Neck Lift in Brazil: deep rejuvenation of the neck
The neck is one of the first areas of the body to show signs of aging. While many people invest in skincare for the face, the neck is often neglected, and when the signs appear — double chin, vertical bands, sagging skin, loss of the cervical angle — the frustration is immense. No cream, laser, or non-surgical treatment can significantly reverse these changes. As a neck lift specialist in Brazil, I offer advanced neck rejuvenation techniques that aim for long-lasting, natural-looking results.
The neck lift, also known as cervicoplasty, is the surgery that specifically addresses the aging of the neck. And when I talk about deep neck lift, I am referring to an even more comprehensive procedure that goes beyond the skin and the platysma muscle to treat deep structures such as subplatysmal fat, digastric muscles, and even submandibular glands when necessary.
In my practice as a plastic surgeon in Londrina, Brazil, neck treatment is an integral part of almost every deep plane facial lift I perform. For international patients considering cosmetic surgery in Brazil, I also combine the neck lift with procedures such as brow lift for comprehensive facial rejuvenation. However, there are patients who benefit from an isolated neck lift or a more aggressive cervical treatment as the main procedure. On this page, I will explain in detail everything about the neck lift and the deep neck lift: when each is recommended, how I perform these surgeries, and what you can expect in terms of results.
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Subscribe on YouTubeWhy the neck ages so much
To understand the neck lift, it is necessary to understand why the neck ages so visibly. The skin of the neck is thinner than that of the face, has fewer sebaceous glands, and receives less attention in daily care. Additionally, the neck is constantly in motion — flexion, extension, rotation — which accelerates the loss of elasticity.
As the years go by, several changes happen simultaneously:
- Loss of skin elasticity: the production of collagen and elastin decreases, and the skin of the neck begins to sag, forming folds and horizontal wrinkles.
- Loosening of the platysma muscle: this thin muscle that extends from the chest to the jaw loses tone. Its medial edges separate, creating the famous platysmal bands — those two vertical cords that appear on the neck.
- Fat accumulation: both above and below the platysma, fat deposits can accumulate, forming a double chin and obscuring the angle between the chin and the neck.
- Ptosis of the submandibular glands: with the loss of support, these salivary glands can become prominent, creating lateral bulges on the neck.
- Hypertrophy of the digastric muscles: the anterior belly of the digastric can contribute to a bulky appearance under the chin.
- Bone resorption: the jaw loses projection with age, contributing to the loss of definition of the cervico-mandibular contour.
Each of these factors requires a specific approach. That is why a well-executed neck lift is not simply "pulling the skin" — it is a detailed job on multiple anatomical layers.
Isolated neck lift versus neck lift as part of a facelift
A question I frequently receive is: "Can I just do the neck, without touching the face?" The answer is: it depends. And this assessment is crucial for the overall balance.
When an isolated neck lift is recommended
There are patients, usually younger (between thirty-five and fifty years old), who show predominant aging in the neck with the middle third of the face still well preserved. These patients may have:
- Genetic double chin, present since youth
- Early platysmal bands
- Excess submental fat that has not responded to diet or exercise
- Naturally short neck or with little definition of the cervical angle
For these patients, an isolated neck lift can produce meaningful improvement without the need for a complete facelift. The surgery is shorter, the recovery is faster, and the result is focused exactly where the problem is.
When the neck needs to be treated along with the face
In most patients over fifty years old, aging affects both the face and the neck. Treating only the neck in these cases would create a visible imbalance — a rejuvenated neck with an aged face. It's like painting half of a wall.
In my deep plane facelift, neck treatment is already included. The dissection in the deep plane naturally extends to the cervical region, allowing me to treat the platysmal bands, remove subplatysmal fat, work on the digastric, and reposition the entire structure in a unified procedure. The result is a natural, balanced rejuvenation of the face and neck as a unit.
The concept of deep neck lift
The term deep neck lift specifically refers to the treatment of structures that lie below the platysma muscle. While a conventional neck lift may be limited to the skin and the platysma, the deep neck lift goes further to treat:
- Subplatysmal fat
- Digastric muscles
- Submandibular glands
- Prevertebral fat
This deeper approach is what can differentiate a basic result from a more complete one, especially in patients with more challenging necks.
