A lot of people ask me the same thing early in a deep plane facelift consultation: if I go ahead with this, will I still need a separate neck lift? It is a fair question. By their fifties and sixties, most people start noticing the face and neck changing at the same time, so jowls, a softening jawline, and a bit of looseness in the neck usually appear together. For many patients, the deep plane technique works on both the lower face and the upper neck at once, because it lifts the same continuous layer of tissue. Some people do need an extra procedure on the neck on the day as well. In this article, I want to go through how the face and neck are linked, what a deep plane facelift can realistically do for the neck and what it cannot, and how we work out the plan together in consultation.
Suitability is individual, and the points below describe general patterns rather than the specifics of any one patient’s plan.
The Anatomical Link Between Face and NeckThe reason face and neck ageing usually happen together is anatomical. The structural layer that supports the lower face does not stop at the jawline. It continues into the neck.
How the SMAS continues as the platysma
The SMAS, the Superficial Musculoaponeurotic System, is the fibromuscular layer beneath the skin and subcutaneous fat of the face. As it crosses the jawline, it becomes the platysma, the broad, thin sheet of muscle that fans across the front of the neck. SMAS and platysma are continuous tissues. They behave as one unit, and they age as one unit. A more detailed discussion of the layers is in the earlier article on deep plane facelift anatomy.
Why does lower face ageing and neck ageing usually happen together
Because the SMAS and platysma are one sheet, descent in the face is almost always mirrored by laxity in the neck. The jowl that softens the jawline above is the same tissue that contributes to the loose contour below. Treating the face without considering the neck often results in a mismatched outcome. Treating both together, through the same continuous layer, is one of the structural arguments for the modern facelift technique.
What a Standard Deep Plane Facelift Addresses in the Neck
A standard deep plane facelift focuses on the face, but its effects extend into the upper neck in many patients.
Jawline definition
Lifting the SMAS-platysma sheet repositions the descended jowl tissue back over the jawline. The jaw appears more defined, with a sharper transition from the lower face into the neck. For patients whose main concern is a softened jawline rather than a hanging neck, the deep plane technique alone can be enough.
Mild platysmal banding
As the platysma loses tone, it can show up as thin vertical bands in the upper neck. When the bands are mild, they often ease off once the SMAS-platysma is repositioned and tightened toward the sides during a deep plane lift. In other words, drawing the layer back from the sides can pull the bands back into place without us having to work on the muscle directly.
Loose skin under the jaw
A modest amount of skin laxity under the jaw improves when the deeper tissues are lifted upwards, and the skin is redraped along the new contour. For patients with mild changes, this is often enough. Patients with more substantial neck skin laxity may need more, and that is where additional procedures come in.
The Extended Deep Plane Facelift: When the Neck is Treated as One Continuous Procedure
The extended deep plane facelift is a variation in which the deep plane dissection extends further down into the neck. The face and neck are then treated as a single continuous structure.
Cervical retaining ligament release
Just as the face has retaining ligaments that anchor the soft tissue to bone, the neck has cervical retaining ligaments that tether the platysma and overlying skin. In an extended deep plane technique, these ligaments are released. Once released, the entire SMAS-platysma sheet can be repositioned as a single unit.
Moving the SMAS-platysma as a single sheet
With the ligaments released, the surgeon can lift the composite of SMAS and platysma upwards along its natural anatomical line. The result is a tightening of the jawline and the upper neck in the same movement, without separating one from the other. The published surgical literature, including work on complete platysma muscle suspension within the deep plane technique, describes this composite approach in technical detail.
Vertical lift vector for the lower face and neck
The direction of the lift matters a lot. Years ago, surgeons often pulled tissue straight backwards, and that tended to leave a swept, slightly windblown look. With the extended deep plane, I lift more vertically, retracing the path the tissues actually travelled as they sank over time. Since the face and neck rise together along that same path, the result tends to look like you, not like skin that has been stretched.
When a Separate Platysmaplasty is Added
Some patients have neck changes that the lateral lift alone cannot fully address. In these cases, a procedure called platysmaplasty is added during the same operation.
Moderate to severe vertical neck bands
If the platysmal bands are prominent or have separated significantly down the front of the neck, the muscle needs to be addressed directly rather than only from the sides. A central platysmaplasty involves stitching the edges of the platysma muscle back together in the midline, which restores the muscular support of the neck.
Submental fat (a double chin appearance)
Fat beneath the chin and along the upper neck does not respond to the lift alone. It is usually addressed by liposuction or direct removal through a small submental incision. This is often performed during the same operation as the deep plane facelift, particularly in patients with a clear submental fat pad.
A small submental incision under the chin
Both the central platysmaplasty and the fat work are performed through a short incision hidden in the natural crease just behind the chin. It is typically two to three centimetres long and heals into a fine line.
When a Full Neck Lift is Still Recommended
Not every neck can be fully addressed in combination with a facelift. Some patients are better served by a more focused neck operation, either as part of the same surgery or staged separately.
