Neck Lift (Platysmaplasty) by Dr Turner in Sydney & Brisbane

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) practising in Sydney with over a decade of experience specialising in facial aesthetic surgery. At his Sydney clinic, Dr Turner offers neck lift surgery for patients experiencing age-related changes in the neck and jawline regions.

The ageing neck undergoes progressive structural changes affecting multiple tissue layers. The platysma muscle weakens and separates along the midline, creating visible vertical bands, whilst skin loses elasticity and excess tissue accumulates beneath the chin. Traditional neck lift surgery addresses these changes through surgical modification of the platysma muscle, excision of redundant skin, and repositioning of superficial tissues to restore definition along the neck-jaw border.

Understanding Neck Lift Surgery

What is Neck Lift Surgery?

Neck lift surgery is a facial aesthetic procedure that modifies the appearance of the neck and jawline by addressing changes associated with ageing. The procedure involves tightening the platysma muscle layer, excising redundant skin, and, when indicated, removing superficial fatty deposits. The surgical approach aims to create a more defined separation between the chin and neck while addressing visible vertical muscle bands.

Anatomical Considerations

The platysma is a broad, thin sheet of muscle tissue extending from the lower face down through the anterior neck region. With advancing age, this muscle tissue tends to separate along the midline, creating visible vertical bands whilst simultaneously weakening in lateral areas. This anatomical change contributes to the appearance of ageing in the neck.

The procedure addresses tissue layers above the platysma muscle, including:

• Subcutaneous fat deposits in the submental and lateral neck regions
• The platysma muscle itself, through tightening and repositioning techniques
• Redundant skin that has lost elasticity over time
• Surface contour irregularities

Technical Approaches

Modern platysmaplasty employs several established surgical techniques:

Medial Plication: This technique involves suturing the separated edges of the platysma muscle together along the midline, addressing visible banding and creating a midline tension that improves neck contour.

Lateral Suspension: The lateral portions of the platysma are elevated and secured to fixed anatomical points posterior to the ears, providing horizontal vector tightening of the muscle layer.

Selective Band Excision: In cases where muscle bands are particularly prominent, partial removal or release of specific portions may be incorporated into the surgical plan to address these issues.

Comparison to Other Techniques

Traditional neck lift focuses on structures superficial to and including the platysma muscle. This differs from deep neck lift procedures, which address structures beneath the platysma such as subplatysmal fat, submandibular glands, and deeper muscle layers. The traditional approach is suitable for patients presenting with typical age-related changes without significant inherited anatomical concerns or deep tissue fullness.

Am I a Suitable Candidate?

Neck lift surgery is suitable for individuals who meet specific criteria and present particular patterns of cervical ageing. This surgical technique requires careful patient selection to achieve optimal outcomes whilst minimising risk.

Physical Health Requirements

Suitable candidates demonstrate:

• Good overall health without medical conditions compromising healing capacity
• Realistic comprehension of surgical outcomes and recovery requirements
• Psychological readiness for surgical intervention (mandatory psychological evaluation required as of July 1, 2023, under Australian regulations)
• Stable body weight maintained for at least six months
• Non-smoking status or willingness to completely cease all nicotine products for a minimum of six weeks before and after surgery

Cervical Characteristics Benefiting from Neck Lift Surgery

The neck lift approach proves remarkably effective for patients experiencing:

• Moderate to substantial platysma muscle laxity with visible vertical banding
• Excess skin accumulation along the neck and beneath the chin
• Loss of definition in the cervicomental angle (neck-to-chin transition)
• Superficial fat deposits above the platysma muscle
• Jowl formation along the jawline affecting neck-jaw demarcation
• Age-related changes responsive to superficial tissue and muscle repositioning

Who May Not Be Suitable

Neck lift surgery may be inappropriate for patients who:

• Present with only mild cervical laxity, better addressed through less extensive techniques
• Cannot commit to the required recovery period
• Have uncontrolled medical conditions affecting surgical safety
• Maintain unrealistic expectations about surgical outcomes
• Are unable to cease smoking completely
• Possess insufficient tissue quality for optimal results

Patients presenting with significant subplatysmal fat deposits, prominent visibility of the submandibular gland, or midline digastric muscle prominence may require deep neck lift surgery rather than a traditional neck lift. These deeper anatomical concerns cannot be adequately addressed through standard superficial tissue and platysma muscle techniques. During consultation, Dr Turner will assess whether your specific anatomy necessitates the more comprehensive deep neck lift approach.

How is Neck Lift Surgery Performed?

Surgical Technique

Neck lift surgery is performed under general anaesthesia in a fully accredited Australian hospital facility. A qualified anaesthetist provides anaesthetic care throughout the procedure. Surgical duration typically ranges from 2-3 hours depending on the extent of correction required and whether additional procedures are performed concurrently.

Dr Turner recommends an overnight stay in hospital following surgery, with discharge occurring the following day once initial recovery milestones are met.

Anaesthesia Options

General anaesthesia is used for all neck lift procedures. This ensures patient comfort throughout the operation and allows the surgeon to work without time constraints whilst maintaining optimal surgical conditions. The anaesthetist monitors vital signs continuously and manages pain control during and immediately after the procedure.

Incision Locations and Approach

Incisions are strategically positioned to provide necessary surgical access whilst minimising visible scarring:

Post-auricular incisions: Placed in the natural crease behind each ear, these incisions are well-concealed in the fold where the ear meets the head

Occipital hairline incisions: Extended along the lower hairline at the back of the head, hidden within the hair-bearing scalp

Submental incision: A small incision placed beneath the chin in the natural submental crease when midline muscle work is required

Incision placement is customised based on individual anatomy and the specific surgical techniques required for each patient.