The structures I treat in a deep neck lift
Let me detail each anatomical structure I address during a deep neck lift. This level of detail is what supports substantial change in selected patients.
Supraplatysmal fat: the superficial layer
Above the platysma muscle is a layer of fat that contributes to the double chin. This fat can be removed by liposuction or direct excision. It is the most accessible layer and the one most surgeons treat. But treating only this layer is insufficient in many cases.
Platysma muscle: the cervical bands
The platysma is a thin, broad muscle that extends from the upper chest to the jaw. With aging, its medial edges separate, forming the platysmal bands — those two vertical cords that become especially visible when you contract your neck or speak emphatically.
In the neck lift, I perform platysmaplasty: through an incision under the chin of three to four centimeters, I bring the medial edges of the platysma closer together at the midline with sutures in multiple layers. In some cases, I also remove a strip of muscle to reduce its volume. The result is a smooth neck, free of cords, with a defined contour.
Subplatysmal fat: the deep double chin
Below the platysma is another layer of fat that conventional liposuction simply cannot reach. This deep fat is one of the main contributors to the lack of definition of the cervico-mental angle. In the deep neck lift, I have direct access to this fat and can remove it under direct vision, with millimeter precision.
Digastric muscles: volume under the chin
The digastric muscles have an anterior belly located just below the chin. In some patients, these bellies are naturally bulky and significantly contribute to a full appearance in this region. When I identify this condition, I perform a partial and controlled reduction of the anterior belly of the digastric, preserving its function while eliminating excess volume.
Submandibular glands: the lateral bulge
The submandibular glands are salivary glands located in the lateral region of the neck, just below the jaw. With aging and the loss of tissue support, these glands can become prominent and visible, creating bulges that impair the cervical contour.
In cases where the glands are significantly ptotic or enlarged, I can perform a partial reduction or repositioning, while preserving salivary function. This is one of the most delicate steps of the deep neck lift and requires deep anatomical knowledge to avoid injury to critical structures such as the marginal mandibular nerve.
How I perform the neck lift: the surgery step by step
The neck lift surgery can be performed in isolation or as part of a deep plane facelift. I will describe the complete procedure here, from preparation to closure.
Anesthesia and positioning
The neck lift is performed under general anesthesia in a fully equipped operating room. I work with experienced anesthesiologists who monitor all vital parameters during the surgery. The patient is positioned with the head slightly elevated to optimize the visualization of the cervical structures.
Submental incision
The main incision is made under the chin, in a natural fold of the skin, approximately three to four centimeters long. This incision usually becomes discreet after healing. Through it, I have access to all the deep structures of the neck.
Superficial liposuction
I start with careful liposuction of the supraplatysmal fat, both in the submental region and on the sides of the neck. I use thin cannulas to preserve the skin's vascularization and avoid irregularities.
Access to the deep plane
I open the platysma at the midline to access the deep structures. It is at this moment that the deep neck lift differentiates itself from the conventional neck lift. Under direct vision, I can identify and treat each structure with precision.
Removal of subplatysmal fat
With the platysma opened, I carefully remove the deep fat that contributes to the double chin. This removal is done under direct vision, allowing for precise sculpting of the cervico-mental angle without the risk of irregularities.
Treatment of the digastrics
When the anterior bellies of the digastric muscles are hypertrophied, I perform a controlled partial reduction. I use bipolar cautery for precise hemostasis and preserve the central tendinous insertion to maintain muscle function.
Treatment of the submandibular glands
In recommended cases, I perform partial reduction or repositioning of the submandibular glands. This step requires maximum care with the marginal mandibular nerve and the Wharton duct.
Platysmaplasty
I bring the medial edges of the platysma closer together at the midline with sutures in multiple layers. This suture creates a continuous muscle band that supports the entire cervical contour. In some patients, I also perform lateral plication of the platysma to further define the cervical angle.
Periauricular incisions (when necessary)
If there is significant excess skin on the neck, incisions around the ear are necessary — in the preauricular fold, around the lobe, and continuing behind the ear to the scalp. These incisions allow me to redrape the excess skin and remove it, creating a clean and defined contour.