Severe neck skin laxity
When the neck skin is very loose, the kind sometimes called a turkey wattle, a side lift on its own will not be enough. Skin that has lost most of its stretch cannot simply be redraped, so these patients may need the excess removed directly through longer incisions behind the ears, and in some cases, a separate neck lift with extra skin work as well.
Heavy submental fat pads
A deep, dense fat pad under the chin may require direct excision rather than liposuction alone. This is planned during the surgical assessment and is often combined with platysmaplasty in the same operation.
Submandibular gland descent
The submandibular glands sit just under the jaw, and in some people, they grow more noticeable with age and add a little fullness below the jawline. Lifting the soft tissue does not change them. They can sometimes be treated directly, but whether that makes sense really depends on the person, so it is something we talk through at your consultation.
Patients with weight-loss related neck changes
Patients who have lost significant weight, including those who have used GLP-1 medications, often have neck changes that are dominated by deflation and loose skin rather than muscular descent.
What the Deep Plane Technique Does NOT Fix in the Neck
Being clear about what is not addressed is as important as describing what is.
Skin texture and crepiness
Fine crepey texture of the neck skin is a dermal issue, not a muscular or structural one. A facelift does not change skin texture. Skincare, energy-based devices and other dermatologic treatments are the relevant tools, and these are best discussed with a dermatologist.
Horizontal necklace lines
The horizontal lines that run across the front of the neck, sometimes called necklace lines, are creases in the dermis itself. They do not flatten out with a lift. Some softening can occur, but they are not the target of the surgery. Heavy submandibular glands without direct treatment.
As noted above, prominent submandibular glands are not lifted by a facelift. Patients who have noticed a bulge below the jawline that does not move when they tense the neck should raise it specifically during consultation so the surgical plan can be tailored accordingly.
How the Decision is Made in Consultation
There is no single algorithm that determines whether to choose a standard deep plane facelift, an extended deep plane facelift, an added platysmaplasty, or a separate neck lift. The decision is made in consultation, based on a structured physical assessment.
Physical assessment of the neck and jaw
It all begins with a proper examination. Dr Hunt looks at where the platysma sits both at rest and when you tense it, how deep the bands are and the way they run, how much submental fat there is and where it sits, how loose the neck skin has become, and where the submandibular glands lie. He looks at the jawline on its own, too, paying attention to how much jowling there is and the line that runs from the earlobe down to the chin.
Skin quality, fat distribution and platysma tone
Skin elasticity, fat compartment depth and platysma tone vary widely between patients of similar ages. Two patients in their early sixties may need quite different operations to achieve broadly similar results. The wider article on “Who is a candidate for the deep plane facelift in Sydney” walks through how candidacy is decided in practice.
Patient priorities and downtime preferences
We also talk about what matters most to you, how much downtime actually fits your life right now, and whether you would rather sort everything out in one go or space the work out over time. None of these calls is made on its own. We work them out together.
Recovery When Face and Neck Are Treated Together
Recovery patterns are broadly similar to those of a standard deep plane facelift, with a slightly wider area of bruising and swelling when the neck is addressed in the same operation.
Bruising and swelling distribution
Bruising and swelling extend further down the neck after treatment and can collect in the upper chest area in the first week or two as gravity does its work. This is normal and resolves on its own.
Drains, dressings and the hemostatic net option
Traditional face and neck lifts often use surgical drains to manage the fluid that collects in the early hours after surgery. Some surgeons now use a hemostatic net technique, which can reduce the need for drains. The article on the drainless facelift and hemostatic net technology covers how this is decided.
Return to social activities
Most patients return to social activities at around three weeks, with residual swelling that continues to settle for several more months. Individual recovery varies, and the “SMAS facelift vs deep plane facelift” article and the deep plane recovery resources on the blog cover the timeline in more detail.
Why Choose Dr Hunt for Deep Plane Facelift in Sydney
Face and neck ageing rarely arrive on their own. The technical reason they often need to be treated together sits in the anatomy, and the technical decisions about how to treat them, whether the lateral lift alone is enough or whether a platysmaplasty, submental work or a separate neck lift is needed, are made on examination, not from a brochure. Dr Jeremy Hunt’s facelift practice is built around individual assessment and a surgical plan that fits the anatomy in front of him, rather than a one-size approach.
Dr Jeremy Hunt is a Specialist Plastic Surgeon (FRACS) with more than two decades of experience in aesthetic and reconstructive plastic surgery. He is a Fellow of the Royal Australasian College of Surgeons in Plastic Surgery, with his profile listed on the RACS register (https://www.surgeons.org/Profile/jeremy-hunt-144103). He is also a member of the Australian Society of Plastic Surgeons, verifiable at https://plasticsurgery.org.au/doctor/mr-jeremy-hunt/, and the Australasian Society of Aesthetic Plastic Surgeons, verifiable at https://aestheticplasticsurgeons.org.au/surgeon/Jeremy-Hunt/
Dr Hunt practises from two locations: his Sydney rooms at 175 Edgecliff Rd, Woollahra NSW 2027, and his Wollongong rooms at Suite 6, 174 Gipps Rd, Gwynneville NSW 2500. Patients are seen from across Sydney, including Double Bay, Bondi Junction and the wider Eastern Suburbs, as well as the Illawarra region. To discuss whether a deep plane facelift, with or without additional neck work, may be appropriate for your anatomy, you are welcome to contact the practice for a consultation.
