Do I Need a Neck Lift With My Facelift? A North Jersey Plastic Surgeon Explains

Among the questions Dr. Farhad Rafizadeh receives most frequently on his RealSelf Q&A page and in his Morristown consultation room, this one comes up in almost every facelift discussion:

It is a fair and smart question. The honest answer is: it depends on your anatomy, and no two consultations produce the same recommendation. But understanding what a neck lift actually addresses — and how the face and neck age together as a connected unit — makes the decision far clearer for North Jersey patients weighing their options.

Dr. Rafizadeh’s Direct Answer

The face and neck do not age independently. When I evaluate a facelift candidate in Morristown, I always assess the neck at the same time. If the neck has significant laxity, banding, or excess skin, doing only the face creates a visible mismatch — the face looks years younger while the neck gives away the surgery. For patients with meaningful neck changes, combining the procedures in one operating session is almost always the right call. For patients whose necks are still reasonably tight, the facelift alone delivers a complete result. This is not a one-size-fits-all answer; it is an anatomy-specific one.

That distinction — anatomy over formula — is the most important thing to take away from this post. There is no default answer. There is only the correct answer for your specific face and neck.

What a Facelift Addresses (and What It Doesn’t)

A facelift — particularly the deep plane facelift technique Dr. Rafizadeh performs — is designed to address the mid-face, lower face, and jawline. It releases deep facial ligaments, repositions the SMAS layer and facial fat compartments, and redistributes skin to restore youthful contour from the cheekbones to the jaw. For patients with jowling, deepening nasolabial folds, and descended facial volume, this produces a transformative result.

What a facelift does not primarily address is the neck below the jaw. Specifically:

• Platysmal bands — the vertical cords that appear in the midline of the neck with age (often called “turkey neck” or “neck wattle”)
• Excess skin below the hyoid (the horseshoe-shaped bone at the base of the throat) — loose skin that hangs below the chin-to-neck junction
• Cervicomental angle loss — the blunting of the clean angle between the underside of the chin and the front of the neck that distinguishes a youthful neck profile
• Submental fat deposits that have not been addressed by liposuction

These require dedicated neck surgery — a platysmaplasty with or without submental skin excision — to correct properly.

What a Neck Lift (Platysmaplasty) Actually Does

A neck lift involves several targeted maneuvers performed through small incisions behind the ears and a tiny hidden incision beneath the chin:

Platysma Muscle Repair

The platysma is a flat, thin muscle that runs from the jaw to the collarbone in two bands separated at the midline. With age, the bands separate further and become visible as vertical neck cords. During a platysmaplasty, Dr. Rafizadeh sutures the medial edges of the platysma together, recreating a smooth, taut floor for the neck. This single maneuver eliminates neck banding and dramatically improves the cervicomental angle.

Submental Liposuction

When excess fat under the chin contributes to a heavy or undefined neck, liposuction through the small chin incision removes it. This sharpens the jawline and restores the definition between the neck and chin that is one of the most immediately visible signs of a youthful profile.

Skin Resection and Re-draping

The incisions behind the ears allow redundant neck skin to be excised and the remainder re-draped in a smooth, natural direction. This addresses the loose, hanging skin that no amount of fat removal or muscle tightening can correct on its own.

When to Combine a Facelift and Neck Lift

For patients in Morristown, Summit, Chatham, Short Hills, and across Northern New Jersey, the following signs indicate that a combined facelift and neck lift will produce a superior, more harmonious result than a facelift alone:

• Visible platysmal bands at rest or with mild neck tension
• Loose, hanging skin below the jaw that does not improve with neck extension
• A blunted or obtuse cervicomental angle (“no chin-neck definition”)
• Significant submental fat that has not responded to diet or exercise
• A general sense that the neck “gives away” the patient’s age even when the face looks rested

The practical advantage of combining the procedures is also significant. One surgery, one anesthesia, one recovery. For most patients, two weeks of recovery is the price of entrance regardless of whether they do one or both procedures. Adding a neck lift to an already-planned facelift adds very little incremental recovery time while delivering a dramatically more complete result.

When a Facelift Alone Is Appropriate

Not every facelift patient needs neck surgery. Patients in their 40s or early 50s who have early jowling and descended facial volume but a neck that is still relatively taut — no banding, reasonable skin tone, a sharp cervicomental angle — will be well served by a facelift alone. In these patients, the neck already looks age-appropriate, and adding surgery to an area that does not need it is not in the patient’s best interest.

Similarly, patients who previously had a facelift and neck lift and are returning for a secondary procedure years later may need only facial work if the neck has held well. Dr. Rafizadeh evaluates each case independently and does not have a standing policy of always combining procedures.

When a Neck Lift Alone Is the Right Choice

A standalone neck lift is appropriate for a distinct subset of patients: those who have isolated neck aging — visible neck bands, submental fat, or mild-to-moderate skin laxity below the jaw — but whose facial skin is still reasonably youthful and does not yet warrant a full facelift.

This is often a patient in their early 40s who has developed neck banding early, or a patient who lost significant weight and is left with excess submental skin and fat. For these patients, a targeted neck lift delivers a meaningful result without the broader intervention of a full facelift.