Auersvald hemostatic mesh
I apply the hemostatic mesh developed by Drs. André and Luiz Auersvald to eliminate dead space, help reduce the risk of hematoma, and eliminate the need for drains. The mesh is removed in forty-eight hours in the office, with minimal discomfort.
Indications and ideal candidates for the neck lift
Not every aging neck requires surgery, and not every patient is an ideal candidate for the neck lift. During the consultation, I carefully evaluate each case to recommend the best treatment.
You may be a candidate for the neck lift if you have
- Visible platysmal bands: those vertical cords that appear on the neck, especially when speaking or contracting the muscles.
- Persistent double chin: accumulation of fat under the chin that does not respond to diet or exercise.
- Loss of the cervico-mental angle: the angle between the chin and the neck should be approximately 105 to 120 degrees, but with aging or unfavorable genetics, this angle opens up, creating a "turkey neck" appearance.
- Excess skin on the neck: skin laxity that creates folds and horizontal wrinkles.
- Undefined jawline: when the transition between the jaw and the neck becomes unclear, with accumulation of fat and skin along the jawline.
- Dissatisfaction with a genetically full neck: some young patients already have a bulky neck due to genetic inheritance, without any aging involved.
Anatomical factors that influence the result
During the consultation, I carefully evaluate some factors that directly impact the result of the neck lift:
- Position of the hyoid bone: patients with a low hyoid bone position will have a naturally more obtuse cervical angle, and it is important for them to know that the surgery significantly improves this, but does not create a 90-degree angle in these cases.
- Retrognathia: a retruded chin worsens the appearance of the neck. In these cases, I combine the neck lift with mentoplasty or genioplasty to project the chin and improve the overall profile.
- Skin quality: thin and sun-damaged skin requires special care to avoid irregularities.
- Body weight: overweight patients may benefit from weight loss before surgery to optimize the result.
Procedures I combine with the neck lift
The neck lift is rarely performed in complete isolation. In the vast majority of cases, I combine it with other procedures for a natural and balanced result.
Deep plane facelift
The most frequent and powerful combination. The deep plane facelift addresses the middle and lower third of the face, while the neck lift completes the rejuvenation of the cervical region. Together, they offer a broad and natural-looking result when indicated. In my technique, the dissection is continuous from the face to the neck, allowing for uniform repositioning of the entire structure.
Mentoplasty or genioplasty
Patients with a retruded chin may benefit from the combination of neck lift with mentoplasty. Chin projection can improve the profile and help redefine the cervico-mental angle. In many cases, mentoplasty is an important complement to the neck lift.
Submental liposuction
In younger patients with good skin elasticity and predominantly fatty double chins, liposuction can be performed as a complement. But it is important to understand that liposuction alone does not address platysmal bands, deep fat, or excess skin.
Blepharoplasty
The blepharoplasty addresses the eyelids and complements overall rejuvenation. When performed together with the neck lift and facelift, the result is a more integrated facial rejuvenation.
Facial fat grafting
The fat grafting restores lost volume in the face and brings stem cells that regenerate the skin. It is the ideal complement for any facial and cervical rejuvenation surgery.
Preparation for surgery
Proper preparation is essential for safer surgery and a better-planned result. I follow a strict protocol that I share with each patient during the consultation.
Pre-operative exams
I request the following exams before surgery:
- Complete blood count
- PT with INR + aPTT
- Creatinine and BUN
- Fasting blood glucose
- Total proteins and fractions
- Urinalysis
- EKG
- Pre-operative cardiac clearance
Medications to be discontinued
Two weeks before and two weeks after surgery, you should discontinue:
- Aspirin (acetylsalicylic acid, ASA, Bufferin)
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- High doses of Vitamin E
- Ginkgo biloba and other herbal remedies
- High doses of Omega 3
- Arnica
Smoking
Cigarette smoking must be stopped at least two weeks before and two weeks after surgery. Nicotine severely compromises blood circulation in the skin, significantly increasing the risk of skin necrosis and healing complications. In the neck, where the skin is thinner and the vascularization is more delicate, this risk is even greater.
