Facelift and Neck Lift together: when the neck needs separate treatment
A DEEP PLANE Facelift at RNWOOD Plastic Surgery does not include a Neck Lift. A Neck Lift or a Submentoplasty is added only when the consultation identifies a need for separate treatment for the sagging on the jawline and upper neck, or addressing the bulkiness under the chin. Before deciding, Dr. Min-Hee Ryu separates the cause: aging symptoms of soft tissue sagging are categorized as mild, moderate, or severe, and the need for surgery is assessed for each area.
What does a DEEP PLANE Facelift cover?
Dr. Ryu’s DEEP PLANE FACELIFT technique lies in the precise release of the Retaining Ligaments within the sub-SMAS plane, which addresses sagging in the anterior face.
What does a Neck Lift address?
A Neck Lift is designed to improve sagging along the jowls, jawline, and upper neck, creating a smoother, more defined facial contour. Dr. Ryu's technique involves an incision extending behind the ear toward the hairline of the neck to address sagging tissues in these areas.
How is the cause separated?
Dr. Ryu carefully evaluates whether the primary concern is sagging skin, muscle laxity, visible neck bands, or excess fat beneath the chin.
While significant skin laxity along the jawline and upper neck may require a Neck Lift, concerns involving weakened platysma muscles or excess fat beneath the chin may be better addressed through Submentoplasty or liposuction.
The appropriate surgical approach depends on each patient's individual anatomy and the underlying cause of their concerns.
When is a neck lift added to a facelift?
A Deep Plane Facelift primarily addresses sagging in the cheeks and anterior portion of the face, while a Neck Lift focuses on the jowls, jawline, and upper neck.
When sagging extends beyond the cheeks into the jawline and neck, Dr. Ryu may recommend combining both procedures. However, a Neck Lift is not necessarily required for every facelift patient. The recommendation depends on the degree and location of sagging.
Can submentoplasty be added instead?
Submentoplasty addresses weakened platysma muscles, visible neck bands (commonly referred to as "turkey neck"), and excess deep fat beneath the chin.
The procedure involves an approximately 4–5 cm horizontal incision beneath the chin, allowing Dr. Ryu to tighten the underlying muscles and remove deep fat when necessary.
If fullness beneath the chin is primarily caused by superficial subcutaneous fat, liposuction may be a more suitable alternative.
Unlike a Neck Lift, which addresses sagging along the jawline and upper neck, Submentoplasty focuses on the underlying structures beneath the chin. Depending on the patient's anatomy, either procedure or a combination of both may be recommended.
The final surgical approach is determined through an in-person consultation and physical examination with Dr. Ryu.
What are the risks of neck surgery?
As with any surgical procedure, a Neck Lift or Submentoplasty carries potential risks, including bleeding, hematoma, infection, asymmetry, temporary or persistent numbness, and nerve injury that may affect lower-lip movement. A large neck hematoma can obstruct the airway and require immediate emergency treatment.
Additional risks may include contour irregularities, residual skin laxity, and persistent or recurrent platysmal bands. The degree of improvement varies depending on individual factors such as skin elasticity, bone structure, and underlying neck anatomy.
Dr. Ryu carefully evaluates each patient's anatomy and discusses the potential risks, limitations, and expected outcomes to determine the most appropriate surgical approach.
How is patient safety managed?
Patient safety is a priority at RNWOOD Plastic Surgery. Comprehensive preoperative medical assessments and testing are conducted to evaluate each patient's suitability for surgery and identify potential risk factors. Throughout surgery, patients are continuously monitored, and all medical staff are trained in CPR and emergency response. While these risks are inherent to surgical procedures and cannot be entirely eliminated, RNWOOD emphasizes careful surgical planning, appropriate safety measures, and attentive postoperative care to minimize potential complications. Individual results and recovery experiences may vary, and all patients receive personalized guidance regarding their surgical procedure and associated risks.
How does the combined stay compare?
RNWOOD's general recommendation after a DEEP PLANE Facelift and Neck Lift is a stay of 7 to 10 days.