A couple of things worth knowing under the current AHPRA cosmetic surgery rules. There is a seven-day cooling-off period that has to pass before any cosmetic surgical procedure can be booked, and you are encouraged to get a second opinion from a suitably qualified health practitioner before you go ahead. Keep in mind too that results differ from one person to the next, and every surgical procedure carries risks, all of which are talked through in detail at your consultation.
Frequently Asked Questions
Does a deep plane facelift include a neck lift?
A deep plane facelift targets the lower face and jawline, and for some people, it also lifts the upper neck a little because the SMAS-platysma layer is all connected. If the neck concerns are more moderate to severe, though, you may also need a platysmaplasty or a more extensive neck lift component performed at the same time. Whether either of those is right for you comes down to your neck anatomy and what you are hoping to achieve, and we sort that out in the consultation.
What is an extended deep plane facelift?
An extended deep plane facelift is a version of the operation in which the deep plane dissection extends further down into the neck. By releasing the cervical retaining ligaments, the entire SMAS-platysma sheet can be lifted as a single continuous unit. That allows the face and neck to be refreshed together in a single operation, and it suits patients whose anatomy lends itself to this approach.
Will I still have neck bands after a deep plane facelift?
Mild platysmal bands often improve when the SMAS-platysma is lifted and tensioned from the sides, even without direct muscle work. Moderate-to-severe vertical bands usually require a separate platysmaplasty, performed through a small incision under the chin during the same operation. The right approach depends on how the bands behave on examination.
Can a deep plane facelift fix a double chin?
Submental fat (the double chin appearance) is not lifted by a deep plane facelift on its own. It is usually addressed with liposuction or direct fat removal through a small incision under the chin, often performed in conjunction with a deep plane facelift in the same procedure. The decision depends on the depth and pattern of the fat on assessment.
Is a face and neck lift the same as a deep plane facelift?
The terms describe different things. Face and neck lift describes what is being treated, the face and the neck together. Deep plane facelift describes how it is being treated, the surgical technique used to lift the tissues. An extended deep plane facelift is one technique used to perform a combined face and neck lift in a single operation.
What if I only have a neck problem and not a face problem?
An isolated neck lift, with or without platysmaplasty and submental work, is a valid option for patients whose face has aged less than their neck. This pattern is reasonably common, particularly in people who have remained slim or who have lost weight. The right approach is determined in consultation based on the neck anatomy and the absence of significant facial change.
Disclaimer: This blog is general in nature and does not constitute medical advice. All surgical and invasive procedures carry risks. Before proceeding with any procedure, you should seek a second opinion from an appropriately qualified health practitioner. Individual results vary depending on anatomy, technique and how the body heals after surgery. AHPRA registration: MED0001151603.
Further Reading
- Who is a candidate for the deep plane facelift in Sydney: https://www.drjeremyhunt.com.au/blogs/who-is-a-candidate-for-the-deep-plane-facelift-in-sydney/
- What is a jowl lift (lower facelift): https://www.drjeremyhunt.com.au/blogs/what-is-a-jowl-lift-lower-facelift/
- Does neck lift surgery (platysmaplasty) leave scars: https://www.drjeremyhunt.com.au/blogs/does-neck-lift-surgery-platysmaplasty-leave-scars/
- Drainless facelift: how hemostatic net technology is changing recovery: https://www.drjeremyhunt.com.au/blogs/drainless-facelift-hemostatic-net-recovery/
Medical References
- Deep Plane Rhytidectomy, StatPearls, National Library of Medicine: https://www.ncbi.nlm.nih.gov/books/NBK545277/
- Complete Platysma Muscle Suspension in Deep-Plane Face-Lift Surgery, PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC11932438/
- Extended deep plane facelift literature, PubMed search: https://pubmed.ncbi.nlm.nih.gov/?term=extended+deep+plane+facelift
- Cosmetic surgery information, HealthDirect Australia: https://www.healthdirect.gov.au/cosmetic-surgery
- AHPRA cosmetic surgery hub and guidelines: https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub.aspx
- Therapeutic Goods Administration (TGA), cosmetic surgery hub: https://www.tga.gov.au/cosmetic-surgery-hub
- Neck lift overview, Cleveland Clinic: https://my.clevelandclinic.org/health/treatments/22510-neck-lift
- Facelift overview, Cleveland Clinic: https://my.clevelandclinic.org/health/treatments/8868-facelift-rhytidectomy