General guidelines
The day before surgery, I recommend a light meal. Nothing by mouth (NPO) for eight hours before the scheduled time. Come to the hospital wearing comfortable clothing, preferably with a front opening (button-up shirt), so you do not have to pull anything over your head post-operatively. Do not wear jewelry, makeup, or nail polish.
Post-operative care for the neck lift: what to expect
The recovery from the neck lift is generally more comfortable than patients imagine. The Auersvald hemostatic mesh greatly contributes to a smoother recovery.
First 48 hours
You will leave surgery with a compressive dressing on your neck and the hemostatic mesh in place. There will be swelling and some discomfort, controlled with medication. Keep your head elevated — sleep with two or three pillows — and apply cold compresses as directed. Avoid sudden neck movements.
Removal of the hemostatic mesh
In forty-eight hours, you will return to the office for the removal of the hemostatic mesh and dressing change. This office step is usually straightforward and causes minimal discomfort. At this point, many patients are surprised by the difference in the contour of their neck.
First week
Swelling peaks between the second and third day, gradually decreasing. Bruising is common and may track down to the chest due to gravity. This is absolutely normal and resolves spontaneously in ten to fourteen days. Stitches from the submental incision are removed between the seventh and tenth day.
Second to fourth week
The majority of patients are presentable for social activities in two weeks, although still with some residual swelling. Makeup can be used carefully to camouflage any remaining bruises. Avoid intense exercise, direct sun exposure, and any trauma to the area.
One to six months
The result progressively refines. Residual swelling continues to subside, tissues settle, and scars mature. The area under the chin may present a temporary sensation of hardness, which is common after this surgery and usually improves over time. Long-term refinement usually appears between six months and one year.
Important care during recovery
- Sleep on your back, with your head elevated
- Avoid lowering your head in the first two weeks
- Do not engage in physical exertion for thirty days
- Use sunscreen on your neck daily after healing
- Strictly follow the prescribed medication
- Attend all follow-up appointments
Risks and complications of the neck lift
Like any surgery, the neck lift involves risks. My philosophy is to be absolutely transparent about them, so you can make an informed decision.
Hematoma
The most common complication of any lift procedure. The Auersvald hemostatic mesh that I use drastically reduces this risk, eliminating the dead space where blood could accumulate. When it occurs, it is usually small and can be drained in the office.
Nerve injury
The most vulnerable nerve during the neck lift is the marginal mandibular nerve, responsible for the movement of the lower lip. Persistent injuries are extremely rare with proper technique. Temporary paresthesias (sensitivity changes) in the skin of the neck are common and resolve in weeks to months.
Contour irregularities
Asymmetries or contour irregularities may occur, especially if fat is removed unevenly. My meticulous approach under direct vision significantly minimizes this risk.
Scars
The submental incision heals very well in most patients, usually becoming discreet in a natural fold. Periauricular incisions, when necessary, are also positioned in natural folds and creases.
Infection
Rare with adequate antibiotic prophylaxis. When it occurs, it usually responds well to antibiotic treatment.
Unsatisfactory results
Factors such as low hyoid bone position, uncorrected retrognathia, or unrealistic expectations can lead to dissatisfaction. That is why the pre-operative consultation is so important: it is where I set expectations and honestly explain what I can and cannot achieve.
Neck lift versus non-surgical treatments
I need to be honest about a topic that many professionals avoid: the limits of non-surgical treatments for the neck.
Microfocused ultrasound (Ultraformer, Ultherapy)
Promises "surgery-free lifting" through ultrasound waves that heat the SMAS. In practice, the result is subtle and temporary. It does not treat platysmal bands, does not remove deep fat, does not reposition structures. It can be useful for maintenance after a lift, but does not replace surgery when there is real sagging.
Radiofrequency (Morpheus8, FLX)
Stimulates collagen through heat. Offers modest improvement in skin quality, but does not treat any of the deep structures we discussed. For platysmal bands and real double chin, radiofrequency is insufficient.
