3 Reasons Why You Should Get a Facelift and Neck Lift Together


Many people inquire about facelifts to treat sagging cheeks, nasolabial folds, and double chins. This article explores the differences between neck lifts and facelifts and explains why it’s often recommended to have both surgeries done at the same time.

1. Long-Lasting Effects Require Comprehensive Undermining

The facial structure is layered from the skin to the bones. 

Skin – subcutaneous fat – facial muscles (SMAS layer) – deep layer (nerves, deep muscles) – periosteum layer

When a high SMAS facelift is performed, tissue separation (undermining) is done between:

  • Subcutaneous fat and the SMAS layer
Skin dissection during facelift
  • SMAS layer and the deeper layers

In cross section, it looks like this:


This dissection, similar to peeling an apple, ensures more durable results. While simpler mini lift techniques exist, the bi-lamellar high SMAS facelift is typically favored by experts, including Dr. Park, who specializes in double-layer facelifts.

Two layer dissection SMAS face lift

2. Facelift vs. Neck Lift: Incision Location and Dissection Area

To understand the synergy of performing a facelift and neck lift together, consider their incision locations and dissection areas.

1) Facelift:

Location of facelift incision(red dotted line)

An incision (red dotted line) is made around the ears, with skin peeling extending to the ‘orange’ area.

Area of skin undermining (orange shaded area)

2)Neck Lift:

Neck lifts can be divided into ‘Short scar neck lifts’ and ‘Extended neck lifts’ depending on how much the skin has to be addressed. This is like deciding between transconjunctival incision and transcutaneous incision in lower blepharoplasty.

a) Short Scar Neck Lift

Incision location (red dotted line) and extent of dissection (yellow shading) performed in mini neck lift.

Performed with a small incision under the chin, short scar neck lift is suitable for mild sagging and double chin. It is also advantageous because this mini neck lift recovery time is shorter.

Neck lift before and after from Noonopi Plastic Surgery

It can be performed when double chin removal with liposuction has been failed. In addition, men in their 50s who are not reluctant to get a facelift can also try a short incision neck lift. The reason a mini neck lift is effective in middle-aged people is because when this surgery is performed, the chin is bent into an L shape and more skin is needed.

neck lift
If the neck and jaw line are bent into an L shape after surgery, more skin is needed.

b) Extended Neck Lift

On the other hand, traditional extended neck lift is necessary are cases where skin sagging is severe on cheeks, too. Therefore, in order to treat redundent skin, an incision must be made not only in front of the ear but also behind the ear.

Incision line for usual extended neck lift

For severe neck tissue sagging, incision requires both in front of and behind the ears as follows:

Both front and back incisions are required to pull the skin in the direction of the green arrow.
Red arrow is an example of wrong direction.

How do you think?
Don’t you feel that it is similar from the ‘incision line for facelift alone’ that we discussed earlier?

3. Benefits of Combining Facelift and Neck Lift

1) Overlapping Incision Lines and Dissection Areas:

Yellow = area of dissection when face lift and neck lift are performed simultaneously

Both surgeries share significant overlapping areas. Those with sagging necks usually also have sagging jowls and nasolabial folds, making it practical to address both issues simultaneously. A single recovery period is also advantageous.

2) Enhanced Safety:


Retaining ligaments, which hold the skin and fat together, need to be cut carefully during a facelift to avoid nerve injury.

Case of facial nerve injury after facelift(by unknown surgeon)

This is because the nerves innervating the peri-oral muscles pass around the retaining ligaments, as shown in the picture below.

Black = location of nerve, Green = location of retaining ligament.Ref: The Relationship of the Marginal Mandibular Nerve to the Mandibular Osseocutaneous Ligament and Lesser Ligaments of the Lower Face

So, neck lifts can safely address these ligaments with a small incision under the chin, reducing the risk of nerve damage.

Submental incision can cut the mandibular ligament without risk of motor nerve damage.

3) Improved Overall Results:

The neck is shown below in cross section from the surface to the deep layers.

Cross section of the neck (deeper tissue toward the right)

The reason neck liposuction fails in many cases is because it cannot treat the deep layer under the muscles.
If a neck lift is performed at the same time with a face lift, tightening the neck muscle(platysma) with removing deep fat and salivary gland are possible.

Deep fat is removed and platysma tightened

The reason why double neck deformity is treated in this way is that when you look straight ahead, the digastric muscles support deep tissues like a hammock, but when you look down, digastric muscles loosens and cannot support deep tissues, making the double chin prominent. 

Changes under the neck depending on posture

Successful facelift outcomes are often judged by the neck’s appearance. 

Pre and post photos of short scar neck lift (Noonopi Plastic Surgery)

Combining the surgeries allows for comprehensive treatment, including tightening neck muscles (platysma) and removing deep fat, ensuring a harmonious and youthful look.


We’ve highlighted the differences between neck lifts and facelifts and why performing them together creates a synergistic effect. In facial rejuvenation, these two procedures work best in tandem, much like a needle and thread. And the face and neck lift cost are around $9,000 at plastic surgery Korea. For a more refined neckline and overall youthful appearance, consider combining both surgeries for optimal results.

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