The Cervicomental Angle: The Defining Measurement of Neck Youth

Plastic surgeons use the cervicomental angle — the angle formed at the junction of the underside of the chin and the front of the neck — as the key geometric measure of neck youth. In the aesthetically ideal neck, this angle is roughly 90–105 degrees: a clean, sharp right angle that creates visible definition between the chin and the neck when viewed from the side.

When submental fat accumulates, when the platysma bands separate, or when skin loses its elasticity, this angle becomes obtuse and ill-defined. The “double chin,” “turkey wattle,” and “heavy neck” appearances are all, in different ways, manifestations of a collapsed cervicomental angle. Restoring it is the central technical goal of a neck lift — and it is the reason a well-performed neck lift can make a patient look a decade younger in profile photographs alone.

Questions to Ask During Your Facelift Consultation in Morristown

When you meet with Dr. Rafizadeh to discuss facial rejuvenation, the following questions will help you understand the recommendation you receive:

• Is my neck showing signs of laxity that a facelift alone won’t address?
• What specifically would the neck lift add to my result?
• What does your facelift technique already do for the neck?
• If I chose not to do the neck lift now, would the face result look unbalanced?
• How much additional recovery time does adding the neck lift require?

A surgeon who cannot answer these questions specifically — who defaults to “it just looks better” or “everyone needs it” — is not giving you the individualized analysis you deserve.

People Also Ask

Common Questions About Neck Lift & Facelift Surgery in North Jersey

How many years does a neck lift last?

Most patients enjoy neck lift results for 10 to 15 years. Because a neck lift removes excess skin and tightens the underlying platysma muscle, the structural changes are durable. Aging continues naturally, but patients who avoid significant weight fluctuations, protect their skin from UV damage, and don’t smoke will see the most lasting results. Your neck will always look better than it would have without surgery — even after many years.

Is 70 too old for a neck lift?

Age alone is not a disqualifying factor. Dr. Rafizadeh evaluates overall health, cardiovascular fitness, medication use, and skin quality — not a number. Many patients in their late 60s and 70s in Morristown, Summit, and Short Hills are excellent surgical candidates and achieve remarkable results. The most important adjustment for older patients is anesthetic approach: local anesthesia with moderate sedation rather than general anesthesia, which reduces physiologic stress and speeds cognitive recovery.

What is the average cost of a neck lift in New Jersey?

In New Jersey, a standalone neck lift typically ranges from $6,000 to $10,000 depending on the complexity of the procedure, surgeon experience, and facility fees. When performed simultaneously with a facelift, the incremental cost of adding neck surgery is substantially less than having each procedure done separately on different occasions. A precise quote is provided following a personal consultation.

What are the downsides of a neck lift?

Like any surgical procedure, a neck lift carries the possibility of bruising, swelling, temporary numbness along the jawline, and small scars positioned discreetly behind the ears and beneath the chin. Most patients find these effects manageable and expected. Serious complications are uncommon when surgery is performed by a board-certified plastic surgeon in a properly equipped facility. Recovery takes two to three weeks before most social activities are comfortable, with continued subtle improvement over four to six months.

Does a facelift include a neck lift?

It depends on the technique and the surgeon. Some facelift approaches incorporate limited neck work as part of the standard procedure. Dr. Rafizadeh’s deep plane facelift addresses the jawline and upper neck by design, but patients with visible neck banding or significant laxity below the hyoid benefit from dedicated platysmaplasty in addition. Always ask your surgeon exactly what the neck component of their facelift technique includes — the answer varies significantly from surgeon to surgeon.

Why is my neck still saggy after a neck lift?

Residual neck laxity after a neck lift most often results from incomplete platysma repair, insufficient skin resection at the time of the original surgery, or significant post-operative weight gain. In some patients, continued natural aging over many years gradually leads to recurrence of mild laxity. A revision consultation will identify whether a targeted touch-up procedure, non-surgical tightening treatment, or continued monitoring is appropriate for your specific situation.

Sources & References

1. Rohrich RJ, Durand PD, Dayan E. “The Neck Lift: State of the Art.” Plastic and Reconstructive Surgery. 2022;149(1):1e–14e. PubMed
2. Stuzin JM. “Discussion: Neck Rejuvenation — A Comprehensive Approach.” Plastic and Reconstructive Surgery. 2021;148(2):310–311. PubMed
3. American Society of Plastic Surgeons. “Neck Lift Surgery — Procedure Overview.” plasticsurgery.org
4. Ellenbogen R, Karlin JV. “Visual Criteria for Success in Restoring the Youthful Neck.” Plastic and Reconstructive Surgery. 1980;66(6):826–837. PubMed
5. Cleveland Clinic. “Neck Lift (Platysmaplasty): Surgery, Recovery & What to Expect.” my.clevelandclinic.org
6. Dr. Farhad Rafizadeh, MD FACS. RealSelf Q&A. realself.com

Related Reading

• Deep Plane Facelift in Morristown, NJ
• Deep Plane Facelift: What Makes It Different
• Marionette Lines & Jowls: Facelift vs. Fillers in North Jersey
• Safest Anesthesia for Older Facelift Patients in North Jersey
• What Is the Price of a Facelift in New Jersey?