PDO lifting threads
Create temporary mechanical support with absorbable threads. The result lasts months, not years. They do not treat fat, do not treat muscle, do not remove excess skin. And when the threads are absorbed, everything returns to how it was — or worse, with irregular fibrosis.
Botulinum toxin in the neck (Nefertiti lift)
The application of Botox on the platysmal bands can temporarily soften them, with results lasting three to four months. Useful for patients who are not ready for surgery or as postoperative maintenance, but it is not a durable solution.
Cryolipolysis (CoolSculpting) on the chin
Reduces localized fat through cooling. Can eliminate a modest percentage of superficial submental fat. Does not treat deep fat, bands, or sagging skin. Modest results for mild cases.
The reality is that when there is significant skin sagging, visible platysmal bands, or deep fat, surgery is the treatment that addresses these structures most directly. Non-surgical treatments have their place — usually for maintenance or very early cases — but do not replace the scalpel when the indication is surgical.
How much does a neck lift cost in Brazil and what about insurance?
The price of a neck lift varies with case complexity: isolated neck lift (younger patients with predominantly cervical aging), deep neck lift (when there is subplatysmal fat, digastrics, or prominent submandibular glands), or combination with a deep plane facelift (the most frequent scenario in patients 50+). The investment covers surgical fees, anesthesia team, supplies, and hospital stay. I provide a personalized quote during the first consultation, after personally evaluating your anatomy, skin quality, and indicated procedures. For international patients traveling from the US or UK, the total typically runs a fraction of equivalent board-certified rates at home, even including flights and hotel.
Neck lift, Medicare, Medicaid, Aetna, BCBS, UHC, Cigna and private insurance
Neck lift is classified as cosmetic surgery by virtually every US and Brazilian insurer — Medicare, Medicaid, Aetna, Blue Cross Blue Shield, UnitedHealthcare, Cigna in the US; Unimed, Bradesco Saúde, Amil, SulAmérica in Brazil — which, as a rule, excludes coverage. Rare exceptions may apply to reconstructive cases following post-trauma deformity, post-oncologic resection, or genetic syndromes; in those situations, medical review can evaluate coverage. In my Brazil-based practice, neck lift is fee-for-service and paid directly by the patient.
What does the neck look like before and after a neck lift?
Before surgery, a patient with cervical aging typically shows visible platysmal bands (vertical cords on the neck), a persistent double chin, loss of the cervico-mental angle (ideally between 105° and 120°), horizontal skin folds and laxity, and an undefined jawline. In more advanced cases, the submandibular glands become prominent, creating lateral bulges beneath the jaw.
After surgery, the neck can gain a more defined contour, platysmal bands can soften, the double chin can be reduced, and the cervico-mental angle can improve. In patients who undergo a deep neck lift, reducing subplatysmal fat, digastrics, and submandibular glands can create definition that is difficult to achieve with superficial techniques. The result appears progressively: in the first days there is edema and bruising; between 2 and 4 weeks the patient is socially presentable; between 1 and 6 months the result refines; at 6-12 months the overall balance is established.
I do not publish before-and-after photos online, following the Brazilian Federal Council of Medicine guidance (CFM Resolution 1.974/2011 and CFM Medical Advertising Manual). During the in-person consultation, I show real case photos (with patients' express authorization, in a private setting) so you can evaluate the standard of my results.
Deep neck lift: what it is and why it makes a difference
The deep neck lift is the technical evolution of the traditional neck lift. While a conventional neck lift treats only superficial structures — skin, supraplatysmal fat, and the platysma muscle — the deep neck lift accesses the compartment below the platysma under direct vision. This anatomical difference is what allows me to solve problems the classic neck lift cannot reach: subplatysmal fat accumulated in the midline of the neck, hypertrophic digastric muscles, ptotic submandibular glands, and even prevertebral fat in selected cases.
In practice, the cervico-mental angle — that crisp transition between the jaw and the neck that defines a youthful neck — depends directly on treating these deep structures. Patients who had only a superficial neck lift frequently complain of "lack of definition" under the chin even after surgery. The reason is that the fat responsible for that lack of definition is subplatysmal, and it is inaccessible without opening the platysma.
