Result Minimum Recovery™ approach.

What is Maximum Result Minimum Recovery™?

One of Dr. Samaha’s key interests in the last 20 years is developing various methods and techniques to make the experience of surgery easier for patients and reduce recovery time by minimizing swelling and bruising. His research, experience, and constant fine-tuning has led Dr. Samaha to create the Maximum Result Minimum Recovery™ system. It is an approach geared towards making the surgical experience as smooth and painless as possible while also minimizing recovery times after surgery.

While there are multiple aspects to this approach at all stages of the process (preoperatively, during surgery, and postoperatively), two important components include Dr. Samaha’s use of a less invasive “twilight” anesthesia and minimally invasive surgical techniques that minimize inflammation, swelling, and bruising. Learn more about Dr. Samaha’s Maximum Result Minimum Recovery™ system.

MAXIMUM RESULT MINIMUM RECOVERY™

Dr. Samaha has developed techniques and methods to minimize swelling and bruising after surgery for his patients to shorten their recovery. This has culminated in his Maximum Result Minimum Recovery system.

Learn More

Is a deep neck lift safe?

Yes. As with any surgical procedure, risks are very low when the surgery is performed by an experienced surgeon. In the case of a deep neck lift, if the surgeon does not have the training or experience operating in the deep neck layers, the risks are higher. Dr. Samaha’s specialty training was in head and neck surgery, and he has the experience of having operated on hundreds of necks in the deeper layers.

Dr. Mark Samaha

Meet Dr. Mark Samaha

A double board-certified otolaryngologist whose practice focuses exclusively on facial plastic surgery, Dr. Samaha is highly qualified in facial aesthetics. Learn more about our physician and how he's carefully refined his skills to sculpt your beautiful face.

Meet Dr. Samaha Doctor credentials

Dr. Samaha looks forward to helping you discover your youthful best with a deep neck lift in Montreal, Quebec. Request your consultation with Dr. Samaha online or call us at (514) 731-2525 to make your appointment.

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