Step-by-Step Surgical Overview

Step 1: Incision Creation Following anaesthetic induction and surgical site preparation, incisions are created in the planned locations. Precise surgical technique during incision creation facilitates optimal healing and minimal scarring.

Step 2: Tissue Dissection The skin is carefully elevated from underlying structures to provide access to the platysma muscle and fat layer. Dissection is performed in the appropriate tissue plane to preserve blood supply whilst allowing adequate mobilisation for later redraping.

Step 3: Fat Management (When Indicated) If excess superficial fat is present above the platysma muscle, this is addressed through direct excision or liposuction techniques. Removing excess fat before addressing the muscle layer creates an improved foundation for subsequent steps. This addresses only fat deposits above the platysma; deeper fat deposits beneath the muscle are not accessed in traditional neck lift.

Step 4: Platysma Muscle Modification The platysma muscle is accessed and tightened using one or more established techniques:

• Medial plication – The separated muscle edges in the neck midline are approximated and sutured together, creating a smooth midline and eliminating visible bands
• Lateral suspension – The lateral muscle is elevated and secured to stable fixed points posterior to the ears, creating horizontal vector tension
• Selective band release – When prominent bands persist despite plication, selective partial release or excision may be performed

The specific combination of techniques used is determined by individual anatomical findings and desired correction.

Step 5: Skin Repositioning and Excision After the deeper tissue work is completed, the skin is gently repositioned in a posterior and superior direction. The degree of skin advancement is carefully judged to create smooth contours without excessive tension. Excess skin is marked and carefully excised. The remaining skin edges are precisely approximated.

Step 6: Drain Placement Small surgical drains may be positioned beneath the skin flaps to prevent fluid accumulation during early healing. Drains are typically removed within 24-48 hours once drainage diminishes to acceptable levels.

Step 7: Wound Closure Incisions are closed in multiple layers using fine sutures. Layered closure distributes tension across tissue planes and promotes optimal healing. Suture selection and technique are designed to minimise scarring.

Step 8: Dressing Application A supportive compression dressing is applied around the neck and lower face. This dressing provides gentle pressure to reduce swelling, holds tissues in their new position during initial healing, and provides support and protection to the surgical sites.

Recovery and Aftercare

Your neck lift recovery begins with an overnight hospital stay for optimal monitoring and comfort management, followed by a return home the following day. The initial two weeks represent the most intensive healing period, with swelling and bruising reaching their peak within the first 72 hours before gradually subsiding. During these early days, maintaining continuous head elevation, wearing the compression garment continuously, and limiting strenuous activities are essential. Sutures are typically removed within 5-7 days for initial follow-up. Whilst discomfort is typically manageable with prescribed medications, patients should anticipate visible post-surgical changes, including tightness, numbness, and temporary asymmetry, as tissues begin to settle into their new positions.

The healing journey extends well beyond the initial fortnight, with most patients resuming sedentary work by week three, though visible signs of recent surgery persist. The compression garment transitions to night-time wear only after the first week of continuous use. Strenuous activities and vigorous exercise must be avoided for four to six weeks to prevent complications and optimise wound healing. Between three and six months post-operatively, the actual results of your neck lift become fully apparent as residual swelling completely resolves, sensation returns, and incision lines mature and fade. Diligent adherence to post-operative instructions, including wound care protocols, activity restrictions, and sun protection measures with SPF 30+ once healed, remains crucial throughout your recovery timeline. Results typically remain visible for 7-10 years, though individual longevity varies based on genetics, skin quality, and lifestyle factors.

For detailed information about each recovery milestone, including specific care instructions and strategies to optimise your healing experience, please visit our comprehensive resource:

Recovery After Neck Lift Surgery

Risks and Complications

All surgical procedures involve inherent risks that must be thoroughly understood before proceeding with treatment. Whilst neck lift surgery, performed by an experienced Specialist Plastic Surgeon, typically achieves excellent outcomes, patients must be aware of both common temporary effects and potential complications. Dr Turner maintains a commitment to transparent communication, ensuring every patient receives comprehensive information about possible adverse outcomes, realistic expectations, and the measures employed to maximise safety throughout the surgical process.

Most individuals experience the expected post-operative effects, including swelling, bruising, temporary numbness, and mild to moderate discomfort, which typically resolve naturally during the healing phase. Potential complications requiring intervention may include haematoma formation (occurring in approximately 1-3% of patients), seroma accumulation, infection, unfavourable scarring, prolonged altered sensation, asymmetry, or skin necrosis, particularly in patients who smoke. More serious but uncommon risks encompass nerve injury affecting facial movement or sensation (typically temporary, resolving within 3-6 months), significant asymmetry necessitating revision surgery (approximately 5-10% of patients may desire refinement procedures), and adverse anaesthetic reactions. Through meticulous surgical technique, comprehensive pre-operative medical assessment, surgery exclusively in accredited facilities with qualified anaesthetic support, mandatory tobacco cessation requirements, and detailed post-operative care protocols, Dr Turner minimises these risks whilst optimising patient safety and surgical outcomes.

For comprehensive information about specific risks, preventive measures, and what to expect during recovery, please visit our detailed guide on:

Risks and Complications After Neck Lift Surgery