The deep neck lift is technically more demanding and requires precise anatomical knowledge to preserve key structures — the marginal mandibular nerve, the Wharton duct, the hypoglossal nerve. For this reason, it is performed by a smaller number of surgeons. In my practice, I adopt the deep neck lift in every patient who presents relevant subplatysmal, digastric, or glandular volume — which, in most cases, is the reality.
Neck lift vs submental liposuction: which one should you choose?
The confusion between a neck lift and submental liposuction (chin lipo) is one of the most common I see in consultation. Let me clarify the difference:
- Submental liposuction — removes supraplatysmal fat (the superficial layer, above the platysma) through small incisions (typically one submental and two retroauricular). It does not treat: platysmal bands, subplatysmal fat, digastrics, submandibular glands, or excess skin. Ideal indication: young patients (<40 years) with good skin elasticity and a strictly superficial-fat double chin.
- Neck lift — treats loose skin, platysmal bands (platysmaplasty), supraplatysmal AND subplatysmal fat (in the deep neck lift), digastrics, and glands. Indication: more advanced cervical aging, skin laxity, visible bands, loss of the cervical angle.
When a patient with a complex neck only undergoes liposuction, the result is usually disappointing: the double chin is modestly reduced, but the bands are still visible and the cervical angle does not appear. Many of my neck lift patients went through chin lipo before and were dissatisfied — their problem was beyond superficial fat.
PDO threads, HIFU, Ultherapy, Morpheus8: do they work for the neck?
Non-invasive neck treatments are often marketed as "alternatives to a neck lift." In my assessment, they are alternatives only for very early cases — not substitutes for a neck lift when there is a surgical indication. Let me go through each one. I do not perform these non-surgical treatments in my practice; I describe them so you understand where they fit:
- PDO / PLLA lifting threads — absorbable threads placed under the skin for "support." Results last months, with no treatment of bands, deep fat, or excess skin. They can cause irregular fibrosis and visible threads. I do not recommend them for an established cervical laxity.
- HIFU (Ultherapy, Ultraformer) — microfocused ultrasound that heats the SMAS and promotes tissue retraction. Subtle, temporary result (6-12 months). Useful only in very young patients (30-40) with early laxity, no bands, and no deep fat.
- Radiofrequency (Morpheus8, Accutite, FaceTite) — stimulates collagen through heat. Modest improvement in skin quality. Insufficient for platysmal bands and consolidated double chin.
- Botulinum toxin on the platysma (Nefertiti Botox lift) — temporarily softens platysmal bands (3-4 months). Useful as maintenance or in patients with very early bands, but not a durable solution.
My position: non-surgical treatments are valid for young patients in the early phase of cervical aging, or as maintenance after a neck lift. When there is established laxity, visible bands, or subplatysmal fat, surgery is the path.
Male neck lift: what is different for men
The neck lift is one of the most sought-after facial procedures by men — especially executives and professionals who are publicly exposed (cameras, presentations, video calls), where a double chin and cervical laxity affect how vitality is perceived. Specifics of the male neck lift include:
- Incision planning — facial hair requires careful positioning of periauricular incisions to avoid transposing hair-bearing skin into hairless areas (and vice versa).
- Jawline contour — in men, the aesthetic goal is to preserve or accentuate the defined, angular jawline, a key anatomical marker of masculinity.
- Cervical angle — slightly less acute than the ideal feminine angle, preserving a natural look.
- Frequent combination with male facelift (SMAS / deep plane) and mentoplasty for chin projection — in my experience, this combination can be especially impactful for the male profile.
- Recovery — similar to female patients, but men typically tolerate bruising better and return to social life in 2-3 weeks.
Who is qualified to perform a neck lift?
A neck lift is a complex surgical procedure. In the United States and internationally, it should be performed by board-certified plastic surgeons, facial plastic surgeons (ENT with facial plastic fellowship), and head & neck surgeons (for reconstructive cases). The specialists typically qualified to perform it are:
- Board-certified plastic surgeon — certified by the American Board of Plastic Surgery (ABPS, an ABMS member board) in the US, or, in Brazil, holding RQE in Plastic Surgery and SBCP membership (ISAPS-affiliated). I trained at the Ivo Pitanguy Institute, a world reference in facial and cervical rejuvenation.
