A facelift and a neck lift are closely related procedures, but they address slightly different areas. A facelift primarily treats sagging and tissue descent in the lower face, particularly around the cheeks, jowls and jawline. A neck lift focuses on the area below the jawline, addressing loose neck skin, fullness beneath the chin and, when present, visible platysma bands.
There is considerable overlap between the two procedures, which is why a facelift and neck lift are often performed together to create a smoother transition from the lower face through the jawline and into the neck.
Some people have ageing changes mainly in one area, while others have changes that extend across both the lower face and neck. In these cases, a combined facelift and neck lift may provide a more balanced result. The most appropriate approach depends on the individual’s anatomy, skin quality, degree and location of tissue laxity, as well as their overall health—not simply on the name of a procedure.
Important: Facelift and neck lift surgery are invasive procedures. Both carry risks, require recovery and are not suitable for everyone. This article provides general education and does not replace an individual consultation.
About this guide: This article explains the differences between a facelift and neck lift, including the areas each procedure addresses and when they may be performed together. For information about the procedure, consultation process and surgery in Sydney, please visit our facelift and neck lift surgery page.
Conceptual guide to the regions commonly assessed. Actual surgical planning depends on individual anatomy.
Facelift and neck lift at a glance
| Question | Facelift | Neck lift |
| Main area | Lower cheeks, jowls and jawline | Under the chin and along the front and sides of the neck |
| Structures that may be addressed | Skin and deeper supporting tissues, including the SMAS | Skin, fat and the platysma muscle, depending on the surgical plan |
| Concerns commonly assessed | Jowls, lower-face tissue descent and reduced jawline definition | Loose neck skin, vertical neck bands, submental fullness and loss of the chin–neck angle |
| What it does not routinely address | Forehead, brow, eyelids or surface skin quality | Cheek descent or jowls that originate above the jawline |
| Can it be performed alone? | Sometimes, when neck changes are limited | Sometimes, when the main anatomical concerns are confined to the neck |
| How much does it cost? | From $12,000AUD | From $18,000AUD (Facelift and Neck Lift) |
These distinctions are general. Surgeons may use procedure names differently, and the components of an operation are tailored to the individual.
What area does a facelift address?
A facelift, also known as a rhytidectomy, primarily addresses ageing changes in the lower face. Rather than simply tightening the skin, modern facelift techniques may reposition the deeper supporting tissues and then redrape the skin more naturally. Depending on the individual’s anatomy and the technique used, this may improve sagging of the lower cheeks, jowls and loss of definition along the jawline.
A facelift does not, however, treat every sign of facial ageing. It does not directly address drooping of the brows or eyelids, nor does it treat skin pigmentation, sun damage or fine surface lines. When these are also a concern, other procedures or skin treatments may be considered separately or in combination with facelift surgery.
The term facelift can also refer to several different surgical approaches. Terms such as mini facelift, short-scar facelift, SMAS facelift and deep-plane facelift describe different techniques or aspects of surgery and are not necessarily interchangeable. These are discussed in more detail in our guide to mini, SMAS and deep-plane facelift techniques.
What area does a neck lift address?
A neck lift focuses on the region below the jawline. The operative components vary according to whether the main concern relates to skin, superficial fat, the platysma muscle or a combination of these tissues.
A surgical plan may include:
- removing or repositioning selected fat beneath the chin where clinically appropriate;
- repairing or tightening separated edges of the platysma muscle;
- redraping and removing selected excess neck skin; and
- extending treatment towards the jawline when the lower face and neck are being addressed together.
A neck lift does not necessarily correct jowls. Jowls arise from tissue descent in the lower face, above the jawline. If both the lower face and neck show laxity, treating only the neck may leave part of the anatomical pattern unchanged.
Jowls versus neck laxity: how are they different?
Jowls and neck laxity often occur together, but they represent changes in different anatomical areas.
Jowls develop when tissues of the lower face descend towards or below the jawline, creating heaviness and loss of a smooth, defined jawline. Because the problem originates primarily in the lower face, it is usually assessed as part of a facelift rather than a neck lift alone.
Neck laxity occurs below the jawline and may involve loose skin, fullness beneath the chin or visible platysma bands. These changes can reduce the definition between the jaw, chin and neck.
When jowls and neck laxity occur together, treating them as connected areas may provide a more balanced transition from the lower face through the jawline and into the neck. For this reason, a combined facelift and neck lift may be discussed.
The appearance alone does not always reveal which tissues are contributing to the problem. During consultation, assessment includes skin quality and elasticity, the degree of tissue descent, fat distribution, platysma activity and chin projection. These factors help determine which areas and tissue layers need to be addressed.
Can you have a neck lift without a facelift?
Yes. In selected patients, a neck lift can be performed without a facelift, particularly when the ageing changes are mainly below the jawline and there is minimal jowling or lower-face laxity.
A neck lift alone may be less suitable when:
- jowls are a significant part of the concern;
- loose skin and tissue laxity extend from the lower face into the neck;
- improvement would require repositioning tissues above the jawline; or
- treating the neck alone could create an imbalance between the lower face and neck.
The reverse is also true. Some people may benefit from a facelift without extensive neck surgery when the main concern is the lower face and the neck has maintained good definition.
The decision is therefore based on where the ageing changes are occurring and which tissues are involved, rather than age or the name of a particular procedure.
When are facelift and neck lift combined?
A combined facelift and neck lift may be considered when ageing changes extend across the jawline and involve both the lower face and neck. The facelift component addresses lower-face tissue descent and jowls, while the neck lift addresses loose skin, fat and platysma changes below the jawline.
When these changes occur together, treating both areas during the same operation allows the surgeon to consider the lower face, jawline and neck as one continuous region, creating a smoother transition between them.