Frequently asked questions
Q1) Does a deep plane facelift include a neck lift?
A1) No. A neck lift or submentoplasty is added only when symptoms are seen on the jawline, upper neck, or bulkiness under the chin.
Q2) When is a neck lift added?
A2) When the consultation finds that the jawline and neck area needs separate treatment, such as clear skin sagging, platysma laxity or banding.
Q3) Can submentoplasty be added instead?
A3) Its need is judged separately. Which operation, if any, is suitable depends on the sagging symptoms.
Q4) Where is the neck lift incision?
A4) Behind the ear.
Q5) Can non-surgical treatment fix neck banding?
A5) Where skin sagging, platysma laxity or banding is clear, non-surgical treatment alone may not be expected to give enough improvement.
Q6) Is every neck problem caused by loose skin?
A6) No. Fat or other tissue can be involved, and the cause is separated first.
Q7) Can bands come back after a neck lift?
A7) Yes. Neck bands may gradually reappear over time due to the natural aging process and individual lifestyle factors. However, periodic non-surgical treatments, such as laser or other energy-based procedures, may help maintain skin firmness, although they cannot prevent the recurrence of muscle bands.
Q8) Does neck surgery change the stay in Seoul?
A8) It remains as 7–10 days if done with the Deep Plane Facelift.
About the Author
Dr. Min-Hee Ryu is the Chief Director of RNWOOD Plastic Surgery in Seoul and a plastic surgery specialist certified in Korea (2008). He has been Faculty of the Mendelson Advanced Facial Anatomy Course (MAFAC) since 2016, an Editorial Board Member of the Aesthetic Plastic Surgery Journal since 2019, and an Educational Council Member of the International Society of Aesthetic Plastic Surgery (ISAPS) since 2024.
Deep Plane Facelift — As with any surgical procedure, a Deep Plane Facelift carries potential risks. Deep plane facelift involves extensive dissection beneath facial tissues. Risks include anesthesia reactions, bleeding, hematoma, infection, seroma, delayed healing, wound separation, persistent pain, and visible scars. Swelling, bruising, tightness, and numbness can last for months, and hair loss or distortion of the hairline or ear position can occur. Poor blood supply can cause skin loss or tissue death. Nerve injury can cause temporary or permanent weakness, an altered smile, or numbness, and injury to the parotid gland or salivary duct can cause salivary leakage. A postoperative hematoma can require urgent drainage or another operation. General risks include thrombosis or embolism, and a complication can require emergency treatment or additional surgery. No result, symmetry, scar quality, or duration can be guaranteed, and sagging can recur.
Neck Lift — As with any surgical procedure, a Neck Lift carries potential risks. Neck lift can require extensive dissection beneath neck tissues. Risks include anesthesia reactions, bleeding, hematoma, infection, seroma, delayed healing, wound separation, persistent pain, and visible scars, as well as prolonged swelling, tightness, numbness, contour irregularity, and asymmetry. Nerve injury can cause temporary or permanent weakness, including lower-lip weakness, or altered sensation, and injury to the parotid gland or salivary duct can cause salivary leakage. A large neck hematoma can obstruct the airway and require immediate emergency treatment. Platysmal bands can remain or return. General risks include thrombosis or embolism, and a complication can require emergency treatment or additional surgery. No result, symmetry, scar quality, or duration can be guaranteed, and revision surgery can become necessary.
Submentoplasty — As with any surgical procedure, Submentoplasty carries potential risks. Submentoplasty can cause anesthesia reactions, bleeding, hematoma, infection, seroma, delayed healing, pain, and scarring, as well as asymmetry, dents, waviness, loose skin, discoloration, and persistent numbness. It can injure deeper structures, and platysmal bands or neck fullness can remain. Bone structure and deep-neck anatomy limit the possible change. General risks include thrombosis or embolism, and a complication can require emergency treatment or additional surgery. No result, symmetry, scar quality, or duration can be guaranteed, and revision surgery can become necessary.