- Facial plastic surgeon (ENT) — certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) or equivalent, with fellowship training in facial plastic surgery.
- Head & neck surgeon — for reconstructive cases following trauma or oncologic resection in the neck.
Before booking your surgery, verify your surgeon's certification: in the US, check ABMS certification at certificationmatters.org; in Brazil, verify the CRM and RQE at the CFM Portal. A neck lift, and especially a deep neck lift, is a procedure of high anatomical complexity — the surgeon's experience in dozens (preferably hundreds) of cases is decisive for safety and outcome. In my Brazil practice, I am a full member of the SBCP, CRM-PR 17.388 and RQE 15.688.
Frequently asked questions about neck lift
What is the difference between a neck lift and a deep neck lift?
The conventional neck lift treats the skin and the platysma muscle. The deep neck lift goes further, accessing structures below the platysma: subplatysmal fat, digastric muscles, and submandibular glands. I perform the deep neck lift on all patients who present volume in these deep structures, ensuring a more complete and defined result.
Can I have a neck lift without having a facelift?
Yes, when aging is predominantly cervical and the middle third of the face is well preserved. This is more common in younger patients with genetic double chins or early platysmal bands. I evaluate each case individually during the consultation to recommend the best approach.
Does chin liposuction replace a neck lift?
Not in most cases. Liposuction only removes superficial fat and depends on the skin's ability to retract. It does not treat platysmal bands, deep fat, digastrics, or submandibular glands. For young patients with good skin and exclusively fatty double chins, liposuction may be sufficient. For others, a neck lift may offer a more complete correction.
How long does the result of a neck lift last?
The result of a neck lift is long-lasting. The fat removed does not return, the treated platysmal bands remain corrected, and the repositioning of deep structures is stable long term. Naturally, aging continues, and after ten to fifteen years some patients opt for a revision. The operated anatomy usually remains better supported than it would have been without surgery, although aging continues.
Does neck lift surgery hurt?
Neck lift recovery usually causes tightness, pressure, and mild to moderate discomfort rather than intense pain. Most patients describe more of a feeling of tightness and pressure than actual pain. The prescribed pain medication controls discomfort very well. After two to three days, most patients only need OTC pain medication such as acetaminophen.
How long does neck lift surgery take?
The isolated neck lift lasts between two and three hours. When combined with deep plane facelift, fat grafting, and other procedures, the total surgery can take five to six hours. It is performed under general anesthesia in a fully equipped operating room.
Does a neck lift leave visible scars?
The main incision is made under the chin, in a natural fold, and usually becomes discreet after healing. When periauricular incisions are necessary for excess skin removal, they are hidden in the folds of the ear and behind it, following the same lines as the facelift.
What is the ideal age to have a neck lift?
The ideal age for a neck lift depends on anatomy rather than chronology, because genetic double chin, platysmal bands, and skin laxity can appear at different ages. I have patients in their thirties to forties with genetic double chins who benefit from an isolated neck lift, and patients in their sixties to seventies who need a neck lift combined with facelift. What determines the indication is the anatomical condition, not chronological age.
Can I have a neck lift if I have already had chin liposuction before?
A previous chin liposuction does not usually prevent a neck lift, but it changes the surgical evaluation because scar tissue and residual deep structures must be assessed. Many of my neck lift patients have already tried liposuction and were dissatisfied because the problem went beyond superficial fat. A neck lift can complement and deepen the treatment, addressing the structures that liposuction did not reach.
What is the hemostatic mesh that Dr. Zamarian uses?
It is a technique developed by plastic surgeons André and Luiz Auersvald, from Curitiba, which consists of transfixing stitches with nylon thread creating a mesh that eliminates dead space under the skin. The benefits are: elimination of the need for drains, reduction of the risk of hematoma, and better neck contour. The mesh is removed in forty-eight hours in the office, with minimal discomfort.
Can men have a neck lift?