However, combining the procedures also means a more extensive operation. Operating time, anaesthesia, recovery and individual surgical risks all need to be considered. A combined facelift and neck lift is therefore not automatically the better option simply because it treats a larger area. The appropriate approach depends on the individual’s anatomy, concerns and overall health.
For more detailed information about assessment, surgical options and the consultation process, visit our facelift and neck lift surgery page.
How might incisions differ?
Incision placement varies depending on the areas being treated and the surgical technique used. In a facelift, incisions are commonly placed around the ear and may extend into or along the hairline near the temple and behind the ear.
A neck lift may use incisions around and behind the ear, often extending into the hairline. In some patients, a small additional incision beneath the chin is used to access fat or the platysma muscle directly.
More limited facelift procedures may use shorter incisions, but they are still surgical procedures and will result in permanent scars.
The expected location and extent of scars, as well as the possibility of visible, widened or raised scars, should be discussed before surgery. Scar quality varies between individuals, and factors such as smoking, certain medical conditions, medications and individual healing characteristics can influence wound healing.
Recovery and risks
Recovery varies depending on the extent of surgery, the tissues being treated, whether a facelift and neck lift are performed together, and the patient’s general health. Swelling, bruising, tightness and some temporary changes in sensation are common during the early recovery period. The timing of return to normal activities varies between patients and will be discussed as part of the surgical plan.
As with any surgery, facelift and neck lift procedures have potential risks. These include bleeding or haematoma, infection, delayed wound healing, unfavourable scarring, asymmetry, contour irregularities, changes in sensation, nerve injury, skin loss, and anaesthetic complications. Occasionally, further treatment or revision surgery may be required.
This is not a complete list of possible complications. The risks relevant to an individual patient depend on their health, anatomy, and the procedure being considered, and these are discussed in detail during the consultation and consent process.
The American Society of Plastic Surgeons’ neck-lift safety guidance provides a broader patient-facing risk overview.
Preparation before surgery
Before surgery, a detailed medical assessment is important. This includes your general health, previous operations, allergies, medications and supplements, smoking or nicotine use, and any other factors that may affect anaesthesia, bleeding or wound healing.
Smoking and nicotine are particularly important in facelift and neck lift surgery, as they can reduce blood supply to the skin and increase the risk of wound-healing problems. Certain medications and supplements may also increase the risk of bleeding or interact with anaesthetic medications.
Instructions regarding smoking, medications and supplements are individualised. Do not stop prescribed medications without discussing this with your surgeon or the doctor who prescribed them.
Good preparation can help reduce some surgical risks, but it cannot eliminate them completely.
For a general overview of what to expect after surgery, read our facelift recovery timeline. Your surgeon’s specific instructions before and after surgery should always take priority over general online information.
What happens during an Australian cosmetic-surgery consultation?
In Australia, patients considering cosmetic surgery require a referral from an independent medical practitioner, preferably their usual GP. Current Medical Board of Australia guidelines also require at least two consultations before cosmetic surgery, with at least one consultation conducted in person with the surgeon who will perform the operation.
There is also a mandatory cooling-off period of at least seven days after the patient has completed two consultations and provided informed consent before the surgery can be booked or a deposit paid.(4)
During your consultation, I will assess your general health, individual anatomy, concerns and expectations and discuss whether surgery is appropriate for you. We will also discuss the proposed operation, alternative options—including having no surgery—the expected recovery, limitations, potential risks and costs.
Ultimately, whether a facelift, neck lift or a combination of the two is appropriate can only be determined after an individual medical and anatomical assessment.
Frequently asked questions
Is a lower facelift the same as a neck lift?
No. A lower facelift generally refers to the lower face and jowls. A neck lift focuses below the jawline. The procedures can overlap and may be combined, but the terms describe different anatomical emphasis.
Does a facelift always include a neck lift?
No. Some facelift operations include neck components, while others do not. The terminology varies between surgeons, so patients should ask exactly which anatomical areas and tissues are included in the proposed plan.
Can a neck lift remove jowls?
A neck lift alone does not necessarily correct jowls because jowls originate in the lower face. Where both concerns are present, a combined approach may be discussed.
Is neck liposuction the same as a neck lift?
No. Neck liposuction and a neck lift address different problems. Liposuction removes selected fat beneath the chin and neck, but it does not tighten the platysma muscle or reliably correct significant loose skin.
Liposuction alone is usually not recommended when there is significant skin or muscle laxity, but it may be suitable when excess fat is the main concern and the skin has good elasticity. When loose skin, platysma bands or other deeper structures are contributing to the neck contour, a neck lift may be more appropriate.
The best option depends on skin quality, fat distribution and the underlying cause of the neck contour concern.
How do I know which procedure is appropriate?
The decision requires examination of the lower face, jawline and neck, together with a review of health, medications, smoking status, previous procedures and expectations. An online article cannot determine suitability.
Further information
Dr Mohammad Hassan Mohaghegh is a registered medical practitioner and Specialist Plastic Surgeon, with specialist registration in Surgery—Plastic Surgery (AHPRA MED0001627149). Consultations are available at the Edgecliff practice in Sydney.
Read about facelift and neck lift surgery or contact the practice for appointment information.
This information is general and does not constitute medical advice. All surgery carries risks, recovery varies and outcomes cannot be guaranteed. Clinical review and an individual consultation are required.
Sources
- American Society of Plastic Surgeons: neck lift risks and safety
- American Society of Plastic Surgeons: facelift anatomy, techniques and complications
- Medical Board of Australia: GP referral requirements for cosmetic surgery
- Medical Board of Australia: cosmetic surgery and procedures guidelines
- Medical Board of Australia: guidelines for advertising cosmetic surgery
- Medical Board of Australia: advertising a regulated health service