Yes, and it is one of the most sought-after facial surgeries by the male audience. The neck lift in men follows the same principles, with special attention to the positioning of the incisions due to facial hair. The male facelift with complete cervical treatment is one of the procedures I perform most on male patients.
How much does a neck lift cost in Brazil?
The price varies with complexity: isolated neck lift, deep neck lift, or combination with a deep plane facelift. I provide a personalized quote during the first consultation, after personally evaluating your anatomy and the indicated procedures. Insurance typically does not cover cosmetic neck lift. For international patients, the Brazil total is usually a fraction of equivalent board-certified rates in the US, even including travel.
Does Medicare, Medicaid, Aetna, BCBS, UHC, or Cigna cover a neck lift?
Not in most cases. Neck lift is classified as cosmetic surgery — Medicare, Medicaid, Aetna, Blue Cross Blue Shield, UnitedHealthcare, and Cigna typically exclude coverage. Rare exceptions: deformity from post-trauma sequelae, post-oncologic reconstruction, or genetic syndromes. In my Brazil practice, neck lift is fee-for-service and paid directly by the patient.
What is the difference between a neck lift and submental liposuction?
Submental liposuction only removes supraplatysmal fat (the superficial layer above the platysma). It does not treat platysmal bands, subplatysmal fat, digastrics, submandibular glands, or excess skin. Ideal for young patients (<40) with good skin elasticity and a strictly superficial-fat double chin. For more advanced cervical aging, a neck lift may offer a more complete correction.
What is a "mini neck lift"?
"Mini neck lift" is a generic marketing term, often used to describe hybrid procedures (submental liposuction + limited platysmaplasty) or lifting threads. In my practice, I prefer to indicate either a full neck lift or isolated liposuction based on anatomy — "mini" procedures tend to produce insufficient results when there is a clear indication for a neck lift.
Do PDO threads, HIFU, Ultherapy, or Morpheus8 replace a neck lift?
Not in most cases. PDO threads, HIFU (Ultherapy, Ultraformer), radiofrequency (Morpheus8, Accutite), and botulinum toxin are valid for very young patients with early laxity or as post-operative maintenance. When there are visible platysmal bands, subplatysmal fat, or established laxity, surgery is usually the treatment that addresses those structures most directly. I do not perform these non-surgical treatments in my practice.
What is the deep neck lift and why is it different?
The deep neck lift is the technical evolution of the traditional neck lift. It treats structures below the platysma muscle under direct vision: subplatysmal fat, digastrics, submandibular glands, and prevertebral fat. The cervico-mental angle — that crisp transition between jaw and neck that defines a youthful neck — depends directly on treating these deep structures.
Who is qualified to perform a neck lift?
Board-certified plastic surgeons (ABPS / ABMS in the US; RQE in Plastic Surgery in Brazil), facial plastic surgeons (ENT with facial plastic fellowship, such as ABFPRS-certified), and head & neck surgeons for reconstructive cases. A neck lift, especially a deep neck lift, is a high-complexity anatomical procedure — verify certification at certificationmatters.org (US) or at the CFM Portal (Brazil), and prefer surgeons with dozens of documented cases.
What does the neck look like before and after a neck lift?
Before: visible platysmal bands, persistent double chin, loss of the cervical angle, loose skin. After: a more defined neck contour, softer bands, and an improved cervico-mental angle. Progressive result: edema in the first days, socially presentable in 2-4 weeks, refinement between 1-6 months, long-term refinement at 6-12 months. I do not publish before-and-after photos online, following CFM guidance; I show real cases during the in-person consultation.
Schedule Your Neck Lift in Brazil via WhatsApp
If you have made it this far, it is because you are seriously considering the neck lift. Whether you are local or an international patient exploring medical tourism in Brazil, the next step is simple: schedule a consultation with me. My team is ready to assist you, answer your questions, and find the best time for your evaluation.
Learn more about the first consultation, the investment, and the guidelines for pre-surgical preparation and postoperative recovery.
Are you ready for this new change? Schedule now!
Dr. Walter Zamarian Jr.
Plastic Surgeon in Londrina - Brazil
Rua Engenheiro Omar Rupp, 186
Londrina - Brazil
ZIP 86015-360
Brazil
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